Diagnosing jaw problems and pains – TMD and TMJ

More than fifteen percent of American adults suffer from chronic facial pain.

Common symptoms can include pain in or around the ear, tenderness of the jaw, clicking or popping noises when opening the mouth or even head and neck aches.

There are two joints and several jaw muscles which make it possible to open and close the mouth. They work together when you chew, speak, and swallow.

These structures include muscles and ligaments, as well as the jaw bone, the mandible (lower jaw) with two joints, the TMJs.

The TM joint is one of the most complex joints in the body. Located on each side of the head, these joints work together and can make many different movements, including a combination of rotating and gliding action when chewing and speaking.

Several muscles help open and close the mouth. They control the lower jaw (mandible) as it moves forward, backward, and side-to-side.

Both TM joints are involved in these movements. Each TM joint has a disc between the ball and socket. The disc cushions the load while enabling the jaw to open widely and perform rotating and translocational movements.

Any problem that prevents this complex system of muscles, ligaments, discs and bones from working together properly may result in a painful TMJ disorder.

If you are suffering from this type of pain, your dentist can help identify its source with a thorough exam and appropriate x-rays.

Often, the problem is a sinus or toothache or it could be an early stage of periodontal disease.

But for some pain, the cause is not so easily diagnosed.

The pain could be related to the facial muscles, the jaw or temporomandibular joint, located in the front of the ear.

Treatments for this pain may include stress reducing exercises, muscle relaxants, or wearing a mouth protector to prevent teeth grinding.
They’ve been successful for many and your dentist can recommend which is best for you.

Should you be concerned about thumbsucking?

Some children suck on their thumbs and parents often wonder if it is harmful.

Sucking on something is a child’s natural reflex. It can help them feel more secure so they start to suck on their thumbs, fingers, pacifiers or other objects.

Since thumbsucking is relaxing, it may also help them sleep.

However, after the permanent teeth come in, sucking may cause problems with the proper growth of the mouth and the alignment of teeth. It can also cause changes in the roof of the mouth.

Whether or not dental problems will result depends on the intensity of the sucking.

A child who vigorously sucks their thumb is more likely to have difficulties than one who rests their thumb passively in their mouth. Young children who suck their thumbs aggressively may even cause problems with their baby teeth.

If you notice changes in your childs primary teeth, consult your dentist.

Usually children will stop sucking their thumbs between the ages of about two and four. They should have ceased sucking by the time the permanent front teeth are ready to erupt.

If your child is continuing to suck their thumbs, here are some tips:

– Praise them for not sucking, instead of scolding them when they are
– If they are sucking because they feel insecure, focus on correcting the cause of the anxiety
– For older children, involve them in choosing the method of stopping

If necessary, your dentist can help by encouraging the child and explaining what could happen to their teeth if they do not stop sucking.

What to expect when having a tooth extracted

The process of having a tooth extracted may seem worrying but you’ll find it much easier if you know what to expect on the day and afterwards.

Your dentist will make the process as comfortable as possible for you by numbing the area around the tooth to be extracted.

In most cases, a small amount of bleeding is quite normal and your dentist will advise you what process to follow to allow healing as quickly as possible.

Generally, you should avoid anything that might prevent normal healing.

For example, it’s best not to smoke, rinse your mouth vigorously or drink through a straw for 24 hours afterwards as these could delay healing.

For the first few days, if you need to rinse your mouth, do it gently. If you are suffering pain or swelling, apply a cold cloth or an ice bag.

If necessary, your dentist will recommend something for any pain.

At the beginning, don’t clean around the socket where the tooth has been removed but you should brush and floss the other teeth as usual.

Modern procedures make having an extraction and the follow-up more comfortable than ever before.

Different types of dentist and how they help your oral care

While many people see dentists as the single group of people who look after the health of your teeth and mouth, there are various specialist categories that help you in different ways.

The categorization of a dentist will depend on their education, training and experience.

