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Toothpaste

Go down the aisles at the store and there are rows and rows of toothpastes.  More toothpastes cause more confusion.  Brushing with toothpaste (also called a “dentifrice”) is important for several reasons.  First and foremost, toothpaste and a correct brushing action work to remove plaque, a sticky, harmful film of bacteria that grows on your teeth that causes caries (decay), gum disease, and eventual tooth loss if not controlled. Second, the toothpaste contains fluoride, which makes the entire tooth structure more resistant to decay and promotes remineralization, which aids in repairing early decay before the damage can even be seen.  Third, special ingredients in the dentifrice help to clean and polish the teeth and remove stains over time. Fourth, toothpastes help freshen breath and leave your mouth with a clean feeling.

I know it can be confusing, but if you don’t have any specific needs, as long as your toothpaste contains fluoride, the brand you buy really does not matter.  It doesn’t matter whether or not it is in paste, gel, or even powder form, or containing a certain flavor.  All fluoride dentifrices work effectively to fight plaque and cavities and clean and polish tooth enamel.

There are however toothpastes that contain a variety of ingredients geared toward specific needs (more confusion!).  If your teeth are hypersensitive to hot or cold, consider trying toothpaste designed for sensitive teeth.  Dentifrices containing baking soda and/or hydrogen peroxide (which are both good cleansing agents) give the teeth and mouth a clean, fresh, pleasant feeling that can offer an incentive to brush more, but fluoride is the true active ingredient at work protecting your teeth.  Some prefer tartar control toothpaste to prevent the buildup of soft calculus deposits on their teeth.  New pastes offer advanced whitening formulas aimed at safely removing stains to make teeth brighter and shinier, although they can’t nearly match the effectiveness of a professional bleaching formula administered or prescribed by a dentist.

To clear up some of the confusion about toothpaste, I thought it would help to give you a list of some of the most common ingredients and how they help:

  • Fluoride – Fluoride acts topically – protects teeth by hardening the outer enamel surface, making teeth less susceptible to decay.  Will not remove current decay.
  • Desensitizing – Strontium chloride, potassium nitrate protects exposed dentin by blocking the tubes in the teeth that are connected to nerves.  Must use the product for several weeks before any therapeutic effects are felt.
  • Whitening – Hydrogen peroxide, carbamide peroxide and abrasive ingredients may lighten and/or remove certain stains from enamel. After prolonged use, may experience gum irritation or increased sensitivity.  Not all teeth will “whiten” the same way. Will not work on all stains.
  • Tartar-control – Sodium pyrophosphate Ingredient adheres to tooth surface and prevents tartar formation above the gum.  Will not remove tartar.  Some patients may experience irritation to the gums with tartar control toothpastes. 
  • Baking soda – Baking soda and mild abrasive cleans surface of teeth. No proven therapeutic value, excessive use may irritate gums.
  • Antimicrobial – Triclosan helps remove bacteria that may cause gum disease. Will not remove or reduce existing gum disease.
  • Note: All toothpastes are more effective after a dental cleaning, which allows the toothpaste ingredients to treat a clean surface.

I hope this has cleared up some of the confusion.  No matter what toothpaste you use, just be sure to brush!

This entry was posted in Prevention on by admin.

Toothbrush and Toothpaste

Skulls of the Cro-Magnon people, who inhabited the earth several thousand years ago, show that humans have been plagued with oral health problems for a long time. In turn, techniques for combating oral health problems have been found dating back to 2900 B.C. when Egyptians drilled holes through the jaw presumably to drain abscessed teeth.  Over time, prevention became the key to successful oral health and the toothbrush and toothpaste were developed.

The Past: Evidence of the first toothbrush suggests they were small twigs mashed at one end to increase cleaning surface. The first “modern” toothbrush found in China dates back to 1000 A.D. with bristles made from a horse’s mane and handles of ivory. Toothpaste has also been around since ancient times-however, not in the tube form that consumers now associate the product. The earliest toothpastes were mixtures of powdered fruit, burnt shells, talc, and honey as well as mice, lizard livers and urine. The first electric toothbrush was marketed in 1880, though the Swiss developed the first effective electric toothbrush just after World War II.  It was introduced in the United States around 1960.  A year later, the first cordless model was developed and proved to be popular with consumers and dentists alike. 

