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Posts for: November, 2021

By Browell & Murphy
November 21, 2021
Category: Oral Health
Tags: tmj disorders   jaw pain  
PersistencePaysOffinFindingReliefFromChronicJawJointPain

Tenderness; headaches; difficulty chewing; excruciating pain. These are a few of the symptoms you could endure with a jaw joint or temporomandibular disorder (TMD or TMJ). This group of disorders disrupts the daily lives of millions of people around the world.

This month is TMJ Awareness Month, to shed light on these debilitating conditions and how best to manage them. Although controlling TMD isn't always easy, it can be done with the right blend of treatments.

The temporomandibular joint—actually a pair of joints connecting the lower jaw to the skull on either side of the face—is "ground zero" for TMD. These are ball-and-socket joints similar to the hip or shoulder, but with a unique addition—a cushioning disk that lies between the adjoining points of the two bones that temper the forces generated when you eat, speak or bite down.

Researchers believe TMD can arise from a variety of sources, including traumatic injury, psychological stress or mechanical dysfunction within the joint and cushioning disk. These problems can create blood flow constriction, which in turn causes the accumulation of chemical waste byproducts in the jaw muscles. This in turn and cause the muscles to spasm and become inflamed and sore.

Treatments are also as numerous as the possible causes of TMD. But for the most part, they range along a continuum of conservative to aggressive approaches.

On the conservative end, doctors treat TMD as a joint problem and borrow heavily from orthopedics. These types of treatments include the use of anti-inflammatory and muscle relaxing medications, icing or heating, stretching exercises, physical therapy and massage. Dentists may also provide mouth guard appliances for patients with clenching or tooth grinding habits to decrease biting forces.

On the more aggressive end are interventions like orthodontics or dental work. But, while these were common recommendations 20-30 years ago, it's no longer thought to be necessary for treating most TMD disorders and should not be recommended as a cure or solution for TMD.  At the furthest extreme is actual jaw surgery to relieve symptoms or repair damage within the joints. The latter, however, has not yet amassed a solid track record, and should be considered as a last resort.

Finding the right combination of therapies to give consistent relief sometimes requires a bit of trial and error. Most doctors recommend starting first with the most conservative methods before considering more aggressive measures. You should also undergo a complete dental exam to see if teeth or gum problems are contributing to your symptoms.

TMD can make your life miserable. But with some persistence and patience, you can find what works for a life without pain and dysfunction.

If you would like more information about managing TMD, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Seeking Relief From TMD.”


By Browell & Murphy
November 11, 2021
Category: Oral Health
Tags: teeth grinding  
GetAheadofTeethGrindingtoAvoidHarmtoYourTeeth

We like to think we're more prone to stress in our modern, fast-paced world than those who lived in "simpler" times, but a finding from the recent discovery of Richard the III's remains in England suggests differently. Investigators noted the king had well-worn teeth, perhaps from grinding them out of stress.

We can't be sure this was the cause for the king's dental problems, or if teeth grinding was common in the 15th Century. But we are sure the problem exists today among adults.

Tooth grinding is the grinding, gnashing or clenching of teeth involuntarily when not engaged in regular dental functions like eating or speaking. It can occur while a person is awake, but most often while they're asleep.

The habit regularly occurs in children, but is not considered a major problem as most outgrow it by adolescence, usually with no lingering damage. Not so with adults: Because the habit generates abnormally high biting forces, teeth grinding can lead to accelerated tooth wear. It can also weaken teeth, making them more susceptible to fracture or disease.

People who grind their teeth will typically awaken with sore jaws or the complaints of family members about the loud chattering noise emitted during an episode. If you suspect a problem, you should see your dentist for a definitive diagnosis, and to learn how to reduce its occurrence and effects.

Treatments for the habit vary depending on underlying causes. They may involve lifestyle changes like quitting tobacco, limiting alcohol or altering your use of certain drugs or medications.  Because stress is often a major factor, learning better relaxation techniques through meditation, group therapy or biofeedback may also help reduce teeth grinding.

These treatments, though, can take time, so you may also need ways to minimize the effects of the habit in the meantime. One of those ways is for your dentist to create an occlusal guard that you wear while you sleep. The guard prevents the teeth from making solid contact, thus reducing the potential biting forces.

It's important, then, to see your dentist as soon as possible if you suspect you're grinding your teeth. Finding out as early as possible and then taking positive steps to stop or reduce its effect can save your teeth from a good deal of harm.

If you would like more information on teeth grinding, 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 “Teeth Grinding.”


RemovingaToothCouldHelpCorrectThisParticularBiteProblem

Dentists extract millions of teeth each year, mostly because of disease. But sometimes a healthy tooth is removed to gain a more favorable, long-term dental health outcome.

An example of this is extracting teeth for the sake of orthodontic treatment. This is often beneficial when treating bite problems caused by crowding, a condition in which not enough space on the jaw exists to accommodate all of the teeth coming in. When this happens, the limited space can force teeth out of their proper alignment.

Crowding also complicates correcting the bite problem with braces: As with the eruption phase, there's no available room for orthodontic movement. One solution that may arise after a detailed examination is to open up space on the jaw by removing some of the teeth.

Planning this kind of tooth extrication requires careful forethought with the end in mind—ultimately, the dental providers involved want the resulting appearance after braces to look as natural as possible. For that reason, dentists usually choose teeth for extraction that are outside of the "smile zone" (the teeth visible while smiling) like premolars and molars.

Additionally, dentists are concerned about bone loss after extracting the teeth. Bone often diminishes around empty tooth sockets, especially if those sockets were damaged during extraction. This loss in bone can weaken the jaw structure and cause significant problems while moving teeth with braces.

To avoid this, dentists take great care during tooth removal not to damage the socket. Additionally, they may place a bone graft within the socket immediately after removing the tooth, especially if the space will remain vacant for a significant period of time. A bone graft serves as a scaffold upon which new bone cells can form and accumulate.

After the extractions, the orthodontist may then proceed with correcting the bite. Patients may also need some form of prosthetic teeth to fill in the spaces while wearing braces. Often prosthetic teeth can be incorporated with the braces for a more natural look. After braces, any remaining gaps may require further restoration, either with dentures, bridges or, later in adulthood, dental implants.

Complex bite problems like crowding pose unique challenges in correcting them. But using techniques like tooth extraction can help achieve a successful and satisfactory outcome.

If you would like more information on treatments for bite problems, 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 “Tooth Removal for Orthodontic Reasons.”