Posts for category: Oral Health
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.”
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.”
Kids get pretty inventive pulling a loose primary (baby) tooth. After all, there's a profit motive involved (aka the Tooth Fairy). But a young Kansas City Chiefs fan may have topped his peers with his method, revealed in a recent Twitter video that went viral.
Inspired by all-star KC quarterback Patrick Mahomes (and sporting his #15 jersey), 7-year-old Jensen Palmer tied his loose tooth to a football with a line of string. Then, announcing “This is how an MVP gets their tooth out,” the next-gen QB sent the ball flying, with the tooth tailing close behind.
It appears young Palmer was no worse for wear with his tooth removal technique. But if you're thinking there might be a less risky, and less dramatic, way to remove a loose tooth, you're right. The first thing you should know, though: Primary teeth come out when they're good and ready, and that's important. Primary teeth play an important role in a child's current dental and speech function and their future dental development. For the latter, they serve as placeholders for permanent teeth developing within the gums. If one is lost prematurely, the corresponding permanent tooth might erupt out of position and cause bite problems.
In normal development, though, a primary tooth coming out coincides closely with the linked permanent tooth coming in. When it's time, the primary tooth lets you know by becoming quite loose in the socket.
If you think one of your children's primary teeth is ready, clean your hands first with soap and water. Then using a clean tissue, you should be able to easily wiggle the tooth with little tension. Grasp the tooth with the tissue and give it a little horizontal twist to pop it out. If that doesn't work, wait a day or two before trying again. If it does come out, be sure you have some clean gauze handy in case of bleeding from the empty socket.
Normally, nature takes its course from this point. But be on the lookout for abnormal signs like fragments of the tooth left behind in the socket (not to be mistaken for the top of the permanent tooth coming in). You should also look for redness, swelling or complaints of pain the following day—signs of possible infection. If you see anything like this, make a prompt appointment so we can take a look. Losing a primary tooth is a signpost pointing the way from childhood to adulthood (not to mention a windfall for kids under their pillows). You can help make it a smooth transition—no forward pass required.
If you would like more information about caring for primary teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Importance of Baby Teeth” and “Losing a Baby Tooth.”
A scoop of ice cream is one of life's little pleasures. But for one in three Americans, it could be something altogether different—an excruciating pain when cold ice cream meets teeth. This short but painful experience that can happen when dental nerves encounter hot or cold temperatures is called tooth sensitivity.
A look at tooth anatomy will help explain why. Teeth are mainly composed of outer enamel, a layer of nerves and blood vessels within the tooth called the pulp, and dentin, a porous layer in between. The pulp nerves pick up temperature and pressure sensations from outside the teeth through a network of tiny passageways (tubules) in the dentin. Enamel muffles these sensations before traveling the tubules, which prevents overstimulation of the nerves.
This careful balance can be disrupted, however, if the enamel becomes eroded by acid from foods or beverages, or as a byproduct of bacteria. This exposes the underlying dentin to the full brunt of outward sensations, which can then impact the nerves and cause them to overreact.
This hyper-sensitivity can also occur around the tooth roots, but for a different reason. Because the gums primarily protect this area rather than enamel, the roots can become hyper-sensitive if they lose gum coverage, a condition known as gum recession caused mainly by gum disease or over-aggressive hygiene.
Besides using dental products that block nerve sensation, reducing sensitivity largely depends on addressing the underlying cause. If gum disease, the focus is on removing plaque, a bacterial film on dental surfaces that causes and sustains the disease. Stopping an infection allows the gums to heal and hopefully regain their original teeth coverage. More advanced cases, though, may require grafting surgery to foster gum regeneration.
If the cause is enamel erosion or other results of decay or trauma, we can utilize a number of treatments depending on the extent of tooth damage including cavity filling, root canal therapy or crowning. As a last resort, we may need to remove a tooth that's beyond reasonable repair.