Today: Toothbrushes with angled heads, raised bristles, oscillating tufts and handles that change colors with use, along with tartar-control, whitening, sensitive and multi-care toothpastes are a few of the many options consumers encounter in the oral health care aisle.

With more than 3,000 toothbrush patents worldwide, sometimes choosing the best products from the myriad of options can be a dilemma for consumers.

The best toothbrush for most consumers is a small-head brush for easy access to the tooth surface with soft-rounded bristles that won’t hurt your gums.  Although there are many modern adaptations to the toothbrush, the small-head soft-bristle brush has proven to be the best choice for most patients for more than fifty years.

Although manual toothbrushes do an excellent job at cleaning your teeth, I still prefer electric toothbrushes for most patients who have difficulty with oral care at home, especially for people with limited manual dexterity and for those who wear braces.

As for toothpastes, most dentists recommend toothpaste with fluoride. Since fluoride’s introductions to toothpaste in 1956, there have been many new formulas created but fluoride is the most significant, proven effective in decreasing cavities and reducing plaque.  When asked which toothpaste is best to use, unless there are some specific needs or concerns the ideal brand is the one you like that has fluoride in it.

The Future: Testing is already in progress on toothbrush bristles that deliver medications through the bristles and powered cleaning devices that clean both accessible and inaccessible tooth surfaces–advancements that may help eliminate oral health disease such as decay and gum disease. But, until these products are proven safe and effective and are available to consumers, stick with the tried and true daily brushing with fluoridated toothpaste, flossing and healthy eating for warding off oral health problems.

As I have said many times before, taking a proactive approach to oral health care is one of your best defenses against the ravages of oral disease.  Fifty years ago patients went to the dentist when they had a toothache and couldn’t stand the pain; today visiting the dentist is a preventive measure in your oral health!  Have a great week and feel free to e-mail me at drlogan@drscottlogan.com if you have any questions.
 

 

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Tooth Decay and Its Causes

I haven’t met a patient yet who is excited when I let them know they have a cavity.  Imagine that!  Understanding decay and how it destroys teeth will go a long way in helping you have a good dental examination.  Tooth decay is the disease known as caries or cavities.  Unlike other diseases, however, cavities are not life threatening and are highly preventable, though it affects most people to some degree during their lifetime.

 

What causes tooth decay?
After eating and drinking, food particles are inevitably left in the mouth and on the surface of your teeth.  The bacteria in your mouth devour the food and a byproduct of their feast is acid.  The acid can eat a hole (or cavity) in the tooth’s enamel.  Left untreated the cavity can cause considerable pain, and destroy the dentin, pulp and the tooth’s nerve.  Thus, diet and nutrition play a major role in oral health and the incidence of tooth decay.

What foods cause cavities?
Many kinds of food can cause cavities.  Foods high in sugar, starch and carbohydrates are particularly problematic because they provide the bacteria with a high-energy source.  Also, sticky foods that adhere to tooth surfaces are a favorite of bacteria because it is a lasting food source.

Diet really does play a major role in the prevention of tooth decay.  Increased consumption of poor food choices increases the chances for tooth decay.  For example, according to the Department of Nutrition and Food Studies, soda consumption has increased from 22.2 gallons of cola per person per year in 1970 to more than 53 gallons per person per year in 2000!  When you realize the average canned soft drink has over 9 teaspoons of sugar in it, you can see a concern.

How are cavities prevented?
The acids formed by plaque can be counteracted by simple saliva in your mouth, which acts as a buffer and remineralizing agent.  A good way to stimulate saliva is chewing sugarless gum.  Gums which contain xylitol have been shown to fight the ravages of decay.  However, even though saliva is the body’s natural defense against cavities, it alone is not sufficient to win the battle.  The best way to prevent cavities is to brush and floss regularly.  To strengthen teeth and rebuild the early damage caused by plaque bacteria, we use fluoride, a natural substance which helps to remineralize the tooth structure.  Fluoride is added to toothpaste to fight cavities and clean teeth, but the most common source of fluoride is in the water we drink.  If you drink only bottled water, be sure to see if the manufacturer has added fluoride or you will be without.

What can I do to help protect my teeth?

1.       Cut down on sweets and between-meal snacks.  Remember, it’s these sugary and starchy treats that put your teeth at extra risk.

