Agony of the daily grind…

DO YOU wake up in the morning with an aching jaw, headache, and difficulty opening your mouth? You have probably been grinding your teeth.

Regular grinding, known as bruxism, can wear teeth away and almost rivals snoring on the annoyance scale.

- Stress is believed to be a major role in the condition and it is also linked to the non-alignment of the top and bottom teeth.

- The mind subconsciously tries to correct the position during sleep, triggering the grinding.

- Other causes include snoring and sleep apnoea, where the upper airway relaxes during sleep causing blockage of airflow.

- Drinking tea and coffee or alcohol before going to bed can also increase the chance of tooth grinding.

- Some may be unaware they are grinding away so it’s worth asking the dentist for a check-up.

- Damage to teeth can often be repaired and there are mouth-guards available to help protect from further damage.

You may have to wear this mouth-guard for life and it’s worth finding out if it needs to be renewed as your teeth change.

- If the grinding is due to misalignment you should talk to your dentist about a brace.

- Other possible remedies include hypnosis and behavioural therapy to allow you relax.

- Avoid chewing gum: the repetitive action of chewing is almost identical to the motion of the jaw during bruxism.

- Hold a warm, damp cloth to your face before bedtime to relax the jaw.

Painful Headaches And Jaw Pain?

Do you clench and grind your teeth? Are you waking up with painful headaches that radiate from your temples, ears or jaw? Do you have limited mouth opening? Do you have sensitive teeth, loose teeth or toothaches in the absence of tooth decay? Do you have crowns or cosmetic veneers that constantly come off and need to be re-cemented periodically? Do you have clicking or popping of your jaw joint?

If you answered yes to any of these questions, then you may be suffering from a common problem known as TMJ Disorder, an often misunderstood or misdiagnosed condition. In our 18 years of experience Downtown, we have successfully treated thousands of patients for this problem. Our experience has led us to believe that TMJ Disorder is prevalent in the Downtown population.

The Downtown patient works on average more than 40 hours per week and shoulders most of the responsibilities in the household. This results in high levels of stress due to the high pressures of daily life. There is no doubt that stress is a major factor in increasing the symptoms of TMJ, but contrary to what most people believe, it’s not the primary cause. The primary causes are reflexes that are triggered by the teeth that cause spasms of the numerous muscles of the jaw, neck and face.

Most joints of the body are fixed in a hinge axis. This is the same movement a door makes when it’s opening and closing from its hinge. The jaw joint is the only joint in the body that is able to slide out of its socket. Because it can do this, it’s able to deviate from its hinge axis and do the complex motion of chewing, an ability we all take for granted.

If teeth occlude (come together) at the hinge axis position of the jaw, most people would be fine. However, if the teeth developed in a position where the bite occludes outside this hinge axis, where the jaw is slightly protruded from the socket, then there is a potential for TMJ symptoms. The average person cannot tell if their bite comes together forward of this hinge axis, only observing that their jaw is intermittently sore or they have a sudden, uncontrollable urge to clench and grind their teeth. Only a properly trained dental professional can diagnose if the teeth are occluding outside of this hinge axis position.

The initial treatment for TMJ Disorder is relatively simple and noninvasive. However, it does require thorough care by a dental professional. We simply make a custom TMJ splint, adjusting it meticulously at several appointments so that the patient’s teeth come together on the device in the ideal hinge axis position. After achieving proper adjustment the splint will eventually neutralize the harmful reflexes. A mouth guard from a drugstore or by mail order will not resolve TMJ Disorder because it will be arbitrarily set to a bite position. After wearing a proper TMJ splint for only 48 hours, the TMJ patient will notice a difference. They will find that their jaw feels more rested, headaches occur less frequently and teeth sensitivity is resolved.

For the most part, TMJ Disorder can be managed with splint therapy. But fixing the bite itself could be required if an individual cannot wear a splint indefinitely, by either re-contouring certain teeth, doing crowns and/or veneers, doing orthodontic treatment or a combination of any of these treatments. But contrary to what most people have heard, there is an effective treatment for this disorder. At the same time, if not treated and ignored, it will worsen, resulting in breaking teeth, worsening gum disease and/or severe jaw joint damage requiring painful surgeries.

About Temporomandibular Joint Disorder

TMD is difficult to diagnose because the symptoms of TMD can mimic those of many other conditions. If you are suffering from jaw pain, you may have TMD.

Is your jaw giving you pain?

If so, you may have TMD. Tempomandibular jaw disease, or TMD, is a broad term for a collection of jaw conditions characterized by problems such as:

• Unexplained pain in the face, jaw or teeth
• Limitations in jaw movement

How is TMD diagnosed?