Here are some of the main specialist areas of dentistry:

Endodontics: Concerned with the dental pulp – the part in the center of a tooth made up of living soft tissue and cells and root canal therapy

Oral and Maxillofacial Pathology: This deals with the identification, and management of diseases affecting the oral and maxillofacial regions

Oral and Maxillofacial Radiology: Deals with the production and interpretation of images and data produced by radiant energy that are used for the diagnosis and management of diseases, disorders and conditions of the oral and maxillofacial region

Oral and Maxillofacial Surgery: Diagnosis and surgical treatment of diseases, injuries and defects of the tissues including extractions, facial surgery and implants

Orthodontics and Dentofacial Orthopaedics: Mainly deals with diagnosis, prevention and treatment of misaligned teeth and modification of midface and mandibular growth

Pediatric Dentistry: Provides preventive and therapeutic oral health care for infants and children through adolescence.

Periodontics: Prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth and the maintenance of the health, function and esthetics of these structures and tissues. Most periodonitist place implants

Prosthodontics: Diagnosis, treatment planning, rehabilitation and maintenance associated with missing or deficient teeth and/or oral and maxillofacial tissues. Includes dentures, bridges and the restoration of implants.

Plus, of course, general dentists provide everyday care and many specialist services to maintain your oral health.

The causes of bad breath

Bad breath – also known as halitosis – is an unpleasant condition that can cause a great deal of embarrassment.

And, for many people, its made even worse by the fact they don’t even know that they have it.

There are many possible causes for bad breath so, if you think you might have the problem, talk to your dentist.

What you eat affects what you breathe out. Certain foods, such as garlic and onions, contribute to objectionable breath odor and even dieters may develop unpleasant breath from infrequent eating.

If you don’t brush and floss daily, particles of food remain in the mouth, collecting bacteria, which can cause bad breath.

Bad breath can also be caused by dry mouth (xerostomia) which occurs when the flow of saliva decreases.

One of the reasons why its especially important to talk to your dentist about bad breath is that it may be a sign of an underlying medical problem such as respiratory tract infection or gastrointestinal problems.

Persistent bad breath or a bad taste in the mouth can also be a warning signs of gum disease.

Smoking can also cause bad breath, stain teeth and reduce your ability to taste foods.

For all these reasons, you shouldn’t put up with the problem of bad breath. Talk to your dentist and find out what might be causing the problem.

How a healthy diet can help you have healthy teeth

Eating the right food plays an important role in developing healthy teeth and gums.

If your diet lacks certain nutrients, it may be more difficult for tissues in your mouth to fight infection and this can contribute to gum disease.

Although poor nutrition does not cause gum disease directly, the disease may progress faster and could be more severe in people with diets which are low in nutrients.

The U.S. Department of Agriculture makes recommendations on the nutrients, vitamins and minerals needed by your body – including your teeth and gums – to promote health and prevent disease.

We have different needs at various stages life and depending on our physical activity. The DOA website provides more information and your dentist will be able to discuss how your diet affects your teeth.

Here are some steps you can take to make sure what you eat doesn’t harm your teeth.
– Maintain a healthy diet
– Drink plenty water
– Limit the number of between-meal snacks. When you must snack, choose nutritious foods that are low in sugar
– Keep a food diary for a week recording every item you eat and drink

It will also help if you brush your teeth twice a day and floss regularly. Schedule regular dental checkups and professional cleanings and talk to your dentist about how your diet affects your teeth.

Common questions about dental insurance

Understanding what’s covered by your dental insurance is an important part of making sure you get the best oral care possible.

Here are some common questions that arise when people want to understand their cover better.

– If treatment my dentist recommends is not covered by my insurance, does that mean it’s not necessary?

Some plans make exclusions such as sealants, pre-existing conditions, adult orthodontics, and specialist referrals. This depends on your dental plan and you should not let the level of cover determine whether you need treatment.

– My dental benefit will only pay for a large filling but my dentist recommends I get a crown. Which should I choose?

