Posts for: October, 2017
You have facial pain that just will not go away. Accompanied by stiffness and strange clicking and popping sounds, that discomfort centers on the two jaw joints under both your ears. Called the temporomandibular joints, these hinge-like joints can malfunction, causing what dentists and physicians call temporomandibular joint dysfunction or TMD. Your Burlington, VT, dentists, Dr. Paul Dunkling and Dr. Greg Penney can offer relief so you can eat, speak and smile normally again.
TMD is no joke
Besides persistent or transitory jaw pain, TMD sufferers also experience:
- Tinnitus, or ringing in the ears
- Jaw swelling and stiffness
- Inability to open and close their mouths easily
- Difficulty biting and chewing
- Dizziness or vertigo
- Ear pain
- Changes in dental bite
- Sensitivity to light
For unknown reasons, women in the 25 to 40 age group seem to suffer from TMD more than men do, says the National Institute of Dental and Craniofacial Research. Additionally, the pain may be inconsistent in frequency and varying in intensity, making diagnosis of this all too common malady very difficult.
Dr. Dunkling and Dr. Penney work with their TMD patients to actively listen to their symptoms, perform complete oral exams and take precise digital imaging to understand how the jaw joints are operating. After they gather all the facts, they formulate treatment options that make sense for the individual patient.
Common strategies include:
- A soft diet
- Over the counter analgesics
- Ice to the side of the face
- Relaxation exercises and physical therapy
- Orthodontic care to alleviate poor dental bites
- Placement of crowns or enamel resurfacing to even chewing surfaces
- Customized acrylic bite guards to cushion teeth from habitual clenching and grinding (bruxism)
Only the most extreme of cases warrant oral surgery to correct malformed and misaligned jaw bones.
If the symptoms described here sound like what you are experiencing, please contact Dunkling and Penney Dentistry today for a jaw pain consultation. The doctors and their caring staff love seeing patients smile when their discomfort finally is resolved. Call (802) 863-3479 for the Burlington, VT office. For Jericho, VT, phone (802) 899-3973.
Saliva probably doesn’t rate high on your amazement meter. You’re more likely to notice its absence and the dry irritation that results.
But you might be more impressed with this unsung bodily fluid if you knew all the things it does. It’s definitely a multi-tasker, performing a number of jobs (including aiding in digestion) that not only keep your oral health on track, but your general well-being too. And there are even new testing methods where saliva may even tell us when you’re not doing so well.
Here are 3 more tasks your saliva is doing for your mouth right now that truly makes it amazing.
Cleansing. Your teeth’s chewing action shreds food so it’s easier to digest. But that also leaves behind tiny particles in your mouth. Bacteria feast on these particles (especially carbohydrates like sugar) and produce acid as a byproduct, which can increase your risk of tooth decay. Saliva serves as a kind of “rinse cycle” for your mouth, helping to wash a good bit of these errant particles down your throat and away from hungry bacteria.
Defense. Speaking of bacteria, your mouth is home to millions of them. While most are harmless or even beneficial, a fraction can harm your teeth and gums. Saliva is your first line of defense, emitting an antibody known as Immunoglobulin A that targets these bacteria. Saliva also produces an antibacterial substance called lyzozyme that prevents bacteria from growing.
Enamel Protection. Although it’s the strongest substance in the body, your teeth’s enamel can’t withstand the effects of mouth acid, the by-product of bacterial feeding and growth. Acid levels naturally rise after eating; but even this sudden rise can begin the process of demineralization where minerals in enamel dissolve. Saliva saves the day by first neutralizing the acid and restoring the mouth’s normal pH in about thirty minutes to an hour. It also helps restore minerals in enamel, a process called remineralization. It’s all in a day’s work for this remarkable fluid.
If you would like more information on the importance of saliva to oral health, 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 “Saliva: How it is used to Diagnose Disease.”
Your teeth and gums have a highly sensitive network of nerves. But while it can signal even the most subtle discomfort we may not be able to identify the cause with pinpoint accuracy. As a result, tooth pain could indicate more than one kind of problem including a decayed tooth, root sensitivity, infected gum tissues (like an abscess) or a dying pulp signaled by diseased nerve tissue inside the tooth.
