A blow to the face can result in a variety of injuries to your jaws and the temporomandibular joints (TMJs) that join the lower jaw to the skull. Only a thorough examination can determine the type and extent of the injury, and how to treat it.
The pain you feel in your jaw may indicate a direct injury, usually near the joint. This could mean the joint head (condyle) has dislocated, or moved out of the joint space. It could also mean you’ve fractured your lower jaw, most commonly just below the head of the joint.
Jaw pain can also indicate structures near the jaw and joint have been damaged and the jaw is indirectly affected. In some cases a damaged tooth may be radiating pain signals through the jaw (along similar nerve paths). More likely, trauma to soft tissue near the jaw joint has swelled with inflammation, putting pressure on the joint and temporarily stopping the condyle from seating fully in the joint space.
Any of these injuries can also cause painful muscle spasms, a defensive reaction from the body that causes muscles on either side of the jaw to limit movement preventing further damage (a natural splint, if you will). Thus, the pain may be compounded by a diminished range of motion when you try to chew or speak.
It’s important, therefore, to determine the exact cause of pain and limited movement before commencing treatment. Spasms and inflammation are usually treated with muscle relaxant drugs and anti-inflammatory pain relievers. In the case of a dislocation, gentle manipulation can ease the condyle back into the joint space. A fracture would require more extensive treatment, including repositioning broken bone and immobilizing the jaw from movement to allow healing. In the most severe cases, surgical treatment may be necessary to internally immobilize the joint.
If you sustain an injury that results in jaw swelling and pain, you should see us without delay. The sooner we can diagnose and begin the proper treatment for your injury, the less likely you’ll encounter long-term problems and the sooner you’ll be pain and swelling free.
If you would like more information on the causes and treatment of 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 “Jaw Pain.”
Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.
In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.
Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.
What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.
Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.
A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”
Allergic reactions aren't necessarily bad: they're your body's responses to possible threats from foreign substances. But the response can go too far and cause a reaction as minor as a skin rash or as life-threatening as a multi-system shutdown called anaphylaxis.
Anything can cause an allergy: animal fur, food, chemicals — or metals. Because metals play such a large role in dental care, it's only natural we're alert to the possibility of allergic reactions from a procedure.
But don't postpone your implants or other dental work just yet — the threat isn't nearly that ominous. Here are a few facts about dental metal allergies to help you sort it out.
Allergic reactions are rare for metals used in medical and dental procedures. Although reactions to metals in joint replacements or coronary stents leading to failure do happen, actual occurrences are rare. Most metal allergies manifest as a skin reaction to jewelry or clothing. It's less likely with medical or dental metals because they're chosen specifically for their compatibility with living tissue.
Amalgam fillings account for most dental work reactions. Dentists have used this multi-metal alloy for fillings and other restorations for well over a century. Tooth-colored resins are now used for most fillings, but amalgam is still used in less visible back teeth. It's very rare for a person to experience a reaction to amalgam, but when it does occur it usually results in minor inflammation or a rash.
Implant titanium isn't just bio-compatible — it's also osteophilic. Titanium is the perfect choice for implants not only because it's tissue friendly, but also because it's bone friendly (osteophilic). Once implanted in the jaw, bone cells naturally grow and adhere to it to create a more durable bond. Not only does the body usually tolerate titanium, it welcomes it with open arms!
While it's still possible for you to have an allergy to implant titanium, the chances are remote. In one recent study involving 1,500 implant patients, titanium allergies occurred in less than 1%. So the chances are high a metal allergy won't stop you from obtaining a smile-transforming restoration with dental implants.
If you would like more information on allergies and dental work, 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 “Metal Allergies to Dental Implants.”
When is the best time to floss your teeth: Morning? Bedtime? How about: whenever and wherever the moment feels right?
For Cam Newton, award-winning NFL quarterback for the Carolina Panthers, the answer is clearly the latter. During the third quarter of the 2016 season-opener between his team and the Denver Broncos, TV cameras focused on Newton as he sat on the bench. The 2015 MVP was clearly seen stretching a string of dental floss between his index fingers and taking care of some dental hygiene business… and thereby creating a minor storm on the internet.
Inappropriate? We don't think so. As dentists, we're always happy when someone comes along to remind people how important it is to floss. And when that person has a million-dollar smile like Cam Newton's — so much the better.
Of course, there has been a lot of discussion lately about flossing. News outlets have gleefully reported that there's a lack of hard evidence at present to show that flossing is effective. But we would like to point out that, as the saying goes, “Absence of evidence is not evidence of absence.” There are a number of reasons why health care organizations like the American Dental Association (ADA) still firmly recommend daily flossing. Here are a few:
- It's well established that when plaque is allowed to build up on teeth, tooth decay and gum disease are bound to follow.
- A tooth brush does a good job of cleaning most tooth surfaces, but it can't reach into spaces between teeth.
- Cleaning between teeth (interdental cleaning) has been shown to remove plaque and food debris from these hard-to-reach spaces.
- Dental floss isn't the only method for interdental cleaning… but it is recognized by dentists as the best way, and is an excellent method for doing this at home — or anywhere else!
Whether you use dental floss or another type of interdental cleaner is up to you. But the ADA stands by its recommendations for maintaining good oral health: Brush twice a day for two minutes with fluoride toothpaste; visit your dentist regularly for professional cleanings and checkups; and clean between teeth once a day with an interdental cleaner like floss. It doesn't matter if you do it in your own home, or on the sidelines of an NFL game… as long as you do it!
If you had chicken pox as a child, you're at higher risk for a painful viral infection later in life called shingles. Besides a painful skin rash and other symptoms that can develop, shingles could also affect your dental care.
About 90% of children contract chicken pox, a disease caused by the varicella zoster virus (VZV), which usually clears up on its own. But later in life, usually after age 50, about a quarter to a third of chicken pox patients will develop shingles.
The onset of shingles usually produces an itching or burning sensation on the skin that's either numb or overly sensitive to the touch. A red rash may ensue with crusty lesions, accompanied sometimes by pain, fever and fatigue. The rash often forms a belt-like or striped pattern along one side of the face or body.
For most patients this painful rash is the extent of their symptoms. But women who are pregnant, patients undergoing cancer treatment or people with compromised immune systems are at risk for more serious complications if they contract the disease. It's important for these at-risk patients to obtain a vaccination, as well as avoid contact with anyone with shingles.
Which brings us to your dental care: in its early stages shingles can be contagious, the virus passing to others through skin contact or by airborne respiratory secretions. That's why it's important if you're currently experiencing a shingles episode that you let us know before undergoing any kind of dental work.Â Even a routine teeth cleaning with an ultrasonic device could disrupt the virus and increase the chances of it spreading to someone else. We may need to postpone dental work until the virus is under control.
Antiviral drugs like acyclovir or famciclovir are highly effective in bringing the disease under control, especially if treatment starts within three days of the onset of symptoms. And don't forget the shingles vaccination: the U.S. Center for Disease Control recommends it for anyone 60 or older regardless of a past history with chicken pox.
See your physician as soon as possible if you begin to notice symptoms. Don't let shingles interfere with your life — or your dental care.
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