Posts for: January, 2019
Have you noticed a clicking, popping, or grating sound when you open or close your jaw? As many as 36 million U.S. adults experience this phenomenon in one or both of the joints that connect the lower jaw (mandible) to the skull.
While the sounds may be disconcerting, there’s generally no cause for concern in the absence of other symptoms. They’re most likely caused by a harmless shift in the position of the disk inside each temporomandibular (jaw) joint, and it can diminish or disappear entirely over time. But, if you’re also experiencing persistent discomfort, severe pain, or limited function in your jaw (which can include getting it “stuck” in an opened or closed position), then you may be suffering from a temporomandibular joint disorder — part of a complex set of conditions affecting one or both jaw joints, muscles and/or other surrounding tissues. (You may have heard the condition called TMJ, which is actually the abbreviation for the temporomandibular joint itself. Health care professionals prefer TMJD or TMD.)
Depending on the severity, TMD can interfere with your ability to speak, chew and even make facial expressions. The cause is unclear, but genes, gender, environment, stress and behavior are believed to play a role. It can also be symptomatic of a larger medical problem, such as fibromyalgia, which can produce pain all over the body.
Management Options for TMD
TMD traditionally was viewed as a bite problem (malocclusion) requiring mechanical correction — e.g., through orthodontic braces or surgery. But the current therapeutic model approaches TMD as an orthopedic problem (joint inflammation, muscle soreness, strained tendons and ligaments, and disk damage) and favors a sequence of conservative, reversible procedures — hot or cold compresses in the jaw area, soft foods, physical therapy/massage, medication, and/or a bite guard to decrease pressure on jaw joints from tooth clenching and grinding — prior to more aggressive, irreversible treatment alternatives.
If you would like more information about TMD, please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine articles “Seeking Relief from TMD” and “Chronic Jaw Pain and Associated Conditions.”
If we could go back in time, we all probably have a few things we wish we could change. Recently, Dr. Travis Stork, emergency room physician and host of the syndicated TV show The Doctors, shared one of his do-over dreams with Dear Doctor magazine: “If I [could have] gone back and told myself as a teenager what to do, I would have worn a mouthguard, not only to protect my teeth but also to help potentially reduce risk of concussion.”
What prompted this wish? The fact that as a teenage basketball player, Stork received an elbow to the mouth that caused his two front teeth to be knocked out of place. The teeth were put back in position, but they soon became darker and began to hurt. Eventually, both were successfully restored with dental crowns. Still, it was a painful (and costly) injury — and one that could have been avoided.
You might not realize it, but when it comes to dental injuries, basketball ranks among the riskier sports. Yet it’s far from the only one. In fact, according to the American Dental Association (ADA), there are some two dozen others — including baseball, hockey, surfing and bicycling — that carry a heightened risk of dental injury. Whenever you’re playing those sports, the ADA recommends you wear a high-quality mouth guard.
Mouthguards have come a long way since they were introduced as protective equipment for boxers in the early 1900’s. Today, three different types are widely available: stock “off-the-shelf” types that come in just a few sizes; mouth-formed “boil-and-bite” types that you adapt to the general contours of your mouth; and custom-made high-quality mouthguards that are made just for you at the dental office.
Of all three types, the dentist-made mouthguards are consistently found to be the most comfortable and best-fitting, and the ones that offer your teeth the greatest protection. What’s more, recent studies suggest that custom-fabricated mouthguards can provide an additional defense against concussion — in fact, they are twice as effective as the other types. That’s why you’ll see more and more professional athletes (and plenty of amateurs as well) sporting custom-made mouthguards at games and practices.
“I would have saved myself a lot of dental heartache if I had worn a mouthguard,” noted Dr. Stork. So take his advice: Wear a mouthguard whenever you play sports — unless you’d like to meet him (or one of his medical colleagues) in a professional capacity…
While tooth decay and periodontal (gum) disease destroy more teeth than any other causes, both of these diseases are largely preventable with proper oral hygiene and dental treatment. It’s more than possible, then, to enjoy a lifetime of healthy, disease-free teeth.
But even with healthy teeth, the effects of aging will cause tooth wear over time. And although we can’t prevent the aging process from occurring altogether, there are steps we can take not to accelerate the process.
Most tissues, including bone and teeth, have a growth cycle in which older cells are broken down (known as catabolism), removed and replaced by newer cells (anabolism). As we develop during childhood, the growth phase exceeds breakdown; when we reach adulthood, the two phases come into equilibrium. But as we age, breakdown will gradually overtake growth. This aging effect results in, among other outcomes, tooth wear.
“Normal” wear appears to be greatest — and most visible — along the biting surfaces of the teeth. The forces generated when we bite or chew causes enamel to erode over time. Unfortunately, you can accelerate this process through bad oral habits: clenching or grinding teeth, often times at night while you sleep, as well as habitually chewing on hard objects like nails or pencils.
Normal forces generated when we bite or chew are actually beneficial for dental health — they help stimulate bone growth. But when they exceed their normal range as when we clench or grind our teeth, they can increase tooth wear and cause other problems such as diminished function or changes in appearance, such as a shortened facial height.
To slow the rate of wear, it’s important to modify any behaviors that may be contributing to it. In many cases an occlusal night guard worn while you sleep helps prevent teeth clenching. You may also need assistance with stress management, a major trigger for these kinds of habits, through biofeedback therapy or counseling.
If you’ve already encountered excessive wear, bonding techniques using colored composite resin, veneers or crowns that attach directly to the teeth can restore lost function and rejuvenate the appearance and color of your teeth. We can perform a “smile analysis” to determine if one of these techniques is right for you to help you regain a more youthful and attractive smile.
If you would like more information on aging and tooth wear, 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 “How and Why Teeth Wear.”