Some plans will only cover the least expensive solution but it may not be the best option for your needs. You should decide based on your health needs and not on your insurance cover.

– My dental plan says it will pay 100 percent for checkups and cleanings but the insurance company says I owe for part of the dentist’s charge. How can this be?

Some plans provide cover based on a “customary fee” for each procedure. So, if your dentist’s fee is higher, your benefit will be based on a percentage of the customary fee instead of your dentist’s fee. Although these limits are called “customary,” they may not accurately reflect the fees that dentists charge in your area.

– Will my plan cover the care my family will need?
If your employer offers more than one plan, check the exclusions and limitations of the coverage as well as looking at the general benefits. It’s a good idea to discuss your family’s likely needs with your dentist before choosing a plan.

The plan document should specify who is eligible for coverage under the plan.

Plans offered by the same provider or employer can vary according to the contracts involved so your dentist will not be able to answer specific questions about your benefit or predict what the coverage for a particular procedure will be.

If you have specific questions about coverage, talk to your plan provider.

Root canal treatment

Root canal therapy is an important treatment that can save a tooth with a diseased nerve and which in the past would probably have needed to be removed.

Inside each tooth is the ‘pulp’ which runs like a thread down through the root and provides nutrients and nerves to the tooth. It is the soft tissue that contains nerves, blood vessels and connective tissue.

If the pulp is diseased or injured, the pulp tissue dies.

The most common cause of pulp death is a cracked tooth or a deep cavity. Both of these problems can let bacteria enter the pulp.

So, if you don’t remove it, your tooth gets infected and you could lose it.

After the dentist – or endodontist (a dentist who specializes in problems of the pulp) – removes the pulp, the root canal is cleaned and sealed off to protect it. Then your dentist places a crown over the tooth to help make it stronger.

Most of the time, a root canal is a relatively simple procedure involving one to three visits with little or no discomfort.

Your restored tooth could last a lifetime, if you continue to care for your teeth and gums and enjoy regular checkups.

Common mouth sores: causes and cures

Mouth sores can be very annoying and painful and can have many causes.

The causes can range from infections – bacterial, viral or fungal – to a loose orthodontic wire or a denture that doesn’t fit or a sharp edge from a broken tooth or filling.

But mouth sores may be symptoms of an underlying disease or problem.

So, if you’ve had any mouth sore that lasts a week or longer, its a good idea to get your dentist to check it out.

Here are some of the most common mouth sores:

Canker sores: These are small ulcers with a white or gray base and a red border. They appear inside the mouth and are not contagious though they often return. Problems such as poor immune systems, viruses or fatigue and stress may be involved. They usually heal on their own after a week or two.

Cold sores: Cold sores are annoying and painful. They are also known as fever blisters or Herpes simplex and are groups of fluid-filled blisters. They often erupt around the lips and sometimes under the nose or around the chin. Cold sores caused by herpes virus type 1 are very contagious and the virus stays in the body. Cold sore blisters usually heal in a week by themselves.

Candidiasis: This fungal infection (also called moniliasis or oral thrush) occurs when the yeast Candida albicans reproduce in large numbers. It is common among denture wearers and people who have dry mouth syndrome are very susceptible to it. The focus is on preventing it or controlling the conditions that caused the outbreak.

Any mouth sores that last more than a few days should be checked with your dentist.

Taking care of your dentures

Your dentures are designed to last a very long time so its important that you take care of them as you would take care of your own teeth.

They are very delicate and may break easily if dropped even a few inches. So its a good idea to stand over a folded towel or a basin of water when handling dentures.

When you are not wearing your dentures, store them away from children and pets.

Like natural teeth, dentures must be brushed daily to remove food deposits and plaque.

Brushing helps prevent dentures from becoming permanently stained and helps your mouth stay healthy.

There are special brushes designed for cleaning dentures but a toothbrush with soft bristles can also be used. Avoid using hard-bristled brushes as these can damage your dentures.

