If you have pain in your jaws or related headaches, you may have Temporo-mandibular Joint Disorder, TMD. You are probably wondering what this is — and how it can be treated. If this sounds like something you may have, read on for some answers.
What is TMD? TMD describes a group of disorders or diseases that have the same symptoms, but may have different causes, hence it is known as “The Great Imposter.” Pain in and around the temporo-mandibular joint (TMJ), the jaw joint involved in opening and closing your mouth — is characterized by pain and soreness in the region of one or both joints, ears, jaw muscles and even the sinuses.
How does the temporo-mandibular joint work? You can feel your jaw joints working if you place your fingers in front of your ears and move your lower jaw up and down. On each side the joint is composed of an almond shaped structure at the end of the lower jaw, called the condyle, which fits neatly into a depression in the temporal bone (the bone on the side of your skull near your ear). A small disc between the two bones allows the lower jaw to move forward and sideways. The joints are stabilized by ligaments and moved by muscles, like all your joints.
What is the most common cause of TMD? Many people clench or grind their teeth as a reaction to stress. This is generally a subconscious habit, and can even occur during sleep. Continual tooth grinding habits can cause the muscles to go into spasm, which is the most common cause of TMD pain. Structures associated with the jaws — teeth, air sinuses, and even neck and back muscles — share nerves with the muscles in the joints, so the pain may be felt in those structures too, making the exact source of the pain difficult to diagnose. Symptoms of TMD may limit your ability to open your jaw and talk or eat normally.
What is the treatment for TMD? Treatment will depend on the cause, but generally the first step is to relieve pain and discomfort with heat, mild painkillers, muscle relaxants, a soft diet, and simple jaw exercises. A bite guard may be recommended, which should be custom made in our office; a rigid yet unobtrusive plastic appliance that fits over the biting surfaces of your upper teeth. Properly fitted and adjusted, it aids and causes jaw muscle relaxation by preventing clenching and grinding. It is worn during times of stress when oral habits tend to recur, and can also be worn at night.
If you are suffering from TMD — whether the pain is moderate or severe — schedule an appointment with us to have it evaluated and treated. You can learn more about TMD by reading the Dear Doctor magazine article “TMD: Understanding the Great Imposter.”
Some train intensively for months ahead of time, so they can achieve peak performance during the season; others simply enjoy occasional pick-up games with friends. But here’s something all athletes, both amateurs and professionals, should know: Dental accidents in sports can happen at any time, and the consequences of not wearing the proper protective equipment can be serious.
Don’t believe us? Just ask American Idol season 5 winner Taylor Hicks. Before his singing career took off, Hicks was a high-school basketball star; he lost his two front teeth during a championship game.
“It was just one of those collisions that happen in sports,” Hicks recently told Dear Doctor magazine. “I never wore a mouthguard in basketball. Obviously I should have.”
We agree. And we want to remind you that basketball isn’t the only game that poses a risk to your teeth (although statistics show it’s the leading cause of sports-related dental injuries). Soccer, bike riding, and equestrian sports — along with some two dozen other games and physical activities — are all on the American Dental Association’s list of sports in which participants should wear a mouthguard.
What’s the best kind of mouthguard? The answer is: the one you actually wear. For the maximum comfort and protection, there’s nothing like a custom-fitted mouthguard provided by our office. This is a piece of protective equipment that’s individually crafted just for you — in fact, it’s made from a model of you own teeth! Not only will it fit your mouth perfectly, but it’s also strong, lightweight and easy to wear.
It’s true that off-the-shelf mouthguards are available from big-box retailers in limited sizes (like small, medium and large); also available are the so-called “boil and bite” types, which you soften in hot water before molding them into shape with the pressure of your fingers, teeth and tongue. Either one of these options is probably better than nothing — but neither provides the level of protection and comfort that a custom-made mouthguard offers.
When you consider the potential cost of tooth replacement — not just its hefty price tag, but also the lost time, trouble and inconvenience it can cause — we think you’ll agree that a perfectly fitted mouthguard, made by our office, is a piece of sports equipment you really can’t afford to do without. Best of all, its cost is quite reasonable.
So if you’re the active type, come in to ask us about fitting you with a custom mouthguard. For more information, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”
Are tooth-colored fillings safer than silver fillings?
No. Both are considered safe based on the most reliable and up-to-date scientific evidence. Still, tooth-colored fillings do have some definite advantages. Not only do they blend in with your smile far better than “silver” (dental amalgam) fillings, but they often require less removal of healthy tooth structure. That’s because in order to fill a tooth with amalgam, it is necessary to create indentations in the tooth called “undercuts” to hold the amalgam in; this requires the removal of some healthy tooth material. With a tooth-colored filling, we need only remove the decayed part of the tooth to place the filling.
Are there any disadvantages?