2.       Brush after every meal and floss daily.

3.       Drink plenty of fluoridated water and brush with a toothpaste containing fluoride.

4.       Chew sugarless gum, (with or without xylitol) after meals or snacks when unable to brush.

5.       Drink water throughout the day to help cleanse teeth of excess bacteria and food debris, and keep the mouth hydrated.  If you do eat meals or snacks containing sugars or carbohydrates, follow the meal with a rinse of water to do the same.

6.       See your dentist at least every six months for checkups and professional cleanings.  Because cavities can be difficult to detect, a thorough dental examination is very important.  Left neglected, cavities can lead to root canal infection, permanent deterioration of decayed tooth structure and even loss of the tooth itself.

This entry was posted in Prevention on by admin.

Tongue Scrapers Reduce Bad Breath

A few months back I wrote an article about bad breath.  In the article I mentioned that good oral hygiene played a major role in its prevention.  Bad breath is a common problem for many people, given the wide variety of substances traveling through our mouths daily. Some people avoid offensive foods and drinks, chew gum, use mouth rinses, or eat mints to mask unpleasant odor. Others cannot escape bad breath quite so easily. At least 40 million Americans suffer from halitosis. Unfortunately, there is no standard treatment for it.

According to a study in the September/October issue of General Dentistry halitosis is a term used to describe any disagreeable odor of expired air.  Bad breath is a generally accepted term for foul smells emanating from the mouth.  Oral malodor is a term reserved for unpleasant smells originating from the oral cavity.  Other than the several reasons I mentioned in the previous article, a common reason for bad breath is post-nasal drip.  It coats the back area of the tongue with bacteria-rich mucous.  For that reason, a tongue scraper is often effective in relieving oral malodor caused by sinus drainage.  I have found that almost everyone brushes their teeth, several floss, but very few utilize a tongue scraper.

The study reviewed literature examining the effects of using tongue scrapers to brush the tongue, rather than using a toothbrush to scrape the tongue.  Data revealed that a tongue cleaner/scraper demonstrated a significant difference in reducing volatile sulfur compounds (VSC) levels, which are produced when bacteria and amino acids interact to produce bad breath. 

Though there is no standard treatment, bacteria-causing halitosis can be reduced by brushing or scraping the middle and back of the tongue.  Tongue scraping can lower VSC concentration, subsequently reducing oral malodor.  The bad news however, is that reduction is only short-term, and not an absolute solution for eliminating malodor.  The authors of the General Dentistry article feel that future research is necessary to determine what role undetected odorants may play in oral malodor, as well as more well designed, randomized clinical trials to compare the effectiveness of tongue scrapers, toothbrushes, and mouth rinses on reducing VSC levels.

Despite the short-term reduction, tongue scrapers are a good tool for the short-term.  Tongue cleaners and scrapers are straightforward and comfortable to use, easy to transport, and inexpensively priced. Cleaning the tongue is quickly and easily accomplished. Everyone from children to elders should be able to incorporate this technique into their oral care regimen without too much concern.

Bad breath basics:

• Halitosis is a general term used to describe any disagreeable odor of expired air, regardless of its origin.
• Bad breath is a generally accepted term for foul smells emanating from the mouth.
• Oral malodor is a term reserved for halitosis originating from the oral cavity.

For those of you who suffer from bad breath (and even those who don’t), think about adding a tongue scraper to your home hygiene routine.  Have a great week and as always, e-mail your questions to drlogan@drscottlogan.com.

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Tobacco Cessation

Give Quitting a Chance: Tobacco Use and Cessation Facts

The last several weeks I have been talking about the ravages of oral cancer.  Just before that I had an article that related the increased amount of tooth loss in people who smoke versus those who don’t.  I won’t continue to harp on the subject of tobacco products and the problems they cause, but I want to relate some facts to all of you.  It has been found that smokers are likely to quit if advised to do so by a health professional so I am making one more attempt to encourage those people who utilize them to consider quitting.