On the other hand, not all tooth pain is the same: it can be dull or sharp, continuous or intermittent. It can feel like a constant, throbbing ache or a sharp wince when you eat or drink something cold or hot, or when you bite down. These differences could point our diagnostic examination in the right direction.
For example, sharp, throbbing pain could indicate deep tooth decay, especially if it suddenly stops. That would likely mean the nerves within the tooth pulp under attack by the infection have died and can no longer transmit pain. The infection, on the other hand is still very much active — this usually requires a root canal treatment (cleaning out the pulp and root canals of diseased and dead tissue and filling the empty spaces) if we’re to save the tooth.
If, however, you’re experiencing sensitivity from temperature or pressure, we could be facing at least a couple of scenarios. For one, your tooth could be fractured. More likely, though, periodontal (gum) disease triggered by bacterial plaque has caused the gum tissues to shrink back (recede) from the affected teeth so that the sensitive dentin layer is exposed and no longer protected by the gum tissue.
If we diagnose gum disease, we’ll need to aggressively remove bacterial plaque from all tooth and gum surfaces. This procedure might require more than one appointment and the possibility of surgery if we encounter deep pockets of infection, especially around the roots. If gum recession is severe you may also need grafting surgery to replace the missing gum tissue or to re-cover the exposed areas of your teeth.
So, knowing the source of tooth pain will direct the course of treatment to follow. With proper treatment, though, the chances are good we can not only restore your teeth and gums to optimum health but we can end the pain.
If you would like more information on treating tooth 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 “Confusing Tooth Pain.”
A recent episode of “America’s Got Talent” featured an engaging 93-year-old strongman called The Mighty Atom Jr. The mature muscleman’s stunt: moving a full-sized car (laden with his octogenarian “kid brother,” his brother’s wife, plus Atom’s “lady friend”) using just his teeth. Grinning for host Howie Mandel, Atom proudly told the TV audience that his teeth were all his own; then he grasped a leather strap in his mouth, and successfully pulled the car from a standstill.
We’re pleased to see that the Atom has kept his natural teeth in good shape: He must have found time for brushing and flossing in between stunts. Needless to say, his “talent” isn’t one we’d recommend trying at home. But aside from pulling vehicles, teeth can also be chipped or fractured by more mundane (yet still risky) activities — playing sports, nibbling on pencils, or biting too hard on ice. What can you do if that happens to your teeth?
Fortunately, we have a number of ways to repair cracked or chipped teeth. One of the easiest and fastest is cosmetic bonding with tooth-colored resins. Bonding can be used to fill in small chips, cracks and discolorations in the teeth. The bonding material is a high-tech mixture of plastic and glass components that’s extremely lifelike, and can last for several years. Plus, it’s a procedure that can be done right in the office, with minimal preparation or discomfort. However, it may not be suitable for larger chips, and it isn’t the longest-lasting type of restoration.
When more of the tooth structure is missing, a crown (or cap) might be needed to restore the tooth’s appearance and function. This involves creating a replacement for the entire visible part of the tooth in a dental lab — or in some cases, right in the office. It typically involves making a model of the damaged tooth and its neighbors, then fabricating a replica, which will fit perfectly into the bite. Finally, the replacement crown is permanently cemented to the damaged tooth. A crown replacement can last for many years if the tooth’s roots are in good shape. But what if the roots have been dislodged?
In some cases it’s possible to re-implant a tooth that has been knocked out — especially if it has been carefully preserved, and receives immediate professional attention. But if a tooth can’t be saved (due to a deeply fractured root, for example) a dental implant offers today’s best option for tooth replacement. This procedure has a success rate of over 95 percent, and gives you a natural looking replacement tooth that can last for the rest of your life.
So what have we learned? If you take care of your teeth, like strongman Atom, they can last a long time — but if you need to move your car, go get the keys.
If you would like more information about tooth restoration, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Crowns & Bridgework.”