Some denture wearers also use hand soap or mild dishwashing liquid for cleaning and thats fine. But avoid using powdered household cleansers, which may be too abrasive. Also, avoid using bleach, as this may whiten the pink portion of the denture.

The first step in cleaning dentures is to rinse away loose food particles thoroughly. Moisten the brush and apply denture cleanser. Brush every surface, scrubbing gently to avoid damage.

Dentures may lose their shape if they are allowed to dry out. When they are not worn, dentures should be placed in a denture cleanser soaking solution or in water. Never place dentures in hot water, which could cause them to warp.

Ultrasonic cleaners are also used to care for dentures. However, using an ultrasonic cleaner does not replace a thorough daily brushing.

You can seriously damage your dentures by trying to adjust or repair them yourself. So see your dentist if your dentures break, crack, chip or if one of the teeth becomes loose.

Over time, dentures will need to be relined, rebased, or remade due to normal wear. They may also need to be replaced if they become loose and the teeth show signs of significant wear.

You need to make regular visits to your dentist to make sure the dentures are working as well as possible for you and to check for more serious problems in your mouth such as oral cancer.

The secrets of brushing and flossing your teeth effectively

Though many of us say we brush our teeth regularly, you get the best results by making sure you brush properly.

Here are the steps you should follow:

First, place the toothbrush at a 45-degree angle to your gums.

Then, move the brush back and forth gently in short (tooth-wide) strokes.

Brush the outer tooth surfaces, the inner tooth surfaces, and the chewing surfaces of the teeth.

Use the “toe” of the brush to clean the inside surfaces of the front teeth, using a gentle up-and-down stroke.

Finally, brush your tongue to remove bacteria and freshen your breath.

As well as brushing your teeth, you should floss them every day. Heres how to floss for best results.

Break off about 18 inches of floss and wind most of it around one of your middle fingers.

Then wind the remaining floss around the same finger on the opposite hand. This finger will take up the floss as it becomes dirty.

Hold the floss tightly between your thumbs and forefingers.

Guide the floss between your teeth using a gentle rubbing motion. Never snap the floss into the gums.

When the floss reaches the gum line, curve it into a C shape against one tooth. Gently slide it into the space between the gum and the tooth.

Hold the floss tightly against the tooth. Gently rub the side of the tooth, moving the floss away from the gum with up and down motions.

Repeat this method on the rest of your teeth.

Don’t forget the back side of your last tooth.

If you have difficulty handling dental floss, consider other types of interdental cleaner such as special brushes, picks or sticks.

Your dentist or hygienist will be able to give your further tips on how to brush and floss for best results.

Making your teeth look better with veneers

Everybody wants the best smile possible and there’s no need to have it spoiled by gaps in your teeth or by teeth that are stained or badly shaped.

Whether the problem was caused by nature or by an injury, you may be able to have a veneer placed on top of your teeth to restore or improve your smile.

Veneers are thin, custom-made shells crafted from tooth-colored materials designed to cover the front side of teeth.

Your dentist will usually make a model of your teeth and the veneers will be made by a specialist dental technician.

A small amount of enamel has to be removed from your teeth to accommodate the shell so having veneers is usually an irreversible process.

In order to make the most of your veneer, your dentist may suggest that you avoid foods and drinks that could discolor them, such as coffee, tea or red wine.

It’s also possible that veneers might chip or fracture.

But, for many people, veneers are well worth it as they give them a completely new smile.

How dentistry has developed over the last 300 years

When you visit a modern dental surgery, its hard to imagine the challenges of dental treatment without all the latest technology.

Yet specialists have been taking care of peoples teeth for thousands of years.

Here are some of the key developments over the last 300 years.

1723: French surgeon Pierre Fauchard – credited as being the father of modern dentistry – publishes the first book to describe a comprehensive system for the practice of dentistry.

1760: John Baker, the earliest medically-trained dentist to practice in America, immigrates from England and sets up practice.

1790: John Greenwood adapts his mothers foot treadle spinning wheel to rotate a drill.