According to the Centers for Disease Control and Prevention (CDC), more than 46 million Americans smoke cigarettes while nearly 9 million develop at least one serious illness in their lifetime due to smoking.  CDC also reports that tobacco use causes more than 440,000 deaths each year in the United States.  Smoking is the major cause of death in America, killing more people than alcohol, illegal drugs, car accidents, suicide, homicide and AIDS combined.  Here are some key tobacco use statistics:

  • Smoking is the most preventable cause of death in America
  • Of the 46 million Americans who smoke, 70% say they want to quit
  • One in every five deaths is attributed to tobacco use
  • The chance of heart attack decreases 24 hours after ending tobacco use
  • Nerve endings regenerate, enhancing the ability to smell and taste within 48 hours after stopping tobacco use
  • Two weeks to three months after quitting tobacco use, circulation improves, walking becomes easier and lung function improves
  • One year after ending tobacco use, risk of coronary disease decreases to half that of a smoker
  • Five years after quitting, the risk of stroke is reduced to that of a non-smoker
  • Former pack-a-day smokers can save $120 to $190 month
  • Spit tobacco is not a safe substitute for cigarettes
  • Spit tobacco contains nicotine, the same addictive drug in cigarettes
  • Spit tobacco can cause chronic bad breath, discoloration of teeth, gum disease and recession, tooth decay and tooth loss, high blood pressure and an increased risk of heart disease

I know it can be hard to quit smoking.  I have seen a lot of people try.  Studies show only 2.5% of patients are able to quit on their own.  If you need some help, consult your physician, dentist or even the world-wide web.  A couple of web sites you might try are www.adha.org (under their patient education section) or www.quitnet.com.  Both of these sites have plans to help smokers quit.  My prayers are with you and I wish you the best of success.

 

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Thumb Sucking and Pacifiers

Thousands of parents rely on pacifiers to calm and soothe a fussy baby.  For children under the age of one, the continuous sucking action is normal and healthy.  However, if parents allow children to continue using a pacifier after age one and into toddler years, this action becomes habit instead of a natural instinct and can be detrimental to a child’s oral health. 

Researchers have found no physiological reason why children should need a pacifier past the age of one, and report a trend that many prolonged pacifier users become prolonged thumb-suckers after the pacifier is taken away.

Prolonged use of the pacifier and thumb sucking can impede the natural development of teeth, the jaw and normal palate formation.  It is generally agreed that if the habit is discontinued before the age of five, no residual damage to the alignment of the teeth is likely to result, however, if the habit persists after the permanent teeth begin to erupt, some disfiguring consequences can occur.  Even with this information, it is best to stop by the age of one if at all possible. 

Pacifier use and thumb sucking can cause the upper teeth to protrude and the lower teeth to jut in.  For the first few years it is more of a social inconvenience, but as the upper front teeth protrude further, they become and easy target for trauma.  Unfortunately, I have seen too many fractured front teeth that “stopped a fall” because they stuck out too far. 

In addition to moving and shifting the teeth, studies show that pacifier users are more likely to suffer from acute middle ear infections.  Continuous sucking on a pacifier causes the auditory tubes to open abnormally, allowing secretions from the throat to seep into the middle ear.  This makes the ears more susceptible to the infection-causing bacteria and viruses.

Prolonged thumb sucking and pacifier use can also relate to tongue thrusting problems, breathing concerns and speech difficulties as well. 

What can be done to help a child stop?

First of all any habit breaking techniques are something to help the child, not a punishment!  Unless the child has an understanding of what needs to be done and wants to stop, it is an uphill climb to break the habit.  Parents must be willing to work with the child or the results may not be as good as expected.  With all of that said here are some things that can be tried:

  • Often, simply talking with the child and explaining the concerns will be all that is needed.
  • Place an over-the-counter bad tasting substance on whatever the child is putting in their mouth.  I’ve seen limited success with this method, but it can be successful.
  • Place a “Band-Aid” on the child’s thumb as a reminder.
  • “Sock method” – if the problem occurs at night while sleeping, place a sock over the child’s hand and lightly tape it to their wrist so the hand is covered and the thumb isn’t accessible.  Be sure not to tape it too tight where the circulation is impaired.
  • “Ace bandage technique” – Wrap a 3-inch “Ace bandage” around the child’s elbow joint.  The joint can still bend and the thumb can still be placed in the mouth, but as the child falls asleep, the pressure on the joint will straighten out the elbow and remove the thumb.  Once again do not wrap it too tight!
  • There are over-the-counter devices that can be utilized as well.  One is called the “T-guard”.  They are somewhat of a bother to put together, but can be effective.