Yes, tooth-colored fillings don’t always wear as well as metal fillings — particularly on back molars where they are subjected to the most stress from chewing. They are also more expensive and less likely to be fully reimbursed under dental insurance plans.
Are there different types of tooth-colored fillings?
Yes, three different choices of tooth-colored fillings are available:
- Composite — This mixture of plastic and glass is the most common type of tooth-colored filling. Newer materials can hold up almost as long as amalgam fillings and look very natural, though they can stain over time just as natural teeth do.
- Porcelain — High-tech dental ceramics are considered the most aesthetic choice of filling material. They don’t stain as composites can, but their relatively high glass content can make them more brittle and prone to breakage. They may be more expensive than composites.
- Glass Ionomer — Made of acrylic and glass powders, these inexpensive, translucent fillings blend in acceptably well with natural teeth and have the advantage of releasing small amounts of fluoride to help prevent decay. However, they generally don’t last as long as other restorative materials.
We would be happy to offer guidance on which choice would be best in your own unique situation.
If you have any questions about tooth-colored fillings, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “The Natural Beauty of Tooth-Colored Fillings.”
Her parents Will and Jada are Hollywood royalty, who helped her land her first acting role when she was 7. She released a hit single, “Whip My Hair,” before she had quite reached the age of 10; shortly afterward, she was signed to a record label. Yet the young singer and actress Willow Smith has at least one thing in common with plenty of ‘tweens and teens across America: She needed to wear braces to correct problems with the alignment of her teeth.
Why do braces seem to be a part of growing up for so many kids? One answer is because they work so well. Braces apply gentle pressure to the teeth through a thin, flexible wire called an archwire. Attached to the teeth with a metal or ceramic bracket, the archwire exerts a light force which causes teeth to gradually move into better positions. Sometimes, when additional force is needed, elastic bands or other appliances may be used in conjunction with braces.
Most everyone is familiar with the silvery metal “tracks” of traditional braces. But did you know that there are a number of other options too? For a more inconspicuous look, you may be able to have braces with tooth-colored ceramic brackets; then, only the thin archwire will be visible in your mouth. It’s even possible in some cases to place the metal wires and brackets on the tongue side of the teeth. With this system, called lingual braces, the orthodontic hardware is truly invisible.
What if you didn’t need metal braces at all? Some people can get good results using a system of clear plastic aligners instead of braces. The aligners are worn 23 hours a day, but can be taken off for cleaning and for important events. They work best for correcting mild or moderate alignment problems.
Still, plenty of people feel that if they’re going to wear braces, they might as well flaunt them. That’s why some types of braces are available with bands that come in different colors. When Willow’s brother Jayden wore braces, he was reported to favor red and black ones. Jayden, who is about two years older than his sister, had his braces removed just before Willow got hers put on.
So if it turns out that you need braces, remember that lots of your favorite celebrities wore them too. And keep in mind that, depending on your own situation, you may have several options to choose from.
If you would like more information about braces or orthodontic treatment, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “The Magic of Orthodontics” and “Orthodontics for the Older Adult.”
When a natural tooth can’t be preserved, it is important to have it replaced as soon as possible. Presently, there are two excellent tooth-replacement systems in wide use: traditional bridgework and high-tech dental implants. What’s the difference between the two methods?
Essentially, it comes down to how the replacement tooth is secured in the mouth. In the dental implant system, a natural looking prosthetic tooth is solidly anchored in place by a screw-like titanium implant. This is inserted directly into the bone of the jaw in a minor surgical procedure, and over a short period of time (usually 6 – 12 weeks) its titanium metal structure will actually become fused with the living bone.
With bridgework, however, the support for the prosthetic tooth (or teeth) comes from the healthy teeth adjacent to it. These teeth must be prepared (shaped) by carefully removing some of the outer tooth material (enamel and some dentin), which enables them to be fitted with coverings called crowns or caps. Crowns are often used on their own, to restore teeth that are missing too much of their structure to be treated effectively with standard fillings. But the bridgework system goes one step further.
Instead of making individual crowns for each tooth, a dental lab will fabricate a bridge — a single unit consisting of crowns for the prepared teeth, plus complete prosthetics to replace the missing tooth (or teeth). A three-unit bridge, for example, consists of one complete prosthetic tooth to replace the one that’s missing, plus two crowns for the adjacent “abutment” teeth. It’s possible to have larger bridges as well: For example, a six-unit bridge might consist of two complete prosthetic teeth in the center, with two crowns for abutment teeth on each end, all linked together in one piece.
While bridgework has been used effectively for decades, it is now being gradually supplanted by dental implants. Implants don’t require the removal of healthy tooth material from abutment teeth, and they don’t place extra stress on those teeth; plus, they generally last much longer than natural tooth bridges. However, the dental bridge remains a viable alternative for tooth replacement in many circumstances.
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