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Lloyd H. Alpert, D.D.S.
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Posts for: October, 2015

October 30, 2015
Category: Jaw
Tags: TMJ   TMD   Jaw Pain   Jaw Discomfort   Facial Pain   Ear Pain  

The Great Imposter: TMJ Dysfunction (The following article is a great tool in understanding your jaw, what a powerful force it is, and what happens when it's strained or not functioning properly)

For about 3 years, Sally heard clicking when she opened her mouth. It wasn't painful, so she didn't worry. But then the sides of Sally's face started to ache. She began having bad headaches and problems chewing and opening her mouth wide.

When the pain continued to get worse, Sally and her parents spoke with their family doctor. He referred Sally and her parents to a local dentist who specialized in jaw disorders. After examining Sally and asking her some questions, the specialist said Sally had a TMJ disorder.

What Are TMJ Disorders?

TMJ disorders are medical problems related to the temporomandibular joint (TMJ), the joint that connects the lower jaw to the skull. These problems can cause pain, difficulty chewing, and other issues.

You can feel your TM joints by placing your fingers directly in front of your ears and opening your mouth. What you're feeling are the rounded ends of your lower jaw as they glide along the joint socket of your temporal bone (that's the part of your skull that contains your inner ear and temple).

TMJ disorders can affect people of any age. Many people who have TMJ disorders are young women.

What Are the Signs and Symptoms?

There are lots of different types of TMJ disorders. So it follows that there are also many different symptoms. Some of the more common signs of a TMJ disorder are:

•Pain in the facial muscles, jaw joints, or around the ear. Some people also feel pain in the neck and shoulders, especially when they talk, chew, or yawn. Occasionally people with TMJ disorders may have muscle spasms.

•Popping, clicking, or grating sounds when opening or closing your mouth. (Some people hear these noises but don't have other symptoms. When that's the case, they may not have a TMJ disorder.)

•Difficulty chewing or biting.

•Headaches, dizziness, ear pain, hearing loss, and ringing in the ears (tinnitus).

•Trouble opening your mouth all the way or jaw locking. It is possible for the jaw to lock wide open or lock shut.

What Causes TMJ Disorders?

It's often not clear what causes a TMJ disorder, but many things can contribute to it.

Jaw clenching or teeth grinding can make a TMJ disorder more likely. When the joint is overworked, a disc can wear down or move out of place. Grinding and clenching also can cause the way the teeth line up to change, and can affect the muscles used to chew. Sometimes people don't realize that they're clenching or grinding — they may even do it during their sleep.

Stress can influence TMJ symptoms by making people more likely to grind their teeth, clench their jaw, or tighten their jaw muscles.

TMJ disorders are also more common in people with other dental problems (like a bad bite), joint problems (like arthritis), muscle problems, or a history of trauma to the jaw or face.

How Are TMJ Disorders Diagnosed?

If you're having symptoms of a TMJ disorder, let your dentist know. The earlier a TMJ disorder is diagnosed and treated, the better.

Your dentist will ask you questions and examine you. He or she may need to order imaging tests, like X-rays, a CT scan, or an MRI in order to see if you have a TMJ disorder.

Treating TMJ Disorders

If you do have a TMJ disorder, the pain may go away on its own in a few days. In the meantime, try to eat soft foods.

Avoid doing things that might aggravate the temporomandibular joint or face muscles, such as chewing gum, clenching or grinding your teeth, or opening your mouth extra wide when you yawn. Applying ice packs or heat on the side of the face may offer some relief.

If the pain is especially intense or does not go away on its own, see your doctor or dentist right away.

If your jaw gets locked open or shut, go to a hospital emergency room. Doctors may manipulate your jaw until you can open or close it. (Sometimes doctors will give people medication if it's needed to keep them comfortable during the procedure.)

Some treatments can help with TMJ disorders. For instance, if pain is caused by clenching your jaw or grinding your teeth, your dentist may fit you with a splint or bite plate to wear at night to help reduce clenching and grinding.