 The bottom line is that if a child is utilizing the pacifier or sucking their thumb past the age of one parents should begin helping them stop.  It may save them a lot of concerns in the future.

This entry was posted in Pre Adolescence on by admin.

Temporomandibular Joint Disorders – Part 3

Happy, Happy New Year and may all your resolutions come true!  Last week I discussed several “at home” and over the counter treatments for temporomandibular disorders (TMD).  This week we will look into more advanced treatments when home care doesn’t give the results you need.  Depending on the diagnosis, people with TMD will receive specific types of professional therapy.  The treatment you receive will depend on the cause and how much discomfort you are having.

 

If your dentist doesn’t provide the following treatments he/she may refer you to another healthcare provider.

  • He/she may refer you for massage therapy and ultrasound treatment if the primary cause of your discomfort is muscle related.
  • Cold spray and stretching can also be utilized to relax the musculature.
  • Exercises and physical therapy to strengthen the muscles of the TMJ may be offered as adjunctive treatment as well.

 

The majority of the time treatment can be provided in the dental office.  Let’s talk about how the whole oral complex works.  The TMJ is part of a system that includes the teeth.  Because the joints and teeth work together, a problem with your teeth or bite can be linked to TMD.  If you clench/grind your teeth or have a bad bite your dentist can often help.  Some of the treatments include:

  • Bite splint therapy – A splint is an appliance that fits in the mouth.  It may also be called an orthotic, night guard or occlusal appliance.  There are different kinds of splints for different kinds of needs.  When adjusted properly, a bite splint will reduce pressure on the joints and align them in their most stable position.  This not only creates an environment for the joints to heal, but also protects the surfaces of your teeth from the stress of clenching or grinding.  They are typically worn at night when you sleep, but in some instances they are worn all day for short periods of time to allow the joints to heal.  Precise adjustment of the bite splint is critical.  Studies have shown the teeth can feel a discrepancy in the bite as small as 9 microns (that is really small!).  A precise adjustment is necessary for proper healing to occur.
  • Equilibration (bite adjustment) – malocclusion (bad bite) means the teeth don’t fit together properly.  A “bad bite” can result in pain and problems with jaw function.  An equilibration equalizes the forces on your teeth to minimize the ravages of grinding.  The teeth are adjusted and reshaped to fit together in positions where the forces are equally dispersed.  A good analogy is to think of it like your car.  If you don’t have the wheels properly aligned, the car will still run but the tires will wear or “blow out” a lot sooner than they should.  Your teeth are the same way.  If they aren’t “aligned” and adjusted to have the proper forces placed on them when your joints are in their most stable position they will still function, but will crack, wear, fracture, loosen and become sensitive long before their time.  Whenever there is excessive force on the system from clenching and/or grinding something will eventually fail.  If the teeth aren’t affected then it will typically be the TMJ or supporting bone and gums that give way.
  • Restorative treatment – If your bad bite is caused by missing or damaged teeth, your dentist may restore the teeth to proper function with crowns, bridges or dental implants.  Missing teeth often cause the remaining teeth to tip and shift.  This in turn requires the teeth to take more of a load than they were designed to withstand.  Losing a single tooth can cause huge problems over time, so carefully consider your alternatives if you ever think you want to have a tooth removed.
  • Orthodontic therapy – Sometimes the upper and lower jaws are out of alignment or the teeth are too far out of line, turned, crowded or spaced to allow equilibration as treatment.  Your orthodontist can align your teeth with braces or other orthodontic devices that will provide a more comfortable bite and joints. 
  • Joint Surgery – Surgery is very rarely needed in the treatment of TMD.  However, if other treatments haven’t worked, you may be referred to an oral and maxillofacial surgeon for evaluation.  Less than 1% of the patients with TMD will need this intervention.

 

I hope the last few weeks have helped your understanding of the temporomandibular joints and their disorders.  I also hope and pray that God will rain His richest blessings down on each of you during the new year.

