Temporomandibular joint disorder (TMD) is an umbrella term for a number of chronic jaw problems. These conditions cause recurring pain for 10 to 30 million Americans, especially women of childbearing age.
But even after decades of treatment and research, a full understanding of TMD's underlying causes eludes us. That doesn't mean, however, that we haven't made progress—we have indeed amassed a good deal of knowledge and experience with TMD and how best to treat it.
A recent survey of over a thousand TMD patients helps highlight the current state of affairs about what we know regarding these disorders, and where the future may lie in treatment advances. Here are a few important findings gleaned from that survey.
Possible causes. When asked what they thought triggered their TMD episodes, the top answers from respondents were trauma, stress and teeth clenching habits. This fits in with the consensus among experts, who also include genetic disposition and environmental factors. Most believe that although we haven't pinpointed exact causes, we are over the target.
Links to other disorders. Two-thirds of survey respondents also reported suffering from three or more other pain-related conditions, including fibromyalgia, rheumatoid arthritis and chronic headaches. These responses seem to point to possible links between TMD and other pain-related disorders. If this is so, it could spur developments in better diagnostic methods and treatment.
The case against surgery. Surgical procedures have been used in recent years to treat TMD. But in the survey, of those who have undergone surgery only one-third reported any significant relief. In fact, 46% considered themselves worse off. Most providers still recommend a physical joint therapy approach first for TMD: moist heat or ice, massage and exercises and medications to control muscle spasms and pain.
These findings underscore one other important factor—there is no “one size fits all” approach to TMD management. As an individual patient, a custom-developed action plan of therapy, medication, and lifestyle and diet practices is the best way currently to reduce the effects of TMD on your life.
If you would like more information on TMD management and treatment, 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.”
Though it sounds like an elite academic society, "The Freshman 15" is anything but. The phrase stands for the weight, pegged at 15 pounds, that many incoming students gain in their first few months at college—the result of poor dietary habits brought on by a hectic schedule and newfound freedoms.
These and other habits have consequences—and not just for unwanted pounds. Many can lead to dental problems, which could continue to overshadow a student's oral health long after college is over.
Here, then, are 5 tips to pass along to your newly minted college student (or anyone else, for that matter) to keep their teeth and gums as healthy as possible.
Brush and floss daily. While a hectic course load beckons, a student should still make time every day to brush and floss their teeth. Along with regular dental cleanings, these two tasks remove the daily buildup of plaque, a bacterial film that causes dental disease. Daily oral hygiene is good insurance against developing future tooth decay and gum disease.
Cut back on sugar. A student may rely on sugary snacks for a boost of energy throughout their day, but it could be setting them up for dental disease. That's because harmful oral bacteria also feed on sugar. Choose instead real, whole foods and snacks that are better for teeth—and for avoiding those dreaded freshman pounds.
Limit acidic beverages. Besides added sugar, sodas, sports and energy drinks also contain acid, another ingredient unfriendly to teeth. During prolonged contact, acid softens and erodes the mineral content in tooth enamel, opening the door to tooth decay. Those who drink these kinds of beverages should limit their consumption as much as possible.
Don't smoke. Smoking dries out the mouth, preventing saliva from buffering the acid that causes tooth decay. Its main ingredient nicotine restricts the mouth's blood vessels, further increasing the chances of dental disease. Tobacco use in general, including smoking, is also a key risk factor for oral cancer.
Avoid mouth "jewelry." It might be the bomb on campus, but lip rings, tongue bolts and other mouth jewelry can cause dental damage. Besides the possibility of chipped teeth, metal jewelry in or around the mouth is more likely to cause infection. Better to skip this fashion statement for healthier teeth.
If you would like more information on good oral practices, 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 “10 Health Tips for College Students.”
There's still much about the underlying nature of chronic jaw joint dysfunction we have yet to unravel. Treating these conditions known as temporomandibular joint disorders (TMDs) may therefore require some experimentation to find what works for each individual patient.
Most TMD therapies are relatively conservative: eating softer foods, taking anti-inflammatory pain relievers or undergoing physical therapy. There have been some surgical techniques tried to relieve jaw pain and dysfunction, but these have so far had mixed results.
Recently, the use of the drug Botox has been promoted for relieving jaw pain, albeit temporarily. Botox contains tiny amounts of botulinum toxin type A, a poisonous substance derived from the bacterium Clostridium botulinum, which can cause muscle paralysis. It's mainly used to cosmetically smooth out small wrinkles around facial features.