1790: Josiah Flagg, a prominent American dentist, constructs the first chair made specifically for dental patients.

1832: James Snell invents the first reclining dental chair.

1841: Alabama enacts the first dental practice act, regulating dentistry in the United States.

1844: Horace Wells, a Connecticut dentist, discovers that nitrous oxide can be used as an anesthesia and successfully uses it to conduct several extractions in his private practice.

1880s: The collapsible metal tube revolutionizes toothpaste manufacturing and marketing.

1890: Willoughby Miller notes the microbial basis of dental decay in a book which started a world-wide movement to promote regular toothbrushing and flossing.

1896: New Orleans dentist C. Edmond Kells takes the first dental x-ray of a living person in the U.S.

1938: The nylon toothbrush, the first made with synthetic bristles, appears on the market.

1945: The water fluoridation era begins when the cities of Newburgh, New York, and Grand Rapids, Michigan, add sodium fluoride to their public water systems.

1950s: The first fluoride toothpastes are marketed.

1960: The first commercial electric toothbrush, developed in Switzerland after World War II, is introduced in the United States. A cordless, rechargeable model follows in 1961.

Why a dental abscess should be treated quickly

If you have any kind of swelling in your gum, it almost certainly indicates a serious infection that should be treated urgently.

Dental abscesses result from a bacterial infection in the teeth or gums.

For example, it may come from an untreated cavity. Cavities result when some of the bacteria in our mouths mix with sugars and starches in our diet to produce acid.

This acid attacks the hard enamel coating of our teeth and, as the cavity gets deeper, it eventually infects the nerve and blood supply of the tooth.

In some cases, a dental abscess is caused by an infection of the gum. Bone loss from gum disease can create a pocket between the tooth, gum and bone.

When bacteria and other debris get into this pocket, an abscess can form.

The treatment for an abscess depends on how severe the infection is.

If the abscess has been caused by decay, root canal treatment may be needed or the tooth may even have to be removed.

If the abscess has been caused by the gum, the gum will need deep cleaning or surgical treatment. Again the tooth may need to be removed.

Sometimes, a small incision may be made into the gum to drain the abscess. If this happens, antibiotics and pain medication may be used to relieve discomfort.

If you wait until the gum is severely swollen before seeking treatment, the situation can become very serious.

The abscess at this stage can prevent you breathing properly and can be life-threatenting.

So if you have any signs of swelling in your gum, contact your dentist immediately.

How dental implants can give you a better smile

If you have missing teeth, you dont just have to rely on crowns, conventional bridges and dentures.

Many people are now choosing dental implants as the best way to restore their smile and solve dental problems.

Implants are placed below the gums during a series of appointments. They fuse to the jawbone and provide a base for individual replacement teeth, bridges or a denture.

As they are fused to the bone, they offer greater stability. And, because they are integrated into your jaw, your replacement teeth will feel more natural.

This secure fit often also makes them more comfortable than other solutions.

In order to have implants, you need to have healthy gums and adequate bone to support the implant.

To find out whether you could be a candidate for dental implants, talk to your dentist about what they could do for you.

How to make visiting the dentist easy for kids

Your child should have their first trip to the dentist by the time they are 18 months old and it’s good to make the process as easy as possible for them from the start.

Dental staff are used to dealing with young children and they will know how to make them feel comfortable.

Sometimes, children under three may be treated on the parent’s lap. In this case, the parent sits in the dental chair facing the dentist, and the child is on their lap.

The dentist will tell the child what he or she is going to do in terms they can understand. They will usually have fun dental toys they can use to help.

They will start with an oral examination checking the teeth present and looking at the development of the jaw, gums and soft tissues.

Naturally, as in any new situation, some children are initially unsettled but this is usually short-lived as they get used to it.

Parents can help by ensuring they are calm and relaxed as any anxiety will transfer to the child.

With older children, the parents may stay in the background though sometimes children behave better when the parent is not in the room!