 

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Temporomandibular Joint Disorders – Part 2

The Problem with Joint Sounds

 Merry Christmas to one and all!  I hope you are having a wonderful Christmas day.  Last week I talked about some of the symptoms and causes of temporomandibular disorders (TMD).  Many people never have discomfort in their TMJ even if joint sounds are present.  Unfortunately though, these warning signs can progress and get worse with time.  Patients may experience any or all of the following symptoms:

  • A jaw that “catches” and/or is difficult to move when opening and closing your mouth
  • Earaches without an infection
  • Ringing or a sense of fullness in one or both ears
  • Frequent headaches
  • Neck and/or shoulder pain
  • Sensitive teeth when no dental problems can be found
  • Jaw pain or a stiff jaw when chewing, biting, eating or yawning
  • Jaw pain or soreness that is more prevalent in the morning or late afternoon
  • A jaw that locks open or closed

 

The most important part of any treatment is proper diagnosis.  Your dentist will do a thorough examination to determine if the cause of your TMD is joint related.  This will typically include a health history and thorough assessment of your head and neck.  They will evaluate the musculature that allows the joints to function for pain, tension or tenderness, listen to the joints for specific types of sounds, evaluate the way your teeth function against each other when you chew, do range of motion studies to assure that TMD has not limited your jaw movements.  Every person with TMD is different and your dentist will tailor the treatment plan to your needs.  Some of the treatments may include:

 

A Little TLC 

Ever sprained your ankle?  If so, you know keeping weight off the ankle helps it to heal.  When injured, the temporomandibular joints (TMJ) need the same treatment.  That’s why self care is so important and home treatment can be very effective.  Chewing strains the TMJ.  When symptoms are bad, you may not be able to chew at all.  To get through times when your symptoms are worst, try these simple tips.

  • Choose soft foods to eat and stay away from chewing gum or anything hard.
  • Avoid opening wide to bite into foods such as apples, carrots and corn on the cob.  Instead, cut foods into bite-sized pieces.
  • Grind or finely chop meats and other tough foods.
  • Use ice and moist heat.  When symptoms first appear, apply a cold gel pack or ice wrapped in a towel to the joint for 15 to 20 minutes several times a day to numb the site.  After a couple of days switch to moist heat to relax the musculature.  The simplest way to apply moist heat is to fill a white tube sock (please make sure it is a clean one!) with the cheapest white rice you can get.  Tie a knot in the sock so you literally have a “sock full of rice”.  Place the rice filled sock in the microwave for approximately three minutes on high.  The sock will mold to your jaw and deliver moist heat for 30 to 45 minutes.  Do this as needed throughout the day.  You can use and reheat the same sock of rice over and over again.  I’ve had mine for several years now and use it any where I have a muscle strain.
  • Restrain yawns to avoid opening wide as this can irritate the joints as well.
  • Maintain good posture during the day when working at a desk or computer station.  Also consider an orthopedic pillow to support your head and neck while you sleep.
  • Manage your stress to reduce clenching and grinding your teeth.

Using Medication

Some medications used to treat TMD are available by prescription only, but others that can work very well are available over-the-counter.  The medication type and dosage will depend on the specific problem you have.  Some common medications include:

  • Anti-inflammatories and analgesics – Ibuprofen and other non-steroidal anti-inflammatory (NSAIDs) medications are often very effective.
  • Muscle relaxants – these medications are often used to treat pain by easing muscle tension. 
  • Antidepressants – At higher dosages, these medications are used to treat depression, but some can be given at very low dosages and often help relieve TMD symptoms when related to bruxism.

Next week I will discuss treatment alternatives that can be provided by your dentist and other health care professionals for the treatment of more severe temporomandibular disorders.

 

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Temporomandibular Joint Disorders – Part 1

The Snap and Crackle of a Fireplace 

Christmas is absolutely wonderful.  I love this time of year.  We even had the opportunity to hear the snap, crackle and pop of a beautiful fire during the cold spell.  I thoroughly enjoy the beauty and sound of a fireplace.  Although snaps and pops are great in a fire, they aren’t so great if the sounds are coming from your jaw!  Joint sounds are one of the most common recognized signs of temporomandibular disorders, commonly referred to as TMD.  While not all joint sound necessarily points to TMD, it could be an early sign and should always be checked out by your dentist. 

Your temporomandibular joints (TMJ’s) are the joints that slide and rotate just in front of your ear.  They are the points at which the lower jaw (mandible) attaches to your skull and are among the most complex joints in the human anatomy.  If you place your fingers on the sides of your face, just in front of your ears, open and close your mouth, you can feel the movement of the mandible in the temporomandibular joints.  It is here that TMD occurs.