Sometimes doctors prescribe medication to help relieve the pain or relax the muscles. And if a problem with your bite is contributing to your TMJ disorder, your dentist may recommend braces or other dental work to fix the problem.

Occasionally, when the symptoms do not respond to other treatments, someone may need surgery to repair damaged tissue in the joint. But most people don't need surgery for a TMJ disorder.

What You Can Do

You can take control and help lessen problems from TMJ disorders by reducing stress through breathing exercises and getting plenty of exercise. Also, try to be aware of times when you might clench your jaw or grind your teeth.

You may notice you're clenching or grinding your teeth when you're under pressure — like during a test. However, lots of people clench or grind when they don't feel stressed — like while they focus intently on a task or push their limits during a workout or game. Just being aware of these habits is the first step to ending them.

Your dentist can give you more tips on avoiding the symptoms of TMJ disorders.

Reviewed by: Kenneth H. Hirsch, DDS –For Kidshealth.org

Date reviewed: July 2015


How Your Dental Visit Can Prevent or Detect Cancer

You may not think of your routine dental visit as a cancer screening test, but, in part, it is. Dentists and dental hygienists examine your mouth, tongue and surrounding tissue much more closely than you do and are most often the people who find pre-cancerous or cancerous lesions in early stages of growth.

A thorough oral cancer screening exam includes more than looking around your mouth. Your dentist will examine and feel your face, neck, lips, mouth, tongue, thyroid gland, salivary glands and lymph nodes for any abnormalities. If you have dentures or partials, they should be taken out to allow the entire mouth to be inspected.

People who smoke, use smokeless tobacco and drink alcohol are at higher risk of developing oral cancers. However, in recent years, oral cancers in younger people without these risk factors are on the rise. This is due to the prevalence of human papillomavirus (HPV), a sexually transmitted virus that is known to cause cancers of the oral cavity, cervix, anus, penis, vagina and vulva. (Learn more about HPV and oral cancers.) In addition, other cases occur in people with no risk factors at all, so screening is important for everyone.

Some dentists offer additional testing to detect pre-cancerous or cancerous lesions such as special lights. These are typically not covered by insurance and can cost 40-100$ out of pocket. The Journal of the American Dental Association published a review of these techniques, which found that there is insufficient evidence to support or refute the use of visually based adjunctive techniques. The study noted the importance of a thorough oral exam as the best method to detect oral lesions.

In addition to routine dental screenings, you should be aware of the potential signs of oral cancers and report these to your healthcare provider. Remember that many of these can be caused by non-cancerous (benign) conditions, but still warrant a trip to your healthcare provider for further investigation.

Signs to report:

•A sore that bleeds easily or does not heal

•A color change of the oral tissues

•A lump, thickening, rough spot, crust or small eroded area

•Pain, tenderness, or numbness anywhere in the mouth or on the lips

•Difficulty chewing, swallowing, speaking or moving the jaw or tongue.

Carolyn Vachani, RN, MSN, AOCN

 Abramson Cancer Center of the University of Pennsylvania


October 19, 2015
Category: Breath
Tags: Bad Breath   Mouth Odor   Halitosis  

11 Ways to Fight Bad Breath Naturally

By Barbara H. Seeber

EverydayHealth.com

What’s even more humiliating and socially unacceptable than the remains of a spinach salad speckled across a toothy grin? Yes, it’s bad breath.

Halitosis. A foul odor emanating from the mouth. It’s not a medical emergency, of course, but some 25 to 30 percent of the world’s population suffer with this distressing problem.

The origins of bad breath are not mysterious: dental cavities, gum disease, poor oral hygiene, coated tongue (a white or yellow coating on the tongue, usually due to inflammation) are among the most common. Hundreds of bacteria live in our mouths and some of them—on the tongue or below the gum line or in pockets created by gum disease between gums and teeth, for example—create sulfurous smells. Other causes may include malnutrition (fat breakdown gives your breath a fruity odor), uncontrolled diabetes, and dry mouth (saliva has an antimicrobial effect). Infections such as sore throat or sinusitis, or intestinal disorders, such as heartburn, ulcers, and lactose intolerance, also result in bad breath.

