Posts for category: Oral Health
We don’t often think about it, but eating is a multi-staged process. It starts, of course, with food that’s hopefully high in nutritional value. But you also need coordinated jaw action to chew and shred your food that when combined with the enzymes in saliva can then be effectively digested in the stomach.
But what if you’re unable to chew some foods because you suffer from chronic jaw pain and dysfunction? This is the situation for millions of people who suffer from problems associated with the jaw joints—temporomandibular joint disorders (TMD). It’s not just the chronic pain and discomfort TMD can cause that’s a real issue—it may also be preventing you from eating foods that are healthy for you.
Because TMD can make it difficult to open your jaws wide or causes pain when you bite down, you might especially have trouble with certain fruits and vegetables as well as many meats. Many people opt to skip otherwise healthy foods because they’re too difficult to eat. That, however, could lead to lack of proper nutrition in the long run.
But with a few techniques and modifications, you can still include many of these foods in your diet even when TMD discomfort flares up. For one, be sure to cut all your food portions (including toast) into small, bite-sized pieces. These should be small enough to limit the amount of jaw opening required to comfortably place the bite in your mouth and chew. When preparing your food, be sure to peel fruits and vegetables that have skin, which is often hard to chew.
You should also try cooking crisper fruits and vegetables to a soft, moist texture. Choose meat cuts, poultry or seafood that can be cooked to a tender, moist consistency—you can also use gravies and sauces to further moisten them.
And don’t forget to chew slowly. Not only does slower eating aid in digestion, it will help you avoid overworking your jaw joints.
With a few adjustments you can have a normal, nutritious diet and minimize the discomfort of your TMD symptoms. Continual healthy eating is a must for overall health and quality of life.
If you would like more information on reducing the impact of TMD on your life and health, 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 “What to Eat When TMJ Pain Flares Up.”
The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.
In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?
The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.
Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.
So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”
Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.
If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”
A third of people treated for cancer develop adverse side effects within their mouth. But while these effects can be devastating to teeth and gums, there are ways to minimize the damage.
Treatments like chemotherapy and radiation work by destroying cancer cells. Unfortunately, they may also destroy normal cells. The accumulation of this “collateral damage” ultimately affects uninvolved areas and organ systems of the body. Chemotherapy, for example, can interrupt bone marrow blood cell formation and decrease the body's ability to fight infection.
These ripple effects can eventually reach the mouth. It's not uncommon for cancer patients to develop mouth sores or see an increase in tooth decay or periodontal (gum) disease. The treatments may also inhibit saliva flow: because saliva neutralizes acid and provides other benefits that lower disease risk, dental disease is more likely to develop when the salivary flow is reduced.
The first step to minimizing these effects is to improve oral health before cancer treatment begins. An unhealthy mouth vastly increases the chances for problems during treatment. Cooperating with your cancer physicians, we should attempt to treat any diseases present as soon as possible.
During cancer treatment we should also monitor your oral health and intervene when appropriate. If at all possible, you should continue regular dental visits for cleaning and checkups, and more so if conditions warrant. We can also protect your teeth and gums with protective measures like antibacterial mouth rinses, saliva stimulation or high-potency fluoride applications for your enamel.
What's most important, though, is what you can do for yourself to care for your mouth during the treatment period. Be sure to brush daily with a soft-bristle brush and fluoride toothpaste. You can use a weak solution of one-quarter teaspoon each of salt and baking soda to a quart of warm water to rinse your mouth and soothe any sores. And be sure to drink plenty of water to reduce dry mouth.
While you're waging your battle against cancer, stay vigilant about your teeth and gums. Taking care of them will ensure that after you've won your war against this malignant foe your mouth will be healthy too.
If you would like more information on taking care of your teeth and gums during cancer 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 “Oral Health During Cancer Treatment.”
It’s estimated that between 10 and 40 million adults in the U.S. suffer from chronic jaw pain and disability. Healthcare providers refer to it as temporomandibular joint disorder (TMJD), a group of conditions characterized by pain and limited function with the jaw joints, as well as related muscles and tissues.
People with TMJD often experience popping, clicking or grating sounds when they move their lower jaw. The more serious symptoms, however, are severe pain and limited movement of the jaw. The causes of TMJD haven’t been fully substantiated, but it’s believed to be influenced by a person’s genetic background, their gender (most patients are women of childbearing age), their environment and behavioral habits. This uncertainty about the underlying causes has made it difficult to improve treatment strategies for the disorder.
One promising area of research, though, is suspected connections between TMJD and other health problems. In one survey of over 1,500 TMJD patients, nearly two-thirds indicated they had three or more other chronic conditions. Among the most frequently named were fibromyalgia, chronic fatigue syndrome, rheumatoid arthritis, and sleep disturbances.
We’re not quite sure how or why TMJD might be linked to these other conditions, but further study is underway. Researchers hope any knowledge uncovered could lead to advances in our ability to diagnose, treat and prevent TMJD.
Until then, the more traditional treatment approach remains the best course of action: medication to relax muscles and relieve pain; thermal therapies using hot and cold compresses during flare-ups; and physical therapy. Switching to softer foods temporarily may also give jaw muscles a rest from over-activity. Although jaw surgery is an option, we should consider it a last resort after other therapies have proven altogether ineffective in relieving pain and restoring function.
If you suspect you have TMJD, please visit a medical doctor first. Other conditions could mimic the symptoms of the disorder and would need to be ruled out first. If the diagnosis is TMJD, you’re not alone. You can receive information, support and updates on the latest research by visiting the TMJ Association at www.tmj.org.
If you would like more information on chronic jaw pain, 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.”
If you're one of over 30% of Americans who wince in pain when eating and drinking certain foods and beverages, you may have tooth sensitivity. Although there are a number of possible causes, the most common place to look first is tooth dentin.
Lying just under the enamel, dentin consists of tiny tubules that transmit sensations like pressure or temperature variation to the nerves of the inner pulp. The enamel, the gums and a covering on the roots called cementum help dampen these sensations.
But over-aggressive brushing or periodontal (gum) disease can cause the gums to shrink back (recede) and expose the dentin below the gum line; it can also cause cementum to erode from the roots. This exposure amplifies sensations to the nerves. Now when you eat or drink something hot or cold or simply bite down, the nerves inside the dentin receive the full brunt of the sensation and signal pain.
Enamel erosion can also expose dentin, caused by mouth acid in contact with the enamel for prolonged periods. Acid softens the minerals in enamel, which then dissolve (resorb) into the body. Acid is a byproduct of bacteria which live in dental plaque, a thin film of food particles that builds up on teeth due to poor oral hygiene. Mouth acid may also increase from gastric reflux or consuming acidic foods or beverages.
Once we pinpoint the cause of your tooth sensitivity we can begin proper treatment, first and foremost for any disease that's a factor. If you have gum disease, we focus on removing bacterial plaque (the cause for the infection) from all tooth and gum surfaces. This helps stop gum recession, but advanced cases may require grafting surgery to cover the root surfaces.
You may also benefit from other measures to reduce sensitivity:Â applying less pressure when you brush; using hygiene products like toothpastes that block sensations to the dentin tubules or slow nerve action; and receiving additional fluoride to strengthen enamel.
There are effective ways to reduce your tooth sensitivity. Determining which to use in your case will depend on the cause.
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: Understanding Your Options.”