Work with your children and your dentist to find the best way of ensuring they get the treatment they need with minimum worries for everyone.

How older adults can handle dry mouth and taste problems

Reduced saliva flow that results in a dry mouth is a common problem among older adults.

It is caused by certain medical disorders and is often a side effect of medications such as antihistamines, decongestants, pain killers and diuretics.

Some of the common problems associated with dry mouth include:
– Constant sore throat
– Burning sensation
– Problems speaking
– Difficulty swallowing
– Hoarseness or dry nasal passages

Left untreated, dry mouth can damage your teeth. Without adequate saliva to lubricate your mouth, wash away food, and neutralize the acids produced by plaque, extensive cavities can form.

Your dentist can recommend various methods to restore moisture. For example, sugar-free candy or gum stimulates saliva flow, and moisture can be replaced by using artificial saliva and oral rinses.

Another issue that can affect older adults is a loss of appetite due to a change in your sense of taste. Besides an age-related decrease in the sense of taste and smell, certain diseases, medications and dentures can contribute to a decrease in your sense of taste.

Whether you are suffering from dry mouth or problems with your sense of taste, your dentist will be able to make suggestions to help.

How to take care of your teeth with braces

Braces are orthodontic apparatus used to help fix crooked and crowded teeth.

While modern braces can be comfortable and inconspicuous, you may have to take extra steps to care for your teeth when wearing them.

Its important that you continue good oral hygiene practices while wearing braces.

You need to continue brushing regularly, following the approach suggested by your dentist, as well as flossing daily and making regular visits to the dentist.

People with braces should stick to a balanced diet and limit the number of snacks between meals.

Your dentist may suggest that you avoid certain foods that could interfere with braces or accidentally bend the wires. This can include nuts, popcorn, hard candy, ice and sticky foods such as chewing gum or caramel.

You can still continue to enjoy sports and other activities but a protective mouth guard is often recommended to reduce the risk of injury to the mouth or jaw. Your dentist will suggest an appropriate mouth guard when the braces are in place.

Braces can make a big difference to your smile and your future dental health. Modern technology and following good practices means you should be able to wear them with comfort and confidence.

Fixing crowded and crooked teeth with orthodontics

Correcting problems with crowded and crooked teeth not only gives you a better smile, it also leads to a healthier mouth.

Malocclusion, also known as bad bite, involves teeth that are crowded or crooked.

Sometimes, the upper and lower jaws may not meet properly and, although the teeth may appear straight, the individual may have an uneven bite.

Problems such as protruding, crowded or irregularly spaced teeth may be inherited. But thumb-sucking, losing teeth prematurely and accidents also can lead to these conditions.

As well as spoiling your smile, crooked and crowded teeth make cleaning the mouth difficult. This can lead to tooth decay, gum disease and possibly tooth loss.

A bad bite can also interfere with chewing and speaking, cause abnormal wear to tooth enamel and lead to problems with the jaws.

Orthodontic treatment can help correcting these problems giving you a better smile but, more importantly, creating a healthier mouth.

Your dentist will advise you on how orthodontic treatment could help you.

Is it safe to have an X-ray while pregnant?

Some women worry about whether its safe to have an X-ray exam while they are pregnant.

This can cause them to put off treatment they need.

However, untreated dental infections can pose a risk to the fetus, and dental treatment may be necessary to maintain the health of the mother and child. Sometimes this will mean an X-ray is necessary.

Radiation from dental X-rays is extremely low but every precaution is taken to minimize radiation exposure.

For example, a leaded apron reduces exposure to the abdomen and should be used when a dental radiograph is taken.

In addition, a leaded thyroid collar can protect the thyroid from radiation, and should be used whenever possible. The use of a leaded thyroid collar is strongly recommended for women of childbearing age, pregnant women and children.

Overall there is no reason to avoid dental radiographs (X-rays) while pregnant, breastfeeding or trying to become pregnant.

Follow your dentists advice and ask questions if you have any concerns.