Bad breath can be intermittent as well. Food and drink, such as garlic, onions, coffee, and alcohol, can temporarily cause bad breath. Smokers also suffer from it. Whatever the cause, treatment involves correcting the underlying disorder—and/or perhaps trying a few easy solutions from 500 TIME-TESTED HOME REMEDIES AND THE SCIENCE BEHIND THEM.

Here are 11 ways to fight bad breath:

•If you wear dentures, remove them at night and clean to get rid of bacterial buildup from food and drink.

•Drink plenty of water and swish cool water around in your mouth. This is especially helpful to freshen “morning breath.”

•Brush after every meal and floss, preferably twice a day.

•Replace your toothbrush every two to three months.

•Arrange regular dental checkups and cleanings.

•Scrape your tongue each morning with a tongue scraper or spoon to decrease the bacteria, fungi, and dead cells that can cause odor. Hold the tip of the tongue with gauze to pull it forward in order to clean the back of the tongue.

•Chew a handful of cloves, fennel seeds, or aniseeds. Their antiseptic qualities help fight halitosis-causing bacteria.

•Chew a piece of lemon or orange rind for a mouth- freshening burst of flavor. (Wash the rind thoroughly first.) The citric acid will stimulate the salivary glands—and fight bad breath.

•Chew a fresh sprig of parsley, basil, mint, or cilantro. The chlorophyll in these green plants neutralizes odors.

•Try a 30-second mouthwash rinse that is alcohol-free (unike many off-the-shelf products). Mix a cup of water with a teaspoon of baking soda (which changes the pH level and fights odor in the mouth) and a few drops of antimicrobial peppermint essential oil. Don’t swallow it! (Yields several rinses.)

Or try this recipe from 500 TIME-TESTED HOME REMEDIES AND THE SCIENCE BEHIND THEM:

CRUNCH IT

Raw crunchy foods clean the teeth. Apples contain pectin, which helps control food odors and promotes saliva production. Cinnamon is antimicrobial. Active cultures in yogurt help reduce odor-causing bacteria in the mouth.

1 cup apple chunks

1 cup grated carrot

 1 cup diced celery

 ½ cup dried cranberries

 ½ cup crushed walnuts

 3 to 5 tablespoons plain nonfat yogurt

 Ground cinnamon

PREPARATION AND USE: Mix the apple, carrot, celery, cranberries, and walnuts together in a large bowl. Add yogurt by the tablespoon to moisten the mixture. Sprinkle with cinnamon. (Serves two.)

Save Your Breath!


Important Information About Baby Teeth: They Do Matter

A child's primary teeth, sometimes called "baby teeth," are as important as the permanent adult teeth.

When Do Baby Teeth Come In?

A baby’s 20 primary teeth are already present in the jaws at birth and typically begin to appear when a baby is between 6 months and 1 year.

When teeth first come in, some babies may have sore or tender gums. Gently rubbing your child's gums with a clean finger, a small, cool spoon or a wet gauze pad can be soothing. You can also give the baby a clean teething ring to chew on. If your child is still cranky and in pain, consult your dentist or physician. Most children have a full set of 20 primary teeth by the time they are 3.

Why Baby Teeth Matter

Not only do primary teeth help children chew and speak, they also hold space in the jaws for permanent teeth that are growing under the gums. When a baby tooth is lost too early, the permanent teeth can drift into the empty space and make it difficult for other adult teeth to find room when they come in. This can make teeth crooked or crowded. That’s why starting infants off with good oral care can help protect their teeth for decades to come.

When Should I Start Taking My Child to the Dentist?

The ADA recommends that a dentist examine a child within six months after the first tooth comes in and no later than the first birthday. A dental visit at an early age is a "well-baby checkup" for the teeth. Besides checking for tooth decay and other problems, the dentist can show you how to clean the child's teeth properly and how to evaluate any adverse habits such as thumb sucking.