TMD is difficult to diagnose because the symptoms of TMD can mimic those of many other conditions. For example, facial pain can be a symptom of a sinus or ear infection, abscessed tooth, migraine or any type of nerve related facial condition. A dentist experienced in diagnosing and treating TMD, such as those at the Art of Smile Making, will perform a complete medical evaluation including a detailed medical history and physical examination of your face, head, neck and jaw areas before making a diagnosis and recommending a course of treatment for TMD.

What are the symptoms of TMD?

While symptoms of TMD vary, the most common symptoms include:

• Dull pain in the jaw joint or surrounding areas
• Problems using the jaw or inability to open the mouth comfortably
• Clicking, popping or grating sounds from the jaw joint
• Locking of the jaw upon opening the mouth
• A bite that feels uncomfortable, painful or misaligned
• Headache or migraine
• Neck, shoulder or back pain
• Swelling of the jaw or on the side of the face
• Dizziness
• Ringing in ears or hearing loss

How is TMD treated?

Treatment for TMD involves relaxation of the jaw muscles and restoration of the jaw joint back to its unstrained position. This can involve the utilization of plastic appliances or other adjustment of the teeth to correct any misalignments of the bite.

If TMD has been present a long time or if the patient is suffering severe trauma, more involved medical or dental procedures may be required. Because untreated TMD may result in increasing discomfort or arthritis of the jaw joint, early detection is the goal.

Who suffers from TMD?

It is estimated that over 10 million people in the United States currently suffer from TMD. Significantly, while both men and women experience TMD, approximately 90 percent of the patients seeking treatment for TMD are women in their childbearing years. Research indicates that women seek treatment for TMD at a higher rate than men and that women are more likely than men to report ongoing pain associated with TMD. Also, research performed by the NIDCR has documented a correlation between hormone replacement therapy and oral contraceptive therapy with pain treatment. This may explain why more women tend to suffer symptoms and seek help for TMD pain.

Can TMJ Cause Arthritis?

TMJ or temporomandibular joint is located right in front of the ears, right on the spot where the lower jaw and upper jaw meet. Open your mouth and feel the ball and socket joints in front of your ears. Close your mouth. The bones that are moving there are your temporomandibular joints. You see, these joints are used several times in a day. You use it when you eat, speak, yawn, and bite. Indeed, it is one of the most used joints in your body. The TMJ is a very complex joint. It is composed of a complicated array of muscles, bones, and tendons.

TMJ disorders or problems of these joints do occur. When that happens, stiffness, ear pain, headaches, clicking sounds, bite problems, and locked jaws can be expected. In worse cases, arthritis may also occur. TMJ can cause arthritis if not treated right away. The most usual underlying conditions of TMJ disorders are teeth grinding problems, habitual fingernail biting, too much gum chewing, dental problems, teeth misalignment, jaw trauma, and stress. It is very important that these conditions are addressed right away so that they won’t evolve into arthritis.
TMJ disorders have a set of symptoms. You know you have it if you experience recurring headaches. You would also feel facial pains from time to time. The pain may start on the joints and spread over the head and the face. It could get worse as you open and close your jaw. The contraction of the jaws is painful, more so if you’re exposed to the cold weather or relatively cold surroundings.

Patients of TMJ disorders would also experience ear pain. Half of the people with TMJ will have ear pain without any signs of infection. The pain is usually associated to the joints and it can be felt somewhere below or in front of the ears. If there were no ear drainage or hearing loss associated with the ear pain you’re feeling, then TMJ is the most likely culprit.

TMJ patients can expect to hear clicking, crunching, grinding, or popping sounds when they open and close their mouth. Pain may accompany these sounds too. Dizziness is also likely. People suffering from TMJ may experience balance problems and vague dizziness from time to time.

Tinnitus and fullness of the ear may also occur to people with TMJ disorders. Their ears may feel clogged or muffled. This feeling is compounded during airplane landings and takeoffs. Ear fullness is associated with the dysfunction of the Eustachian tube. Because of the hyperactive muscles in that part on people with TMJ, this symptom becomes almost natural. On the other hand, patients with tinnitus due to TMJ would experience relief from their condition once the joint disorder is resolved.

Improper brushing can be destructive for teeth and gums

We all know that we need to brush and floss every day. Proper brushing removes food debris and bacteria from the teeth. Improper brushing can be abrasive and destructive, causing problems like: receding gums, wearing away of the tooth root, sensitive teeth or weaker teeth. Sometimes it’s hard to tell if you’re brushing destructively, and brushing habits can be hard to break. To avoid destructive tooth brushing these are some factors to keep in mind.

