Jaw pain and TMJ Disorders

The temporomanibular joints are a set of sophisticated hinges that allow us to open and close our jaws. They are constantly used throughout our waking hours to chew, swallow and express ourselves. Therefore, it is no surprise that pain and injury to these structures is not uncommon. Read on to learn more about what causes jaw joint pain and how to treat it!

The temporomandibular joints (“TMJs”) are a two hinging joints that allow the mandible to move against the Temporal bone of the skull. They have a complex movement, where the joint's head initially rotates in its socket and eventually slides forward to complete the movement. There are a number of muscles and ligaments that stabilize the TMJ, along with a cartilage disc that cushions and smoothens its action.

Most TMJ pain comes from acute injury to one of the attached joints or ligaments. Excessive gum chewing, staying open for a dental procedure and night time tooth grinding are all common culprits. Just like any other sprain, the best therapy is to allow the joint time to heal. Rest, ice packs, warm compresses and anti-inflammatory medicines like Ibuprofen are all great ways to get your jaw joints feeling great again.

Long-standing jaw pain, pain combined with a change in the joint’s range-of-motion  and pain after extreme trauma (like a car accident or physical violence) are signs of a more serious problem. The jaw joints or the cushioning disc can become dislocated, creating painful and limited motions. Fractures of the mandible can manifest as TMJ pain as well. Pain with new grinding or popping sounds can also be a sign of arthritic damage or traumatic disc displacement. In these cases, evaluation by an oral surgeon or oral-facial pain expert is the best course of action. This is also a good time to note that jaw popping without pain is usually not an emergent concern.

A final note on TMJ pain is that there are other medical conditions that can manifest themselves as jaw problems. Toothaches, ear infections and even sore throats can feel like jaw pain. Your best bet is to visit your general dentist for an initial evaluation and referral. To learn more about the jaw joints, TMJ disorders and other types of dental pain, please give our office a call!

Antibiotics in Dentistry

Antibiotic overuse is one of the most pressing issues in healthcare today. On top of the well-covered rise of MRSA infections, new strains of resistant bacteria are becoming more prevalent. With this in mind, clinicians around the world are working hard to cut back on antibiotic prescriptions and only use them when absolutely necessary. In the dental setting, many infections are not effected by antibiotics, and their use can potentially cause more harm than good. 

Most bacterial diseases of the mouth are addressed by either removing the bacteria or the "food source" for the infection. For example, a root canal works by disinfecting the inside of the tooth, removing the dead/dying tissue, and sealing the nerve canal with a rubber material. By cutting off the infection source, the immune system can naturally eliminate the bacteria from your body. Research has shown that adding antibiotics to this treatment does not improve healing or decrease chances of re-infection. Likewise, deep cleanings to treat periodontitis work by removing tartar/ infected tissue and giving the body a clean surface to reattach the gums and teeth. Again, the typical patient will not benefit from an antibiotic prescription (though antimicrobial rinses may be used to work locally in the mouth). 

Antibiotics are used in dentistry for instances of severe infection, pain and swelling that spreads away from the tooth. In these cases, the immune system may be "losing" its fight against the bacteria, and can benefit from some outside help. If you are prescribed antibiotics, take the entire bottle as directed, even if you start to feel better earlier. Finishing only part of a regimen puts you at risk for developing a new, stronger infection. For more information on dental infections, antibiotics and tooth pain, please give our office a call. 

How Can I Soothe a Toothache?

Note: Never start taking any medication for the first time (even OTC products) without consulting a medical or dental professional first. Never exceed the prescribed dosing for a medication or use it in a method for which it was not designed. 

Toothaches always seem to spring up at the least convenient times. Often enough, they show up 6pm on a Friday before a long weekend. When you can't get to a dentist right away, what should you do about your pain? In this article, we hope to give you some direction (and comfort) in helping your dental woes.

The first thing to do with any type of dental pain is give your general dentist a call. Even after hours, every office should have a means of getting into contact with either your own dentist or one of their associates. An exception to this would be excruciating pain, possibly combined with swelling, fever and warmth around a tooth. In these instances, your first choice should be to head to an emergency room, as this can be the sign of a serious infection. 

