Some 60 million Americans have TMJ.  Simply put, TMJ is the syndrome that happens when the muscles in the jaw and the temporomandibular joint are out of alignment or misaligned, causing problems when chewing.  In plain English, the ligaments, muscles, bones, and joints do not line up, causing pain.

 

Some Symptoms Associated with TMJ:          

1.  Clicking, popping, or grating sound when opening or closing the mouth          

2.  Headaches and/or dizziness          

3.  Tenderness in the jaw muscles          

4.  Earache          

5.  Jaws that sometimes lock open when yawning or if mouth is held open          

6.  Spasm or cramps in the jaw area (very common)

 

What Causes TMJ? 

These are the most common causes:          

1.  Accidents          

2.  Developmental (natural) defects, including the wearing-down of teeth or fillings causing a misalignment of the teeth          

3.  Surgery          

4.  Orthodontics          

5.  Stress that causes clenching of the jaws and grinding of the teeth          

6.  Naturally misaligned teeth

 

What can be done to correct TMJ?       

If the temporomandibular area has been damaged by arthritis or as a result of an accident, surgery may be needed to correct the TMJ and re-establish the proper occlusion.  Far more likely, your doctor will recommend a therapy that may include a bite splint and specific exercises to keep the teeth from touching and to allow the joint to remain lined up, allowing the jaw’s hinge area to relax.  Such therapy increases your comfort by diminishing the TMJ pain.  If a splint is prescribed for you, it is very important that you follow your doctor’s instructions regarding the amount of time and time of day you must wear it. ·  If your condition is temporomandibular joint irregularity (TMJ), you need to wear your splint all the time unless directed otherwise.  Do not remove the splint when you eat, as this would compromise your treatment and diminish its effect.  The splint stops tooth-to-tooth contact and keeps your jaw lined up properly, allowing the muscles and joint area to heal.  As this healing takes place and the symptoms gradually disappear, your doctor will adjust your splint to keep your teeth properly aligned.  During this period of your therapy, you will begin wearing the splint fewer hours of the day and, after a period of time; you will no longer need to wear a splint.  

 

Grinding (“bruxism”) and Clenching: 

These conditions require you to wear your splint only at night, while sleeping.  Clean the splint by brushing it.  Keep it in water and mouthwash solution when it is not in your mouth  

 

Teeth may crack when subjected to the stress of chewing hard food or ice, or by biting on an unexpected hard object.  Teeth with or without restorations may exhibit this problem, but teeth restored with typical silver-alloy restorations are most susceptible.

 

Symptoms and Signs of Cracked Teeth (some or all of the following): 

1)  Pain while chewing;

2)  Pain upon cold air application;

3)  unsolicited pain (usually leakage of sugar into a tooth crack)  

 

Treatment of Cracked Teeth: 

Simple Crack: The majority of cracked teeth—about 9 out of every 10—can be treated by placement of a simple crown (cap) on the tooth.  When the tooth is prepared for the crown, and a temporary restoration is placed, the pain usually leaves immediately.  If this is the case with your tooth, we will place the final crown on your next appointment, and the condition should be resolved. 

Complex Crack: Occasionally - about 1 in 10 - a crack is pronounced or severe enough to access the pulp (nerve) of the tooth.  If pain persists after placement to the temporary crown, you may have such a crack into the pulp of the affected tooth.  To verify, please call us.  The tooth may require endodontics (root canal therapy) before the crown is placed.  

 

Occlusal equilibration is the mechanical adjustment of your teeth, dentures, fillings, or other appliances to a position which allows your lower jaw to function as a natural hinge in relation to your upper jaw reducing needed tooth structure to assure that all teeth fit together with equal pressure on all teeth and surfaces.  This allows you a better chewing surface and comfort. 

