Posts for: May, 2018
If you're suffering from jaw pain or impaired function, it may not be the only source of chronic pain in your body. Of the millions of adults with temporomandibular joint disorders (TMD), many have also been diagnosed — among other conditions — with fibromyalgia, rheumatoid arthritis or sleep problems.
TMD is actually a group of painful disorders that affect the jaw joints, muscles and surrounding tissues. Besides pain, other symptoms include popping, clicking or grating sounds during jaw movement and a restricted range of motion for the lower jaw. Although we can't yet pinpoint a definite cause, TMD is closely associated with stress, grinding and clenching habits or injury.
It's not yet clear about the possible connections between TMD and other systemic conditions. But roughly two-thirds of those diagnosed with TMD also report three or more related health conditions. Debilitating pain and joint impairment seem to be the common thread among them all. The similarities warrant further research in hopes of new treatment options for each of them.
As for TMD, current treatment options break down into two basic categories: a traditional, conservative approach and a more interventional one. Of the first category, at least 90% of individuals find relief from treatments like thermal therapy (like alternating hot and cold compresses to the jaw), physical therapy, medication or mouth guards to reduce teeth clenching.
The alternative approach, surgery, seeks to correct problems with the jaw joints and supporting muscles. The results, however, have been mixed: in one recent survey a little more than a third of TMD patients who underwent surgery saw any improvement; what's more alarming, just under half believed their condition worsened after surgery.
With that in mind, most dentists recommend the first approach initially for TMD. Only if those therapies don't provide satisfactory relief or the case is extreme, would we then consider surgery. It's also advisable for you to seek a second opinion if you're presented with a surgical option.
Hopefully, further research into the connections between TMD and other inflammatory diseases may yield future therapies. The results could help you enjoy a more pain-free life as well as a healthy mouth.
If you would like more information on TMD, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Chronic Jaw Pain and Associated Conditions.”
If you're considering dental implants to replace one or more missing teeth, you'll need to undergo a minor to moderate surgical procedure (depending on the number of implants) to install them. Depending on your current health status and medical history, you may need antibiotics before or after the procedure to help ensure a successful outcome.
Although implants have a high success rate (over 95%), they can still fail — and bacterial infection is a major culprit. Installing implants requires surgically accessing the bone through the gum tissues; you may also need other invasive procedures like tooth extraction or bone or gum tissue grafting. These disruptions to the soft tissues can introduce bacteria into the bloodstream.
In certain individuals, this can increase infection risk not only around the implant but also in other parts of the body. You may be at higher risk, for example, if you have serious health problems like cardiovascular disease or diabetes, a weakened immune system, you use tobacco or you're over or under normal weight. The American Dental and American Heart Associations both recommend antibiotics before dental implant surgery as a preventive measure against infection if you have a prosthetic heart valve, a history of infective endocarditis, a heart transplant or some congenital heart conditions.
For other patients with low to moderate risk for infection, there's vigorous debate on administering antibiotics before implant surgery. There are some side effects to antibiotic use, ranging from diarrhea to allergic reactions, and an increased concern in general to the developing resistance of many infectious agents due to the prevalent use of antibiotics. Many dentists and physicians are becoming more discriminate in the patients for which they prescribe antibiotics before surgical procedures.
It really comes down, then, to your particular case: not only the specific procedures you need but also your general health. After weighing these factors against the possible benefits for protecting your health and improving your odds of a successful outcome, we'll recommend whether antibiotic treatment for implants is right for you.
With exciting innovations in cosmetic dentistry over the last few decades, we can now transform nearly any unattractive smile. One of the best and most cost-effective of these is the porcelain veneer. These thin layers of dental porcelain are bonded over the front of chipped, slightly misaligned or stained teeth to create an entirely new look.
Veneers have evolved over time, especially with the materials they contain that give them their beauty and life-likeness. The first veneers were made mainly of feldspathic porcelain, a mineral composition known for its similarity in color and translucence to natural teeth.
But because this early porcelain had a high amount of silica (in essence, glass), and because they were created through overlaying several thin layers that weren’t as strong as a single piece, they were prone to shattering. This made them problematic for teeth subject to heavy biting forces or patients with clenching or grinding habits.
The situation changed dramatically in the 1990s, when dental labs began adding Leucite, a sturdier glass-like mineral that didn’t diminish the porcelain’s translucence. Not only did Leucite make veneers more shatter-resistant, it also enabled dental technicians to fashion most of the veneer in one piece to further strengthen it.
More recent veneers may now incorporate an even stronger material called lithium disilicate. Because lithium disilicate has twice the strength of Leucite, veneers made with it can be as thin as 0.3 millimeters. Not only does this blend together the most desirable qualities expected of a veneer—strength, aesthetic appeal and easy fabrication—it allows for a broader range of situations and uses.
Both of these materials can be pressed or milled to assume the exact shape necessary to fit a particular tooth. The manufacturing process also allows for creating smaller veneers that can then be overlaid with porcelain for the most life-like appearance possible.
Thanks to these stronger materials enhancing the natural beauty of porcelain, we now have a wider creative palate for transforming your smile.
If you would like more information on porcelain veneers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Porcelain Veneers: Your Smile—Better Than Ever.”
Chronic stress is like a tea kettle on the boil—all that “steam” has to go somewhere. We often do this through behaviors like biting our nails, binging on comfort food—or grinding our teeth. That latter habit, however, could have a detrimental effect on teeth, including excessive enamel wear or even fractures.
Also known as bruxism, teeth grinding is the forceful and often involuntary contacting of teeth that often generates abnormally high chewing forces. While not considered a relatively big problem with young children, it can be if you’re an adult. While there could be other causes, chronic stress is often a prime factor for adults with bruxism.
While teeth grinding can occur during the day when you’re awake, it often occurs at night during sleep and may be associated with other sleep disorders like snoring. Although you might not be consciously aware of a grinding episode as it happens, you may notice its effects the next morning, including sore jaws or headaches. Over time, your dentist may begin noticing its effects on your teeth.
So, how can you lessen teeth grinding? For starters, if you’re a tobacco user, quit the habit. Many studies indicate tobacco users report twice the incidence of teeth grinding as non-users. Excessive caffeine, alcohol or drug use can also contribute.
People have also found it helpful to address chronic stress through a number of relaxation techniques like meditation, more relaxing bedtime preparation, bio-feedback or therapy to “de-stress.” Although there’s not a lot of empirical evidence for these techniques’ effectiveness, there’s much anecdotal data from people who’ve found stress relief from them.
There’s also a dental treatment using an occlusal guard that, while not stopping bruxism, can help prevent dental damage. Usually worn during sleep, the custom-made guard fits over the teeth of one jaw, usually the upper. Its high impact plastic prevents the teeth from making solid contact, thus reducing the biting force. You may also be able to reduce bruxism effects through dental work and orthodontics,
You and your dentist can explore the options to find the right treatment strategy for you. By taking action now, you may avoid much more extensive—and expensive—problems with your teeth down the road.
If you would like more information on teeth grinding and what to do about it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Teeth Grinding: Causes and Therapies for a Potentially Troubling Behavior.”