Beyond getting into contact with a dental professional, there are a few steps you can take to reduce your symptoms. If the pain feels like it is coming from a tooth directly, we suggest taking an NSAID medication like ibuprofen (Advil). Most dental pain comes from pressure inside the tooth or bones, and is best treated by drugs (such as ibuprofen) with anti-inflammatory properties. We do not suggest taking any left over narcotics you may have on hand, as they are potentially harmful and will not stop the pain as effectively as an NSAID. 

If your pain feels like it is coming from your gums, try flossing gently to see if you can dislodge any stuck food (popcorn kernels are the worst offenders). Beyond this, we recommend rinsing with warm salt water to soothe inflamed tissue. Never try to apply Asprin, Advil or other medications directly to the gums. This will only irritate the tissue and create more pain. We also suggest staying away from topical toothache creams/gels, due to their lack of effectiveness and potentially dangerous side effects.

If your pain has a specific trigger, make note of it and try to avoid using your teeth in that manner. Knowing what causes the tooth to flare up can be an important factor in diagnosing the exact problem. If you would like to know more about toothaches, dental pain or gum pain, please give our office a call! 

Technology and Root Canals

If you need a root canal, chances are you will be referred to one of the wonderful endodontists in our specialist network. With today's advances in dental technology, root canals are quicker, safer and more predictable than ever before. In many instances, these new products and techniques have allowed specialists to save teeth that were one destined for extraction. Take a look!

For starters, a root canal is a procedure performed on a tooth with an active infection or dead nerves. An opening is made in the top of the tooth and the innermost layer, called the pulp chamber, is thoroughly cleaned. The nerve canals (which follow the length of the tooth roots) are cleaned and shaped as well and filled with a resilient rubber material. After the root canal is finished, you will typically have to return to our office to have a crown placed on the tooth. 

One of the most important aspects of dentistry is being able to properly visualize the problem you are trying to fix. This is particularly challenging in the field of root canals, where the root shape and location makes diagnosis and treatment difficult. Today, cone beam CT scans can make this process much more straight forward. In these images, tooth roots, nerve canals and possible fractures are visualized in three dimensions. The endodontist can then accurately predict how he will perform his procedure before starting. 

Another important advancement in visualization is the use of dental microscopes in endodontic offices. The canals within your teeth can be as small as half a millimeter and vary in location from tooth to tooth. The microscope allows for much more accurate treatment and minimizes the risk of missed canals.

In the actual treatment of root canals, many advances have been made in the art of cleaning out the inner tooth. Flexible metal files shape the canals with ease while ultrasonic cleaners eliminate any residual bacteria. New materials create a better seal between the rubber filler and tooth while fending off recurrent infections. All in all, the entire process is now much more streamlined.

These technologies have helped make performing the root canal easier, which in-turn makes the patient experience more enjoyable. At any endodontist's office, your comfort is the most important aspect of the treatment. If you would like to know more about root canals, why teeth need them and how they are performed, please give our office a call.

Dental Questions: What can I do to make a toothache feel better?

Generally, toothaches are caused by inflammation of the nerve inside the tooth. The best way to temporarily relieve the pain is by taking a nonsteroidal anti-inflammatory over-the-counter medication such as naproxen sodium (Aleve) or ibuprofen (Motrin).  If the tooth is sensitive to temperature and biting pressure, then it likely needs a root canal to completely resolve the pain.  If there is swelling around the tooth or in the face, then the nerve inflammation has progressed to an infection and antibiotics and a root canal are required to fix the situation. 

You may be tempted to use over-the-counter toothache remedies such as topical anesthetic (Orajel). However, these medications are best used to treat sore gum tissue caused by ulcers or canker sores and will do little to remedy actual tooth pain. Remember, a toothache is caused by an inflammatory process that is occurring within the tooth (and not in the surrounding gums). Additionally, do not try crushing aspirin or other medications and placing them against the tooth area. These medications are only meant to be taken orally, and can cause serious chemical burns on the gum tissue and mucosa.