If you've begun to experience sensitive teeth, it's important that you see us as soon as possible. The earlier we can diagnose the cause, the less invasive we can be with treatments to ease or even stop this most unpleasant experience.
If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity.”
Regular check-ups with your dentist can maintain your oral health and catch potential concerns, including oral cancer. Prevention and early treatment is key in managing this condition. Dr. Chad Slocum and Dr. Sara Lundgaard serve the Millcreek, WA, area at Penny Creek Family & Implant Dentistry, offering routine oral cancer screenings.
What are some warning signs of oral cancer?
- Difficulty swallowing
- Inflamed, red patches in the mouth
- White sores or lesions
- Dramatic weight loss
- Loose teeth or tooth loss
- Heaviness at the back of the throat
- Bleeding that comes and goes
- Changes in the voice
- Chronic hoarseness
- Having a hard time moving the structures of the mouth, like the tongue, jaw and cheeks
Since the mouth heals quickly, lesions or sores in the mouth should generally not take more than two weeks to heal. If your mouth has a growth, bump, or lump that will not go away, contact your dentist as soon as possible.
How can I examine myself at home before my appointment?
- Lift your tongue and check for any discolorations or changes in the texture of your tongue.
- Examine your lips and cheeks for any lumps
- Push two fingers down on the underside of the tongue. At the same time, push two other fingers up underneath the chin. Check to see if there are any bumps or changes in your chin.
- Check the palate of your mouth with your fingers to ensure it is smooth and lesion-free.
- Gently massage your neck to make sure your lymph nodes are not swollen
Have you been looking for signs but you are unsure about the result of your home test? No need to panic. Contact Dr. Lundgaard and Dr. Slocum at Penny Creek Family & Implant Dentistry in Millcreek, WA, at (425) 337-7300 to schedule a consultation.
By the time a person passes the half-century mark, they've done quite a bit of living: their share of ups and downs, successes and failures, and joys and sorrows. But while aging can take its toll on their physical and cognitive health, older adults still have much to offer from their life experience. It often falls to other family members to keep them in the best health possible—including their oral health.
Helping an older adult maintain healthy teeth and gums is crucial to their overall well-being. So in recognition of Older Americans Month in May, here are 4 tips for helping an older family member keep a healthy mouth.
Support their daily hygiene. Age-related physical and cognitive impairment can make the simple tasks of brushing and flossing much more difficult. You can help by providing an older family member with tools that make it easier for them to clean their teeth, like larger handled toothbrushes or water flossers. In some cases, you may have to perform their hygiene tasks for them, but it's worth the effort to reduce their risk of dental disease.
Watch for "dry mouth." If an older person complains of their mouth being constantly dry, take it seriously. Chronic dry mouth is a sign of not enough saliva, which could make them more prone to dental disease. The likely culprits, especially for older adults, are prescription medications, so speak with their doctor about alternatives. You can also encourage them to use saliva boosters or to drink more water.
Ask for oral cancer screens. Ninety percent of oral cancer occurs in people over the age of 40, with the risk increasing with age. Be sure, then, to ask for an oral cancer screen during their dental visits, presuming it's not already being done. Screenings usually involve visual and tactile examinations of the inside of the mouth and the sides of the neck, looking for unusual lesions, swelling or discolorations. The sooner oral cancer is found, the better the chances of a successful treatment outcome.
Have dental work checked. An older person may have acquired various forms of dental work like bridges, implants or removable dentures. Because these play an important role in their oral health, you should have their dental work checked routinely. This is particularly true for dentures, which can lose their fit and comfort over time. Dental work in need of repair makes dental function more difficult and can increase their risk of disease.
Given the depth of responsibility in caring for an older adult, it's easy to let some things slip by the wayside. Their oral health shouldn't be one of them—giving it the priority it deserves will pay dividends in their health overall.
If you would like more information about oral care for an older adult, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Aging & Dental Health” and “Dry Mouth.”