The joint works properly when the lower jaw and its joint (both right and left) are synchronized during movement.  They are very complex joints in that unlike other joints of the body, they can move in all directions while functioning in harmony with the joint on the other side.  Because of this several are muscles involved: some to close, some to open, some to move forward and others to pull back.  Normal function for this group of muscles allows you to chew, swallow, speak, make facial expressions and communicate with little or no thought.

But, if all is not functioning properly, temporomandibular disorders can arise.  They are a collection of conditions characterized by pain in the jaw and surrounding tissues, joint sounds and limitations in jaw movements.  The National Institute of Dental and Craniofacial Research (NIDCR) states that over 10 million people in the United States suffer from TMJ problems at any given time.  While both men and women experience TMJ problems, the majority of those seeking treatment are women in their childbearing years.

A number of things can cause temporomandibular disorders.  Grinding your teeth or clenching them when your bite is not in proper alignment with the stable position of the jaw joints is often a cause.  Trauma to the head, face or jaws can be another cause for the concerns.  Various forms of Arthritis, genetics, hormones, low-level infections, auto-immune diseases, stretching of the jaw as occurs with inserting a breathing tube before surgery and believe it or not, bad posture can also lead to eventual TMD.  Stress plays a major role in joint inflammation and pain in the temporomandibular joints.  It isn’t unusual for me to see a lot of college students with painful jaws during this time of final exams! 

Diagnosing TMJ diseases and disorders can be complicated. For example, facial pain can be a symptom of many conditions, such as sinus or ear infections, decayed or abscessed teeth, various types of headache, and facial neuralgia (nerve-related facial pain).  In most cases a complete evaluation, including a detailed medical history, the patient’s description of symptoms, and physical examination of the head, neck, face and jaw provide information useful for making a diagnosis.  Next week I will go into more detail on causes and treatment of temporomandibular disorders.  I hope you have a blessed Christmas season. 

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Swimming and Your Teeth

Having grown up in Texas, I love the summer.  It’s a time to be outdoors, to play and have a good time at any number of different activities.  One thing my family and I absolutely love to do is go to the pool; as do most children I know.  The pool is great, but some common sense precautions should be taken to protect our teeth while having fun.  During the summer, swimming pool accidents are one of the major causes of dental trauma emergencies at the office.  Swimming underwater and quickly coming to the surface causes some children to hit the hard ledge, fracturing or loosening one or more teeth.  Also, even though we have been told hundreds of times not to do it, running on slippery, slick cement and ceramic pool surfaces sends many children headfirst into the ground.  Unfortunately, their front teeth often break the fall resulting in disaster.  Diving into shallow water not only is dangerous if someone hits their head, hitting the bottom can push a tooth up resulting in a fracture of segments of bone as well as the teeth.  As I mentioned, all of these take a little common sense to avoid, but kids will be kids and I still see summer accidents occurring quite often. 

Something many people who love to swim don’t think about is what water in the pool can do to the teeth.  People who spend a lot of time in the pool have some other things to think about other than avoiding contact with the side and bottom.  Competitive swimmers or those who swim a lot for exercise may be at risk for developing yellowish-brown or dark-brown stains on their teeth.  Athlete swimmers, who often swim laps more than six hours a week, expose their teeth to large amounts of chemically-treated water.  Pool water contains chemical additives like antimicrobials, which gives the water a higher pH than saliva, causing salivary proteins to break down quickly and form organic deposits on swimmer’s teeth.  The result is swimmer’s calculus – hard, brown tartar deposits that appear predominantly on the front teeth.  It’s a common cosmetic condition among swimmers.  It isn’t a major concern for a person’s oral health as long as the tartar is removed, but because of the cosmetic effects someone most likely won’t be winning any big, beautiful smile contests with it present on their teeth!  Avid swimmers who notice the stains should talk to their dentist and perhaps increase their dental visits for oral hygiene appointments to three or four times a year (or at least more often during the swimming season).

Swimming pools are a great place for exercise and play, but be careful not to let an accident put a damper on your summer fun.  Following the rules, using common sense and remembering dental first aid steps can help save your teeth the next time you get the opportunity to dive in and cool off.  I hope each of you has an incredible summer of fun.

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