Choose a soft toothbrush. A soft toothbrush also makes it much easier to remove the plaque below the gumline, where periodontal disease starts. You can make the bristles even softer by running hot water over them before use.

Use a pea-sized amount of non-abrasive toothpaste with fluoride. Toothpastes that are labeled “whitening” or “tartar control” can sometimes be too rough on receding gums and exposed roots, wearing away the root’s protective layer. You can be sure a toothpaste is non-abrasive if it’s labeled “sensitive.”

Use proper brushing technique. Angle the bristles of the brush along the gumline at a 45-degree angle and apply just enough pressure so the bristles slide under the gumline. Vibrate the brush while you move it in short back-and-forth strokes and in small circular motions.

Don’t brush too hard. If you’re not sure whether you’re pressing too hard, hold the end of the brush with two fingers. That will give you enough force to get the job done without doing damage. You can also check your brush bristles. If they are bent over or broken, you’ve probably been pressing too hard. If you find that you have a hard time brushing gently, consider using an electric toothbrush. Electric toothbrushes make it much easier to use less pressure.

Tooth abrasion is caused mainly from improper brushing but can also be caused by grinding your teeth, using your teeth as a cutting tool or chewing on hard objects. Tooth abrasion can occur gradually over a period of time or very quickly. Gradual tooth abrasion allows the body to reduce the severity of tooth abrasion as the body has sufficient time to repair itself. Quick tooth abrasion can cause irreversible damage to the pulp and lead to the consequences of tooth abrasion which not only include crooked teeth but also increase tooth sensitivity, infection and ultimately loss of the tooth.

Talk to your dentist about any of your concerns on brushing or other causes of tooth abrasion. Let them show you what you need to know to keep your mouth healthy and bacteria-free without damaging your teeth.

Neuromuscular Dentistry

There is a relatively new area of dentistry that deals with the whole mouth in a more holistic approach. It’s called neuromuscular dentistry. The word holistic is not a mystical new age shamanism, but simply means that the mouth and all its moving parts are taken into consideration when evaluating mouth pain; it is taken as a whole.

Neuromuscular dentistry is primarily concerned with treating a common disorder of the jaw joint known as Temporomandibular Joint Disorder, or TMD.

What is TMD?

It is a misaligned jaw joint. The jaw joint is in front of each ear. It’s where the lower jaw (mandible) meets the temporal bone of the skull. Inflammation and pain associated with this joint occur with regularity. A neuromuscular dentist diagnoses and treats TMD.

A Simple Guide On What Is TMJ

When people talk about things that are discussed a lot or about conditions and situations that involve words that are hard to pronounce, they usually use initials as a stand-in for the real words. This is especially common when it comes to talking about diseases or medical conditions.

One example of this is when people talk about the temporomandibular joint. Rather than saying the whole word every time they talk about it, they usually just say “TMJ.”

What is TMJ? What problems does a person face when they suffer from TMJ?

The temporomandibular joint is a ball and socket joint. It is located on both sides of your face and it is responsible for moving your jaw. Whenever you open or close your mouth (or move your lower jaw in a side-to-side), you are using the TMJ. Both parts of the joint (the ball and the socket) are cartilage-covered and are separated by a small sized disk. This disk is there to absorb a small amount of the shock that comes from using your TMJ and it helps with the joint’s free form movement.

Usually the TMJ will work without you having to worry much about it. Every once in a while, however, some people encounter severe problems when the joint fails to work correctly. Between five and fifteen percent of the population has problems with their TMJ at least once in his or her life. While a lot of the problems that most people experience aren’t severe, there are some people who have to deal with extreme problems when the TMJ fails to work correctly.

One of the most prolific problems with the temporomandibular joint is a clicking sound. While this isn’t considered severe or even classified as a real disorder it happens because the termporomandibular joint isn’t working correctly. Other intense problems that happen with TMJ are jaws that are not aligned correctly or an overly worked joint that has been worn down because its owner has been grinding his or her teeth or has a habit of chewing on pens or pencils. Problems with the TMJ can also cause uneven bites. Uneven bites can induce intense headaches or jaw aches with pain that radiates up into the ear area. These problems make eating incredibly uncomfortable and your jaw might hurt even when it is still.

If you are having problems with your TMJ, your dentist or physician can probably help you treat your problems. Often your dentist will refer you to an orthodontist because many of the problems associated with TMJ result from teeth that don’t line up correctly or inappropriate biting or clenching habits. While some problems are small and can be dealt with simply and matter of factly, other problems are more severe and will require extended dental and medical treatments.