There are many reasons why teeth and jaws do not occlude (meet) in a comfortable position.  Some of them are: 

1)  Numerous fillings or bridges over period of years;

2)  Orthodontics;

3)  Developmental defects;

4)  Oral surgery, trauma;

5)  Malocclusion (poor bite);

6)  Bruxism (grinding one’s teeth), and clenching; 

 

Your mouth is being equilibrated because some problem exists; i.e. pain, abnormal wear, breaking of restorations, or other situations.  The problem is usually present because your teeth and/or fillings do not meet in harmony with your lower jaw at a proper position.  The teeth and fillings have not “worn in” properly.

 

We approach occlusion adjustments in a very conservative way.  In most cases we will make minor adjustments, and then if you still have discomfort we will re-adjust until you have the comfort and chewing capability we are trying to accomplish.  Your comfort as well as your ability to chew is important to us!  

 

We have placed tooth-colored restorations in your teeth.  The resin material used is a plastic with small “filler” particles of glass-like material—the finest and most up to date materials available today.  These restorations will serve you well for several years; however, you should be aware of the following.  

 

Chewing:  As with natural teeth, avoid chewing excessively hard foods on the restored teeth (hard candy, ice, raw carrots, bones, etc.) because extreme force can cause the resin material to be broken from the tooth - just as it can in a natural tooth.  In the event that a breakage occurs, replacement of a restoration is not difficult.  

 

Recalls:  Visit us at regular six-month examination periods.  Often problems that are developing around the restorations can be detected at an early stage and repaired easily.  Waiting a longer time may require redoing the entire restoration. 

 

Preventive Procedures: To provide optimum longevity for your restorations and to prevent future dental decay and supporting tissue breakdown, please brush and floss after eating and before bedtime.  We do recommend you swish vigorously with mouthwash for at least 30 seconds daily. Please call us if you notice any change in your tooth-colored restorations, or if you have any questions at all about them.  

 

Your “Routine cleaning” is not routine here! 

We want you to feel that your recall (check-up and cleaning) visit is as important as your other dental treatment visits.  Your continuing-care visit includes many services that are extremely important for your long-term oral health.  We don’t take these services for granted and we hope you don’t either.

 

The examination (check-up) portion of your recall visit includes a health history update and a soft-tissue/oral cancer screening.  Your dentist will:  examine your bite and your TMJ (temporomandibular joint); examine your entire mouth and look for any signs of disease, particularly caries (decay) and periodontal (gum) disease; prescribe any necessary films so that we can see the 75% of your mouth that we can’t see by looking directly in your mouth; and discuss these films with you before your visit is over.  We encourage you to ask as many questions as you feel necessary.  

 

The prophylaxis (cleaning) portion of your recall visit will be provided by your hygiene team members in conjunction with your dentist.  Your team member may start with an “air polisher” (an air, water, and flavored baking soda spray) to remove stains and soften deposits.  Our team member will, of course, polish and floss to remove any remaining stains and give you that “freshly polished” feeling.  We use a 1.64% fluoride solution in our polishing paste for everyone, not only because it strengthens the teeth against decay but also because it has a proven anti-bacterial effect, which helps to prevent periodontal disease.  So you see, not only children, but also adults get fluoride treatments in our practice.  No matter what your age, you will be given personalized home care instructions. 

 

We will recommend the best recall interval for your dental needs – usually 3, 4 or 6 months.  Remember, the six-month interval is not ideal for many patients.  We want your recall visit to be a pleasant, personally rewarding experience.  Please help us by notifying us if we fail to meet your comfort expectations.  

 

What is “Periodontal Therapy?” 

Periodontal Therapy is a “conservative” (non surgical) program consisting of a series of 2, 4, or 6 visits to control gum disease.   If you are diagnosed with periodontal disease; pockets (deeper or greater) than 3 mm with bleeding points upon non-traumatic toothpick probing; your dentist may recommend a periodontal therapy program to control your disease.  The severity of the periodontal disease determines the length of your program.  Our goal is to eliminate bleeding and mouth odor, as well as reduce pocket depths to eliminate bacterial re-infection.  Remember:  Healthy gums never bleed!  