How to Care for Your Child's Teeth

It’s important to care for your baby’s teeth from the start. Here's what to do:

    Begin cleaning your baby’s mouth during the first few days after birth by wiping the gums with a clean, moist gauze pad or washcloth. As soon as teeth appear, decay can occur. A baby’s front four teeth usually push through the gums at about 6 months of age, although some children don’t have their first tooth until 12 or 14 months.

    For children younger than 3 years, caregivers should begin brushing children’s teeth as soon as they begin to come into the mouth by using fluoride toothpaste in an amount no more than a smear or the size of a grain of rice. Brush teeth thoroughly twice per day (morning and night) or as directed by a dentist or physician. Supervise children’s brushing to ensure that they use of the appropriate amount of toothpaste.

    For children 3 to 6 years of age, use a pea-sized amount of fluoride toothpaste. Brush teeth thoroughly twice per day (morning and night) or as directed by a dentist or physician. Supervise children’s brushing and remind them not to swallow the toothpaste.

    Until you’re comfortable that your child can brush on his or her own, continue to brush your child's teeth twice a day with a child-size toothbrush and a pea-sized amount of fluoride toothpaste. When your child has two teeth that touch, you should begin flossing their teeth daily.

Mouth Healthy

American Dental Association


Easing Dental Fear in Adults

If you fear going to the dentist, you are not alone. Between 9% and 20% of Americans avoid going to the dentist because of anxiety or fear. Indeed, it is a universal phenomenon.

Dental phobia is a more serious condition than anxiety. It leaves people panic-stricken and terrified. People with dental phobia have an awareness that the fear is totally irrational, but are unable to do much about it. They exhibit classic avoidance behavior; that is, they will do everything possible to avoid going to the dentist. People with dental phobia usually go to the dentist only when forced to do so by extreme pain. Pathologic anxiety or phobia may require psychiatric consultation in some cases.

Other signs of dental phobia include:

• Trouble sleeping the night before the dental exam

•Feelings of nervousness that escalate while in the dental office waiting room

•Crying or feeling physically ill at the very thought of visiting the dentist

•Intense uneasiness at the thought of, or actually when, objects are placed in your mouth during the dental treatment or suddenly feeling like it is difficult to breathe

Fortunately, there are ways to get people with dental anxiety and dental phobia to the dentist.

What Causes Dental Phobia and Anxiety?

There are many reasons why some people have dental phobia and anxiety. Some of the common reasons include:

• Fear of pain. Fear of pain is a very common reason for avoiding the dentist. This fear usually stems from an early dental experience that was unpleasant or painful or from dental "pain and horror" stories told by others. Thanks to the many advances in dentistry made over the years, most of today's dental procedures are considerably less painful or even pain-free.

• Fear of injections or fear the injection won't work. Many people are terrified of needles, especially when inserted into their mouth. Beyond this fear, others fear that the anesthesia hasn't yet taken effect or wasn't a large enough dose to eliminate any pain before the dental procedure begins.

• Fear of anesthetic side effects. Some people fear the potential side effects of anesthesia such as dizziness, feeling faint, or nausea. Others don't like the numbness or "fat lip" associated with local anesthetics.

• Feelings of helplessness and loss of control. It's common for people to feel these emotions considering the situation -- sitting in a dental chair with your mouth wide open, unable to see what's going on.

• Embarrassment and loss of personal space. Many people feel uncomfortable about the physical closeness of the dentist or hygienist to their face. Others may feel self-conscious about the appearance of their teeth or possible mouth odors.

The key to coping with dental anxiety is to discuss your fears with your dentist. Once your dentist knows what your fears are, he or she will be better able to work with you to determine the best ways to make you less anxious and more comfortable. If your dentist doesn't take your fear seriously, find another dentist.

If lack of control is one of your main stressors, actively participating in a discussion with your dentist about your treatment can ease your tension. Ask your dentist to explain what's happening at every stage of the procedure. This way you can mentally prepare for what's to come. Another helpful strategy is to establish a signal -- such as raising your hand -- when you want the dentist to immediately stop. Use this signal whenever you are uncomfortable, need to rinse your mouth, or simply need to catch your breath.

Reviewed by Michael Friedman, DDS on May 22, 2014

 




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