Posts for: January, 2016
As many as 36 million adults in the U.S. suffer from some form of chronic jaw pain. What’s more, many of these may also experience other painful conditions like arthritis or chronic fatigue in other parts of their body.
Chronic jaw pain is actually a group of difficult to define disorders collectively referred to as temporomandibular joint disorders (TMJD or also TMD). TMD not only refers to pain symptoms of the temporomandibular (jaw) joints but also of the jaw muscles and surrounding connective tissue. Most physicians and dentists agree TMD arises from a complex range of conditions involving inheritable factors, gender (many sufferers are women of childbearing age), environment and behavior.
A recent survey of approximately 1,500 TMD patients found that nearly two-thirds of them also suffered from three or more related health problems like fibromyalgia, chronic fatigue syndrome, rheumatoid arthritis, headaches, depression and problems sleeping. The understanding of TMD’s connection with these other conditions is in its early stages of research, but there’s avid interest among healthcare providers to learn more and possibly devise new treatments for TMD in coordination with these other related conditions.
In the meantime, TMD patients continue to respond best with the traditional approach to treatment, including physical therapy, thermal (hot or cold) compresses to the area of pain, medication and modifying the diet with more easier to chew foods. In extreme cases, jaw surgery may be recommended; however, success with this approach has been mixed, so it’s advisable to get a second opinion before choosing to undergo a surgical procedure.
Hopefully, further study about TMD and its connection with other conditions may yield newer treatments to ease the pain and discomfort of all these conditions, including TMD. You can stay up to date on these and other developments for coping with the discomfort of TMD at www.tmj.org and through your healthcare provider team.
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.”
Somewhere between bites during a recent meal, the inside of your cheek found itself in the way of your teeth. You winced with pain at the resulting bite, and while it was sore for a day or two it seemed to heal over. Now, though, you’re noticing this same area of your cheek gets in the way of your teeth a lot more often, with more bites and sores.
What’s likely happened is that you have developed a traumatic fibroma. When the soft tissues of the inner cheek, lips or tongue heal after being injured, a small bit of fibrous tissue composed of the protein collagen forms like a callous over the bite wound to protect it after it heals. If, however, the process is interrupted by another bite, the fibrous tissue that subsequently forms may be thicker and thus more raised on the surface of the skin. This higher profile makes it more likely the site will be involved in repeated episodes of biting.
If the fibroma continues to be a problem, it can be solved with a simple surgical procedure. A surgically-trained dentist or oral surgeon will remove portions of the fibroma (usually with local anesthesia) to flatten the skin profile, and then close the resulting wound with a couple of stitches unless a laser was used. Any discomfort after the procedure can usually be managed with a mild anti-inflammatory drug like aspirin or ibuprofen, and the site should heal in just a few days to a week.
Although the vast majority of fibromas aren’t dangerous, it’s routine practice to have the excised tissue biopsied for abnormalities. More than likely the fibroma tissue will be normal; but by having the fibroma removed and examined, you’ll gain peace of mind about your oral health. In the process, you’ll also eliminate a bothersome and painful problem.
If you would like more information on mouth sores, 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 “Common Lumps and Bumps in the Mouth.”
For years preparing teeth for fillings or other restorations has required the use of a drill. Although quite effective in removing decayed structure and preparing the tooth for bonding, it usually requires a local anesthetic. That and the noise it generates can be unsettling for many patients.
In recent years, a different type of technique known as “air abrasion” has increased in popularity among dentists. Known also as “particle abrasion,” the technique uses a stream of fine particles to remove decayed tooth structure and is less invasive than the traditional drill. Although the technology has been around since the mid-20th Century, recent developments in suction pumps that remove much of the dust created have made it more practical. It also works well with new natural-looking bonding materials used for tooth structure replacement.
The fine particles — usually an abrasive substance like aluminum oxide — are rapidly discharged through a hand-held instrument using pressurized air aimed at affected tooth areas. Decayed teeth structure is softer than healthier tissue, which allows air abrasion to precisely remove decay while not damaging the other.
Besides removing decay or abrading the tooth for bonding, air abrasion can also be used to minimize stained areas on surface enamel and to clean blood, saliva or temporary cements from tooth surfaces during dental procedures. It’s also useful for smoothing out small defects in enamel or aiding in sealant applications.
It does, however, have a few limitations. It’s not as efficient as the traditional drill with larger cavities or for re-treating sites with metal (amalgam) fillings. Because of the fine texture of the abrasive particles, affected teeth need to be isolated within the mouth using a rubber dam or a silicone sheet. High-volume suction must be continually applied to capture the fine particles before the patient swallows them or it fills the procedure room with a fine cloud of material.
Still, while air abrasion technology is relatively new, it has clear advantages over the traditional drill in many procedures. As advances in the technology continue, air abrasion promises to offer a more comfortable and less invasive experience in dental treatment.
Cavities can happen even before a baby has his first piece of candy. This was the difficult lesson actor David Ramsey of the TV shows Arrow and Dexter learned when his son DJ’s teeth were first emerging.
“His first teeth came in weak,” Ramsey recalled in a recent interview. “They had brown spots on them and they were brittle.” Those brown spots, he said, quickly turned into caviÂties. How did this happen?
Ramsey said DJ’s dentist suspected it had to do with the child’s feedings — not what he was being fed but how. DJ was often nursed to sleep, “so there were pools of breast milk that he could go to sleep with in his mouth,” Ramsey explained.
While breastfeeding offers an infant many health benefits, problems can occur when the natural sugars in breast milk are left in contact with teeth for long periods.Â Sugar feeds decay-causing oral bacteria, and these bacteria in turn release tooth-eroding acids. The softer teeth of a young child are particularly vulnerable to these acids; the end result can be tooth decay.
This condition, technically known as “early child caries,” is referred to in laymen’s terms as “baby bottle tooth decay.” However, it can result from nighttime feedings by bottle or breast. The best way to prevent this problem is to avoid nursing babies to sleep at night once they reach the teething stage; a bottle-fed baby should not be allowed to fall asleep with anything but water in their bottle or “sippy cup.”
Here are some other basics of infant dental care that every parent should know:
- Wipe your baby’s newly emerging teeth with a clean, moist washcloth after feedings.
- Brush teeth that have completely grown in with a soft-bristled, child-size toothbrush and a smear of fluoride toothpaste no bigger than a grain of rice.
- Start regular dental checkups by the first birthday.
Fortunately, Ramsey reports that his son is doing very well after an extended period of professional dental treatments and parental vigilance.
“It took a number of months, but his teeth are much, much better,” he said. “Right now we’re still helping him and we’re still really on top of the teeth situation.”
If you would like more information on dental care for babies and toddlers, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “The Age One Dental Visit” and “Dentistry & Oral Health for Children.”