Because of these properties, some physicians have proposed Botox for TMD treatment to paralyze the muscles around the jaw to reduce pain and discomfort. While the treatment sounds intriguing, there are a number of reasons to be wary of it if you have TMD.
To begin with, the claims for Botox's success in relieving jaw pain have been mainly anecdotal. On the other hand, findings from randomized, double-blind trials have yet to show any solid evidence that Botox can produce these pain-relieving effects.
But even if it lived up to the claims of TMD pain relief, the effect would eventually fade in a few weeks or months, requiring the patient to repeat the injections. It's possible with multiple Botox injections that the body will develop antibodies to fight the botulinum toxin, causing the treatment to be less effective with subsequent injections.
Of even greater concern are the potential side effects of Botox TMD treatment, ranging from headaches and soreness at the injection site to more serious muscle atrophy and possible facial deformity from repeated injections. There's also evidence for decreased bone density in the jaw, which could have far-reaching consequences for someone with TMD.
The best approach still seems to lie in the more conservative therapies that treat TMD similar to other joint disorders. Finding the right combination of therapies that most benefit you will help you better manage your symptoms.
If you would like more information on treatments for 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 “Botox Treatment for TMJ Pain.”
For some, the excitement over their braces coming off gets dampened a bit with the prospect of now having to wear a retainer. But it has to be—newly realigned teeth have a tendency to revert to their previous positions out of a kind of “muscle memory.” A retainer prevents that from happening.
But as essential as it is, the standard retainer is almost as noticeable as braces, a major reason why many patients are less than enthusiastic about wearing them. And, because it's common for them to become lost when out of the mouth, replacing one becomes an added expense.
But there's another option—the bonded retainer. This retainer consists of a metal wire bonded to the back of the teeth to prevent them from moving. Because it's fixed in place, only a dentist can remove it.
The bonded retainer addresses the previous two issues associated with a removable retainer. Because it's behind the teeth rather than in front, it's out of sight to others. And, because it's fixed in place, there's no danger of losing it.
But unlike its removable cousin, which can be taken out for oral hygiene, the bonded retainer can make flossing more difficult. And, by nature, a bonded retainer must be worn all the time; a removable retainer allows for a more flexible schedule later in the treatment of a few hours a day.
So, which retainer option is best for you or another family member? A bonded retainer may be more attractive for appearance's sake, if it must be worn indefinitely, or if there's a high probability of the teeth moving out of alignment. And, it might be the right choice where there's a concern about a patient's ability to keep up with a removable retainer.
If you do decide to go with a bonded retainer, ask your dental hygienist for training on using floss with the fixed appliance—this can help improve oral hygiene. Whatever you choose, bonded or removable, your retainer will help you keep that new, beautiful, straightened smile.
If you would like more information on orthodontic retainers, 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 “Bonded Retainers.”
Millions of people are currently caring for an elderly family member. If that describes your family, then you know how overwhelming that responsibility can be at times.
A part of that responsibility is making sure they have healthy teeth and gums, a critical part of their overall well-being. But as with the rest of the body, teeth and gums can wear and become disease-prone as a person gets older. To further complicate things, an older adult may not be able to take care of their own oral health due to physical and cognitive decline.
Maintaining an older loved one's oral health is difficult, but not impossible. Here are 4 areas on which you should focus to ensure they have the healthiest teeth and gums possible.
Oral hygiene. It's important for all of us to avoid tooth decay and gum disease by brushing and flossing daily to remove bacterial plaque, the prime cause for dental disease. You can switch an older adult who is having trouble performing these tasks because of physical impairment to large handled toothbrushes or a water flosser to make things easier. In some cases, you may have to perform these tasks for them.
Dental visits. Dental cleanings at least twice a year further lower the risk of disease, especially in older adults. Regular dental visits are also important to monitor an older person's oral health, and to initiate treatment when the need arises. Catching dental disease early at any age improves outcomes.
Dental work. An older person may have various forms of dental work like fillings, crowns, bridges or dentures. Keeping them in top shape helps them maintain their oral health and protect any of their remaining teeth. Have their dental work checked regularly by a dentist, especially dentures that can lose their fit over time.
Oral cancer. Although not as prevalent as other forms, this deadly cancer does occur in higher rates among people over 65. Be sure, then, that an oral cancer screening is a component of your older family member's regular dental evaluations. And any time you notice a sore or other abnormality in their mouth, have it evaluated by their dentist as soon as possible.
If you would like more information on dental care for older adults, 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 “Aging & Dental Health.”
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