When it comes to chronic pain, one of the most common problems you can face is Temporomandibular Disorder (TMD), which was formerly known as Temporomandibular Joint Disorder (TMJ). TMD is a condition that can be tricky to diagnose because it frequently mimics other conditions. This is why many healthcare professionals refer to it as “the great imposter.” However, regardless of what it is called, the pain it causes is real and can become quite severe — especially if left undiagnosed and untreated.

To grasp the condition fully, you must first understand the TMD pain cycle. It can start with any traumatic, psychological, metabolic, or mechanical stimulant that causes spasm in the muscles that move the jaw joints (opening, closing, chewing, and even smiling.) This is because of the constricted blood supply to the muscles resulting in less oxygen along with the accumulation of waste products. This is followed by chemical changes in the muscles and a buildup of lactic acid due to muscle fatigue. Abnormal or involuntary muscle contractions or spasms lead to pain signals to the brain that can stop muscle movement. Depending on the severity, this cycle can repeat itself resulting in acute pain that may be extremely severe at times. The pain may then seem to disappear only to resurface again later. The good news is that our office has highly trained professionals who cannot only diagnose but also treat your TMD.

If you suffer from chronic jaw pain and feel that you might have TMD, please let us know so that we can address your concerns and conduct a thorough history and examination. Or if you are in constant or severe pain, contact us immediately to schedule an appointment. You can learn more about the signs, symptoms, and treatment options for TMD by reading the article “TMD — Understanding The Great Imposter.”

Having someone tell you that you have bad breath can be humiliating, but it can also be a sign that you need to see your dentist. Bad breath (or halitosis) can be a sign of an underlying dental or health problem, so before you run out and stock up on breath mints, make an appointment with our office. Using breath fresheners will only disguise the problem and not treat the root cause.

It's important to remember that if you have bad breath, you're not alone — it's the third most common reason people seek a dental consult. We use a systematic approach to determine the cause of your halitosis and offer a solution.

Causes: Ninety percent of mouth odors come from mouth itself — either from the food you eat or bacteria that may be present. Most unpleasant odors originate from proteins trapped in the mouth that are processed by oral bacteria. When left on the tongue, these bacteria can cause an unpleasant smell. Dry mouth, sinus problems, diet and poor oral hygiene can also cause bad breath. In rare cases, a medical condition may be the cause.

Treatment: The best solution will depend on determining the real cause of your halitosis. If bad breath emanates from the mouth, it most commonly is caused by gum disease or even tooth decay, which need to be treated to correct the problem. If halitosis is of systemic (general body) origin, a more detailed examination might be needed from a physician. But the solution may also be as simple as demonstrating how to effectively remove bacterial plaque from your teeth, or offer instruction on proper tongue cleaning. If the cause is gum disease, we may suggest a deep cleaning and possible antibiotic therapy.

Contact us today to schedule an appointment to discuss any questions you may have regarding bad breath. Read more about this topic in the Dear Doctor magazine article “Bad Breath: More Than Just Embarrassing.”

Just as you would expect, we highly recommend the use of protective mouthguards to anyone participating in contact sports or rigorous physical exercise. The primary reasons we feel this way are substantiated by evidence-based research and experience within our practice. If you don't think mouthguards are helpful, here are some facts you should know:

• Research conducted by the American Dental Association (ADA) found that individuals are 60 times more likely to damage their teeth when not wearing a mouthguard while engaged in contact sports or rigorous physical exercise. This shocking fact alone illustrates the importance of protective mouthguards.
• A study reported by the American Academy of General Dentistry (AAGD) found that mouthguards prevent more than 200,000 injuries to the mouth and/or teeth each year.
• Sports-related injuries often end-up in the emergency room; however, the US Centers for Disease Control (CDC) reports that more than 600,000 of these visits involve injury or damage to the teeth and mouth.
• In addition to the trauma of having a tooth (or teeth) knocked out, individuals who have suffered from this type of injury may end up spending $10,000 to $20,000 per tooth over a lifetime for teeth that are not properly preserved and replanted. This staggering statistic is from the National Youth Sports Foundation for Safety.
• While protective mouthguards were first used in the sport of boxing during the 1920s, the ADA now recommends their use in 29 (and growing) different high contact sports and activities. Some of these include acrobatics, baseball, basketball, bicycling, field hockey, football, handball, ice hockey, lacrosse, martial arts, skateboarding, skiing, soccer, softball, volleyball and wrestling.
• It used to be that only males were considered when it came to needing mouthguards. However, recent studies have revealed that the growing interest and participation of females in these same sports and activities makes it just as important for them to protect their teeth.

To learn more about the importance of mouthguards, continue reading the Dear Doctor magazine article “Athletic Mouthguards.” You can also contact us today to schedule an appointment or to discuss your questions about protecting your mouth and teeth. And if you have already suffered from a dental injury, let us evaluate the damage and work with you to restore the health and beauty of your teeth.

We in dentistry, advise parents to have an orthodontic evaluation some time before your child is 7 years of age. At this time, some of your child's adult teeth have come in and some primary (baby) teeth remain. This is a good time to check for developing problems. Treatment that begins while your child's teeth are coming in is called “interceptive orthodontics.” It provides an opportunity to achieve the best results in orthodontic treatment.

Once this evaluation takes place, it may mean that orthodontic treatment may need to take place in two-stages. A first phase of orthodontic treatment may prevent, intercept or minimize future orthodontic treatment. The first stage may be a process of guiding the growth of the jawbones that support the teeth. This is called “growth modification.” Then when the adult teeth have erupted through the gums, it may be time to do the second and final stage.

If a second phase of treatment is necessary it will probably require braces. These are small metal brackets that are bonded to the teeth. Thin flexible wires are threaded through them, and the wires are designed to push or pull on the teeth to provide a small amount of pressure that makes the teeth slowly reposition themselves within the jawbone. A light and controlled force pulling on a tooth causes new bone and ligament (the fibers that hold teeth in place) to be formed. These are living tissues that are constantly changing and remodeling themselves.

If you wait until your child's permanent (adult) teeth have all come in to start this process, it will be too late to correct some types of orthodontic problems, such as some types of malocclusions (“mal” – bad, “occlusion” – bite). It's better to work together with your child's stages of growth and development in order to have an optimum correction, both in looks and function.

You may be wondering whether a two-stage treatment costs twice as much. In fact, it is likely to be less expensive than a late one-stage treatment would be. Sometimes, the first stage may correct an underlying problem and make further treatment unnecessary. If a second phase is needed, it is likely to be easier and less costly.

Contact us today to schedule an appointment to discuss your questions about orthodontia for your child. You can also learn more by reading the Dear Doctor magazine article “Preventative & Cost Saving Orthodontics.”