Posts for: October, 2017
Your temporomandibular joints (TMJ), located where your lower jaw meets the skull, play an essential role in nearly every mouth function. It’s nearly impossible to eat or speak without them.
Likewise, jaw joint disorders (temporomandibular joint disorders or TMD) can make your life miserable. Not only can you experience extreme discomfort or pain, your ability to eat certain foods or speak clearly could be impaired.
But don’t assume you have TMD if you have these and other symptoms — there are other conditions with similar symptoms. You’ll need a definitive diagnosis of TMD from a qualified physician or dentist, particularly one who’s completed post-graduate programs in Oral Medicine or Orofacial Pain, before considering treatment.
If you are diagnosed with TMD, you may then face treatment choices that emanate from one of two models: one is an older dental model based on theories that the joint and muscle dysfunction is mainly caused by poor bites or other dental problems. This model encourages treatments like orthodontically moving teeth, crowning problem teeth or adjusting bites by grinding down tooth surfaces.
A newer treatment model, though, has supplanted this older one and is now practiced by the majority of dentists. This is a medical model that views TMJs like any other joint in the body, and thus subject to the same sort of orthopedic problems found elsewhere: sore muscles, inflamed joints, strained tendons and ligaments, and disk problems. Treatments tend to be less invasive or irreversible than those from the dental model.
The newer model encourages treatments like physical therapy, medication, occlusive guards or stress management. The American Association of Dental Research (AADR) in fact recommends that TMD patients begin their treatment from the medical model rather than the dental one, unless there are indications to the contrary. Many studies have concluded that a majority of patients gain significant relief with these types of therapies.
If a physician or dentist recommends more invasive treatment, particularly surgery, consider seeking a second opinion. Unlike the therapies mentioned above, surgical treatments have a spotty record when it comes to effectiveness — some patients even report their conditions worsening afterward. Try the less-invasive approach first — you may find improvement in your symptoms and quality of life.
If you would like more information on treating 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 “Seeking Relief from TMD.”
Your tooth is in peril if its innermost layer, the pulp, becomes infected and inflamed. Deep tooth decay, repeated dental procedures or fractures can all expose the pulp and ultimately the roots to infection and lead to tooth loss.
But that scenario isn't inevitable — we can often save the tooth with a root canal treatment. By accessing the tooth's interior through a prepared hole, we're able to clean out the infected tissue in the pulp chamber and root canals, and fill the empty space with a special filling. We then cap the tooth with a custom crown to protect it from a re-infection.
Root canal treatments have a very high success rate — chances are good your tooth will survive for many years afterward. But there's a slight chance the tooth may become re-infected; in that case, a second root canal treatment may be in order.
In a few cases, though, a second root canal may not be advisable, and could even accelerate damage to the tooth. For example, if past dental work resulted in an extensive crown restoration, accessing the root canals the conventional way will require disassembling that restoration. This could weaken the tooth significantly.
We can approach the problem from a different route: instead of accessing the tooth's interior through the crown (the visible part of the tooth), we instead perform a surgical procedure called an apicoectomy, which accesses the tooth at the root end through the gums.
In this procedure we numb the area with local anesthesia and then make a small incision through the gums at the level of the affected root. After access, we remove any diseased tissue around the root and a few millimeters of the root tip itself. We then insert a small filling in its place to seal the canal and prevent further infection. In some cases we may also insert a graft to encourage bone growth and aid in healing.
Over time, the affected area will heal and return to normal function. Even if a traditional root canal treatment can't be used, an apicoectomy could be another option for saving your tooth.
If you would like more information on your options for preserving a problem tooth, 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 “Apicoectomy.”
Your diet can play as important a role in your dental health as brushing and flossing. What you eat (particularly sugar) could increase your risk of tooth decay despite your hygiene habits. And vice-versa: a nutritious diet may help boost your preventive efforts even more.
Let’s look at two very different approaches to diet and see how your dental health is likely to fare under each.
A High Sugar/Low Fiber Diet. Modern western diets heavy with processed foods are inundated with two particular types of refined sugars. The first is sucrose, which comes mainly from either beets or sugar cane. Foods (and beverages) may also contain a refined sugar from corn known as high fructose corn syrup. Refined sugars are added for taste to thousands of products like cake, candy, soft drinks or even condiments like catsup. These “free” sugars are easily processed by bacteria into acid. Combine that with fewer fibrous vegetables in the diet and you have a recipe not only for obesity and other health issues, but tooth decay as well.
A High Fiber/Low Sugar Diet. Fruits and vegetables make up a large part of this kind of diet, while added free sugars much less so. That doesn’t make this diet sugar-free: all plant products contain simple sugars produced by photosynthesis. The difference, though, is that these sugars — glucose, fructose and sucrose (natural, not the refined versions) — are more slowly absorbed into the bloodstream during digestion because of the fiber content of fruits and vegetables. You’ll also receive other nutrients like vitamins and minerals necessary for good health. Eating this kind of diet will help decrease the risk of tooth decay.
So there you have it: eat more fresh fruits and vegetables and restrict your intake of processed foods and sweets. You may also want to fine-tune a few items to maximize decay prevention: for example, eat starches in their natural form (whole grains, beans or certain fruits) as much as possible rather than refined or in combination with added sugar (cakes, cookies, etc.). And while fresh fruits with their naturally occurring sugars aren’t a significant factor in tooth decay, dried fruits (especially with added sugar) might.
If you would like more information on proper diets for better oral health, 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 “Nutrition & Oral Health.”