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.”
A few days before the Oscars, Vanity Fair magazine asked Academy Awards host Neil Patrick Harris to name his most treasured possession. Was it his Tony award statuette for best leading actor in a musical? His star on the Hollywood Walk of Fame? The stethoscope he wore while playing teenaged doctor Doogie Howser on TV? No, as it turns out, the 41-year-old actor’s most treasured possession is… his wisdom teeth. Yes, you read that correctly. “Oddly, I still have my four wisdom teeth,” Harris said. “I refuse to let them go or I’ll lose my wise parts.”
How odd is it for a 41-year-old to have wisdom teeth? Actually, not that odd at all. While it is true that wisdom teeth are often removed, there’s no one-size-fits-all approach to this. It all depends on whether they are causing problems now, or are likely to cause problems in the future.
The trouble wisdom teeth cause is related to the fact that they are the last molars to come in, and that molars are large in size. By the time wisdom teeth appear between the ages of 17 and 21, there often is not enough room for them in the jaw. Sometimes it’s because you may have inherited a jaw size that’s too small for your tooth size; and generally speaking, the size of the human jaw has evolved to become smaller over time.
If room is lacking, the adjacent molar (that came in earlier) can interfere with the path of eruption — causing the wisdom tooth to come in at an odd angle. The wisdom tooth can hit up against that other tooth, possibly causing pain or damaging the adjacent tooth. This is known as “impaction.” Sometimes the wisdom tooth breaks only partway through the gum tissue, leaving a space beneath the gum line that’s almost impossible to clean, causing infection. A serious oral infection can jeopardize the survival of teeth, and even spread to other parts of the body.
If a wisdom tooth is impacted, will you know it? Not necessarily. A tooth can be impacted without causing pain. But we can see the position of your wisdom teeth on a dental x-ray and help you make an informed decision as to whether they should stay or go. If removal is the best course of action, rest assured that this procedure is completely routine and that your comfort and safety is our highest priority. If there is no great risk to keeping them, as Neil Patrick Harris has done, we can simply continue to monitor their condition at your regular dental checkups. It will be particularly important to make sure you are reaching those teeth with your brush and floss, and that you keep to your schedule of regular professional cleanings at the dental office. All healthy teeth are indeed worth treasuring.
If you would like more information about wisdom teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
Even after decades emphasizing oral hygiene and supplemental fluoride to fight dental disease, we’re now seeing an increase in tooth decay, especially among children. What’s causing this alarming trend?
Many in both the dental and medical professions link this and other health problems to a rise in the amount and consumption of sugar added to food products. A number of years ago our annual average consumption of added sugar was about 4 pounds per person; today, it’s closer to 90 pounds.
The increase in sugar consumption can be traced to the 1970s when the food industry began adding more sugar to make processed foods stripped of oils and fats taste better. Today, 77% of the approximately 600,000 food items sold in the United States contain some form of sugar (under a variety of names).
This additional sugar, however, has produced an unintended consequence: sugar triggers the release of a brain chemical called dopamine that regulates our sense of reward when we engage in a desirable behavior. The excess dopamine creates a weak addiction to sugar, which then leads to overconsumption, contributing to our current obesity epidemic and the rise in health problems like heart disease or Type 2 diabetes. This is especially alarming among children: thirty years ago Type 2 diabetes was unheard of among children — today there are over 55,000 diagnosed pediatric cases.
For both you and your family’s general and dental health, you should consider ways to reduce your sugar intake: purchase and eat most of your food from the “outer edges” of your supermarket — meats, dairy, and fresh vegetables and fruits (which do contain the sugar fructose, but are mostly fiber that slows the liver’s processing of the sugar); limit processed foods with added sugar, and learn to recognize its inclusion in products by reading ingredients labels. You should also be wary of sweetened beverages such as sodas, sports drinks, teas or juices, and try to drink more water.
The recommended daily sugar consumption is less than six teaspoons a day (about two-thirds the amount in one can of soda). By restricting this consumption, you’ll improve your general health and reduce your risk for dental disease.
Perhaps you've seen Nate Berkus on The Oprah Winfrey Show or watched his television program, The Nate Berkus Show. You may even have read his best-selling book, Home Rules: Transform the Place You Live Into a Place You'll Love. Regardless of where or how you discovered Berkus, you will surely have noticed his dazzling smile.
Berkus recently opened up about the facts behind his trademark smile during an interview with Dear Doctor magazine. First off, his smile is totally natural, as he never wore braces or had any cosmetic work, including porcelain veneers. However, Berkus does give credit to his childhood dentist for the preventative healthcare he received as a young boy. “I'm grateful for having been given fluoride treatments and sealants as a child,” he said. Nate also shared the important flossing advice he learned from his dentist that he still follows today: “Floss the ones you want to keep.” Berkus went on to say that he feels, “healthy habits should start at a young age.”
And we totally agree! For this reason we have put together the following list of facts and oral hygiene tips:
- Over 50% of plaque accumulation occurs in the protected areas between teeth — a place that may be difficult or even impossible to reach with a toothbrush.
- A thorough brushing may take up to two minutes at first, and it may feel awkward as you reach some places in your mouth.
- Remember, more is NOT always better! Brushing or flossing too hard can be damaging to your teeth and gums. And never saw back and forth with your floss.
To learn more about oral hygiene, including brushing and flossing techniques, you can continue reading the Dear Doctor article “Oral Hygiene Behavior - Dental Health For Life.” Or you can contact us today to schedule an appointment so that we can conduct a thorough examination, review your brushing and flossing techniques, and discuss any questions you have as well as treatment options. As needed, we will work with you to teach you the proper brushing and flossing techniques so that you feel confident before you leave our office. And to read the entire interview with Nate Berkus, please see the Dear Doctor article “Nate Berkus.”
When choosing among different ways to solve a problem, knowledge is power. In the case of selecting the best repair for a dental problem, count on your team of dental professionals to advise you. But you as the patient make the final decision, and it helps to thoroughly understand the different options, their advantages and disadvantages. If you have a chipped or broken front tooth, your likely repair options are composite resin or porcelain veneer.
Composite resins are synthetic materials that can be colored to match your natural teeth. The material is bonded to the tooth surface using adhesives that become part of the tooth structure, strengthening the original tooth. The repair looks as good as, or even better than, your original tooth. Such repairs can be used to restore small to large chips and other damage caused by decay or trauma.
Since the composite resin repair is applied directly to the tooth in the dental office, the repair can be made in a single appointment. You do not need to use a temporary repair while waiting for the final replacement to be made at a dental laboratory. This also means that the repair will cost less.
Another advantage of composite resin is that less of the healthy tooth needs to be removed to prepare the tooth to receive the replacement, since it bonds directly to the original tooth structure.
Porcelain veneers are very thin layers of tooth-colored porcelain that are also bonded to the tooth. They are usually recommended in situations with more serious injury or risk to the tooth, such as teeth that have been fractured, treated for root canal, or injured in contact sports.
Application of porcelain veneers may require more tooth preparation (in which more of the original tooth material must be removed) before the restoration can be bonded in position. Bonded porcelain veneers are likely to be longer-lasting than composite resins. They must be fabricated in a laboratory, so they require more than one visit and cost more.
All of the above are factors to consider in choosing composite resin or porcelain veneer to restore your chipped or damaged tooth. As usual in making such decisions, the final choice will depend on your individual situation.
Contact us today to schedule an appointment to discuss your questions about bonding to repair chipped teeth. You can also learn more by reading the Dear Doctor magazine article “Artistic Repair of Front Teeth with Composite Resin.”
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