Posts for: December, 2012
Temporomandibular Disorder (TMD), which was formerly known as Temporomandibular Joint Disorder (TMJ), is an interesting condition because it can be hard to diagnose and often mimics many other conditions. It arises when there are problems inside the temporomandibular joint, and the muscles attached to it, causing pain. When treating TMD, we typically start by relieving the symptoms of pain and discomfort with heat, mild pain medications, a diet of soft foods, and some simple jaw exercises. We feel that it is critical to address your pain issues as soon as possible before preceding any further with treatment.
Once we have provided some pain relief and after having completed a thorough history and examination, we can move to the next phase of treatment. This may include the introduction of a bite guard or some form of oral appliance therapy. A bite guard is an unobtrusive yet rigid plastic horseshoe-shaped appliance that fits snuggly over the biting surfaces of the upper teeth. When in place and properly adjusted, this custom-made appliance allows your muscles and therefore jaw joints to relax. And it will prevent you from grinding your teeth, another contributing factor to TMD. We will probably ask you to wear it when sleeping or in times when you are feeling stressed when clenching or grinding habits may be active. We may also suggest that you obtain some relaxation therapy and/or biofeedback from a licensed therapist, as this can prove helpful in treating TMD.
If you have suffered from frequent jaw pain in the past and suspect that you may have TMD, please let us know so that we can address it at your next appointment. Or if you are currently in constant or severe pain, contact us immediately to schedule an appointment. You can learn more about the signs, symptoms, and treatment options for TMD by reading “TMD — Understanding The Great Imposter.”
Because our main goal is to help you maintain optimal oral health, we use the latest proven technologies, techniques, and treatments to ensure we achieve them. One tool, radiographs or x-ray pictures, has been around for a long time with an inordinate amount of scientific research backing up both its safety and value. Here's a brief summary of why.
X-rays are a form of electromagnetic radiation just like natural daylight, except that they can easily penetrate soft bodily tissues, such as skin and muscles, without causing any harm if used properly. And as you may have guessed, we use them to examine what we can't see with the naked eye. For example, they enable us to see inside tooth structure, bones, and joints of the jaws. This ability makes x-rays a critical tool that we rely upon to monitor your oral health.
How often you need x-rays really depends upon your individual health needs and often is different from family member to family member given their age and oral health. During adolescence, we may need to take x-rays more often, so we can closely monitor the development of the teeth and jaw to check for normal growth and abnormalities, which can be corrected with early diagnosis. We may also need to use x-rays to diagnose trauma if you or any family member has experienced injury or disease. This will enable us to ensure the correct treatment is given and, in fact, is working and that there are no other related concerns.
Today's ultra-sensitive technology uses extremely low dosage x-rays and ensures early diagnosis and monitoring of your oral and dental health in safety and with confidence.
The CDC (Centers for Disease Control and Prevention) calls fluoridation of drinking water one of the ten most important public health measures of the 20th century, along with such measures as vaccination and motor-vehicle safety.
A fluoride concentration of about one milligram per liter (1 mg/L), or 1 part per million (1ppm), in the water supply is associated with substantially fewer cavities. This concentration of fluoride (equivalent to a grain of salt in a gallon of water) has been found to have no negative health effects.
The connection between fluoride and oral health was confirmed in the first half of the 20th century, and by 1955 the first clinically proven fluoride toothpaste was launched. Fluoride-containing toothpastes are common today, along with other fluoride-containing products.
Protective Effects of Fluoride
Ongoing studies have shown that fluoride has both a systemic (through the body) effect and a local effect at the tooth surfaces. Tooth decay takes place as part of a kind of active war between de-mineralization and re-mineralization, in which acids produced by bacteria in plaque (a biofilm in your mouth) soften and dissolve the minerals (de-mineralization) in the tooth's surface. At the same time, the saliva bathing the tooth acts to re-harden the tooth's surface by adding minerals back (re-mineralization). If fluoride is present in the biofilm and in the saliva, it protects against de-mineralization.
The fluoride you drink in your water is deposited in your bones. Bone is an active living substance that is constantly broken down and rebuilt as a normal body process. As this happens the fluoride is released into the blood, from which it can enter the saliva and act on the tooth surface. The fluoride in toothpastes and products like rinses is delivered directly to the tooth surface. Fluorides can also be eaten in foods with high fluoride content such as teas, dry infant cereals and processed chicken, fish and seafood products.
Problems with Over-use
Eating or swallowing too much fluoride can contribute to a discoloration of teeth called dental fluorosis, which varies in appearance from small white striations to stained pitting and severe brown mottling of the enamel. To avoid this effect, monitor children's tooth brushing to make sure they use only a small amount of fluoride toothpaste and do not swallow it.
Adding fluoride to water has been controversial because some people believe that it may cause other harmful effects. However, most health experts believe that fluoridated water carries no significant health risks and significantly contributes to public health by preventing tooth decay.
It is important to brush your teeth every day to remove plaque (that sticky white film, composed of bacteria, on your teeth near your gums), but it is possible to overdo it — particularly if you find that your teeth are becoming sensitive to hot and cold or to variations in pressure.
Brushing your teeth too hard or too many times per day can aggravate tooth sensitivity, which can range from a mild twinge to a severe pain. You can accomplish the goal of tooth brushing — plaque removal — by using a soft brush with a very gentle action. Repeated aggressive brushing with a hard brush is not required and can even be harmful to your teeth and gums.
To understand how teeth become sensitive, you need to know about the internal structure of your teeth. Teeth are covered by enamel, a hard mineralized coating that protects them from changes in temperature and pressure. If the enamel is worn away, it exposes the next lower layer of the tooth, the dentin. The dentin is a living tissue containing nerve fibers that connect to the nerves in the tooth's root.
Excessive tooth brushing can irritate your gums and cause them to shrink away from your teeth, particularly if you have thin gum tissues. The thickness or thinness of your gum tissues is something you inherit from your parents, so you can't change it. Hard brushing can begin to wear away the enamel covering of your teeth. Exposure to acids or sugars in the foods you eat and drink can continue the damage.
Acidic foods and drinks such as fruit juices dissolve some of the minerals in your teeth by a process called “demineralization.” Fortunately, your saliva can interact with the enamel and bring back minerals that are leaving the tooth's surface. This process is called “remineralization.” It is important to let your healthy saliva wash your teeth's surfaces for a while before brushing so that dissolved minerals get a chance to be returned to your enamel. It takes between twelve and twenty-four hours for plaque to form on your teeth, so you don't need to brush more than twice a day.
The best way to make sure you are brushing your teeth properly is to have us evaluate your brushing technique at your next dental appointment. We will be able to tell you whether you need to change the angle of your brush or the pressure you are applying for the most effective removal of plaque with the least wear on your teeth and gums. Tooth brushing serves an important purpose, but remember that you can actually have too much of a good thing.