Posts for: June, 2019
If you have chronic jaw pain, you may be one of an estimated 10 million Americans suffering from temporomandibular joint disorders (TMD). If so, it's quite possible you're also coping with other health conditions.
TMD is an umbrella term for disorders affecting the temporomandibular (jaw) joints, muscles and adjoining tissues. The most common symptoms are limited jaw function and severe pain. Determining the causes for these disorders can be difficult, but trauma, bite or dental problems, stress and teeth clenching habits seem to be the top factors. Women of childbearing age are most susceptible to these disorders.
In recent years we've also learned that many people with TMD also experience other conditions. In a recent survey of TMD patients, two-thirds reported having three or more other health conditions, the most frequent being fibromyalgia, chronic fatigue syndrome, rheumatoid arthritis or chronic headaches. Researchers are actively exploring if any systemic connections exist between TMD and these other conditions, and how these connections might affect treatment changes and advances for all of them including TMD.
In the meantime, there remain two basic approaches for treating TMD symptoms. The most aggressive and invasive approach is to surgically correct perceived defects in the jaw structure. Unfortunately, the results from this approach have been mixed in their effectiveness, with some patients even reporting worse symptoms afterward.
The more conservative approach is to treat TMD orthopedically, like other joint problems. These less invasive techniques include the use of moist heat or ice to reduce swelling, physical therapy and medication to relieve pain or reduce muscle spasming. Patients are also encouraged to adopt softer diets with foods that are easier to chew. And dentists can also provide custom-fitted bite guards to help ease the stress on the joints and muscles as well as reduce any teeth grinding habits.
As we learn more about TMD and its relationship to other health conditions, we hope to improve diagnosis and treatment. Until then, most dentists and physicians recommend TMD patients try the more conservative treatments first, and only consider surgery if this proves unsatisfactory. It may take some trial and error, but there are ways now to ease the discomfort of TMD.
If you would like more information on the causes and treatments of 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.”
Dental implants have soared in popularity thanks to their life-likeness, functionality and durability. But these prized qualities have also created an ironic downside—people are much more likely to replace a tooth with an implant rather than go through the time and effort to preserve it.
We say downside because even though an implant is as close to a real tooth as we can now achieve in dentistry, it still can't rival the real thing. It's usually in your long-term health interest to save a tooth if reasonably possible. And, there are effective ways to do so.
Most dental problems arise from two common oral diseases. One is tooth decay, caused by contact with acid produced by bacteria living in dental plaque. We can often minimize the damage by treating the early cavities decay can create. But if we don't treat it in time, the decay can advance into the tooth's pulp chamber, putting the tooth in danger of loss.
We can intervene, though, using root canal therapy, in which we drill into the tooth to access its interior. We clean out the decayed tooth structure, remove the diseased pulp tissue and fill the empty chamber and root canals to seal the tooth and later crown it to further protect it from re-infection.
Periodontal (gum) disease also begins with bacteria, but in this case the infection is in the gum tissues. Over time the ensuing inflammation locks into battle with the plaque-fueled infection. This stalemate ultimately weakens gum attachment, the roots and supporting bone that can also increases risk for tooth loss.
We can stop a gum infection through a variety of techniques, all following a similar principle—completely removing any accumulated plaque and tartar from the teeth and gums. This stops the infection and starts the process of gum and bone healing.
You should be under no illusions that either of these approaches will be easy. Advanced tooth decay can be complex and often require the skills of an endodontist (a specialist in root canals). Likewise, gum disease may require surgical intervention. But even with these difficulties, it's usually worth it to your dental health to consider saving your tooth first before you replace it with an implant.
If you would like more information on how best to treat 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 “Save a Tooth or Get an Implant?”
Although cancer treatment has advanced steadily in recent decades, the most used therapies continue to be radiation and chemotherapy to eradicate cancerous cells. And while they often work, both can cause "collateral damage" in healthy tissues near the targeted cells.
This can create a number of indirect consequences for a patient's health, including in the mouth. The salivary glands, for example, can be damaged by radiation treatments aimed at the head or neck. The effect on these glands can interrupt the normal flow of saliva and cause xerostomia or "dry mouth."
Lack of adequate saliva causes more than an unpleasant, sticky mouth feeling. One of saliva's main functions is to neutralize acid that builds up naturally after eating. Without it, high acid levels can cause enamel and root surface erosion and lead to tooth decay.
Cancer treatment can also contribute to gastro-esophageal reflux disease (GERD). This disease causes stomach acid to bypass the natural tissue barriers of the esophagus and enter the mouth. As with dry mouth, the increased acid level from GERD can be just as devastating to enamel—and the damage will be permanent.
To minimize these effects on your dental health, it's important to take proactive steps before, during and after cancer treatment. If at all possible, have any needed dental work performed before you begin radiation or chemotherapy—it's better to start it with teeth and gums as healthy as possible.
During treatment, try to continue regular dental visits to monitor your oral health and receive any needed preventive or therapeutic treatments. Depending on your condition and the advice of your dentist, you may need to increase your visit frequency during this time. Your dentist can help with boosting your saliva production and strengthening your tooth enamel. But you should also practice daily brushing and flossing, drink plenty of water and seek treatment for any resulting GERD symptoms.
Even with the best efforts, though, your teeth and gums may still incur damage while treating your cancer. Fortunately, there are a wide array of materials and procedures that can effectively restore them to health. So, once your treatments are completed consult with a dentist on your options for improving the health and appearance of your teeth and gums.