 

The therapy consists of ultrasonic scaling (a device utilized for the removal of calculus, stain, and bacterial toxins on teeth utilizing the principle of high frequency vibration), hand scaling, root planning (smoothes roots) and curettage (removes diseased tissue), and irrigation with antibiotics.  Depending on the severity of disease, we may recommend oral antibiotics, fluoride treatment, and antibacterial rinses.  Also, a home-care regimen of tooth brushing and flossing is instructed in conjunction with other home-care devices (specific electric toothbrushes) which may be required for continued health of your tissues.   We want your Periodontal Therapy to be a pleasant, comfortable, healthy and personally rewarding experience. 

 

For your comfort, topical anesthetic and local anesthetic are routinely used.  As always, nitrous oxide, oral valium and tranquilizers are available for your relaxation.   After therapy, your hygienist will see you for a periodontal maintenance visit to evaluate the success of your Periodontal Therapy.  Pocket depths and bleeding points will be re measured, checked, and treated as needed. 

 

It takes six months to one year before new gum attachment fibers become mature and more resistant to bacterial re-infection, therefore the doctor/hygienist recommends a three month recall/continuing care interval so that your level of periodontal health can be monitored and maintained.  As your mouth continues healing, the interval between hygiene appointments will be evaluated according to your individual progress and the rate of calculus formation.  Your personal home care is the determining factor in the continued success of your treatment.  We will do our best to assist you in anyway necessary to have healthy tissues surrounding your tooth for a lifetime.  

 

What Is  Oral Cancer?

Cancer is a number of diseases caused by the abnormal growth of cells.  Sometimes cells grow out of control, divide, and form masses known as tumors.  

 

Facts on Oral Cancer

Oral cancer accounts for only 3 percent of all cancers.  It is treatable when detected early by your dentist.  If treated promptly, there is a very good chance that it can be cured.  More than 90 percent of oral cancers are squamous cell cancers, which develop in the lining or covering of the mouth, lips, tongue, and throat.  It can also be spread through the lymph nodes and into the neck.  

 

The most common sign of oral cancer is a sore which does not heal and bleeds easily.  A lump or thickening in the mouth or white patches which last longer than two weeks, difficulty in chewing or swallowing food and the inability to move the tongue freely can also be signs of oral cancer.  Dentists detect oral cancer during routine check ups.  The American Cancer Society recommends getting a dental exam every 6 to 12 months.  Dental x-rays are the only way your dentist can see if tumors are present in your jaw and beneath the gum surface.  

 

1)  Don’t use tobacco in any form.  Don’t smoke cigarettes, cigars, or pipes, or use chewing tobacco or snuff;

2)  If you drink alcohol, drink only in moderation;

3)  Avoid exposure to strong direct sunlight.  Those who must be in the sun should use a sunscreen and apply often;

4)  Have regular dental checkups.  Any jagged teeth or irritating dentures should be fixed.;

5)  Any white patch, lump, or scaly area on the lips or in the mouth that last longer than two weeks should be checked by a doctor; 

If you have questions or concerns about your oral health, contact your dentist.  For free pamphlets from the American Cancer Society, call 1-800-422-6237.  

 

The average amalgam is 50% mercury bonded to 30% silver and a bit of copper, tin, and zinc.  A tooth colored filling is stronger because it actually bonds to your tooth.  The composite bonds all the remaining walls of the tooth together.  Because amalgams do not bond to tooth structure, there is a gap between the filling and the tooth, which significantly decreases the strength of the tooth.  This gap provides a pathway for bacteria and acids to get into and cause further decay.  

 

Amalgam fillings expand and contract when subjected to various temperature, this continuous expansion and contraction makes the filling act like a wedge in the tooth leading to a weakened tooth structure.  The tooth, over time will eventually break apart and the only thing remaining in your mouth will be the filling. Currently insurance companies cover 80% of amalgam fillings but do not cover 80% of composite fillings.  Although we realize there is an increased cost to our patient, we feel that the quality of dental care associated with composite fillings greatly outweighs the added cost incurred.