Posts for: September, 2018
Have you noticed a clicking, popping, or grating sound when you open or close your jaw? As many as 36 million U.S. adults experience this phenomenon in one or both of the joints that connect the lower jaw (mandible) to the skull.
While the sounds may be disconcerting, there’s generally no cause for concern in the absence of other symptoms. They’re most likely caused by a harmless shift in the position of the disk inside each temporomandibular (jaw) joint, and it can diminish or disappear entirely over time. But, if you’re also experiencing persistent discomfort, severe pain, or limited function in your jaw (which can include getting it “stuck” in an opened or closed position), then you may be suffering from a temporomandibular joint disorder — part of a complex set of conditions affecting one or both jaw joints, muscles and/or other surrounding tissues. (You may have heard the condition called TMJ, which is actually the abbreviation for the temporomandibular joint itself. Health care professionals prefer TMJD or TMD.)
Depending on the severity, TMD can interfere with your ability to speak, chew and even make facial expressions. The cause is unclear, but genes, gender, environment, stress and behavior are believed to play a role. It can also be symptomatic of a larger medical problem, such as fibromyalgia, which can produce pain all over the body.
Management Options for TMD
TMD traditionally was viewed as a bite problem (malocclusion) requiring mechanical correction — e.g., through orthodontic braces or surgery. But the current therapeutic model approaches TMD as an orthopedic problem (joint inflammation, muscle soreness, strained tendons and ligaments, and disk damage) and favors a sequence of conservative, reversible procedures — hot or cold compresses in the jaw area, soft foods, physical therapy/massage, medication, and/or a bite guard to decrease pressure on jaw joints from tooth clenching and grinding — prior to more aggressive, irreversible treatment alternatives.
If you would like more information about TMD, please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine articles “Seeking Relief from TMD” and “Chronic Jaw Pain and Associated Conditions.”
Dentures, removable restorations for missing teeth and gum tissue, can take a number of different forms, but are usually of two different types: complete and partial. A complete denture replaces all the teeth in a given arch. A removable partial denture (RPD), on the other hand, replaces several missing teeth while using the remaining teeth as support.
A common type of RPD formed of plastic is known as a “flipper” because it’s lightweight enough to be “flipped out” or moved around with the tongue. They serve an important purpose as a temporary appliance for use between periodontal treatment, implant placement and similar treatments before obtaining a more permanent restoration. In fact, they’re often referred to as “transitional” RPDs because they’re not designed for permanent tooth replacement.
Because of their low cost relative to other restorations, however, they often become the permanent choice for many people. While a well-constructed, properly fitting RPD in a healthy mouth can be an affordable alternative for people on modest budgets, their long-term use may increase the risk of dental disease and accelerated bone loss. Decades of research verify that people who permanently wear RPDs encounter more tooth decay and periodontal (gum) disease than non-wearers.
This is because the attachment points of a plastic RPD to remaining teeth increases bacterial growth, which can cause both tooth decay and gum disease. This doesn’t only endanger the survival of the remaining teeth, it can lead to bone loss that will affect the RPD’s fit.
While the better course is to consider RPDs as a stepping stone to dental implants or a fixed bridge, there’s an intermediary RPD constructed of cast vitallium or gold alloy that could be considered a permanent choice. These are even lighter weight than plastic and less obtrusive in their attachments in the mouth, which can reduce plaque stagnation and promote a better oral environment.
Regardless of your choice in dentures, it’s always important to maintain good consistent oral hygiene with daily brushing and flossing and semi-annual professional cleanings and checkups. Keeping a healthy mouth will help reduce your risk of dental disease and increase your satisfaction with your denture of choice.
If you would like more information on RPDs and other denture restorations, 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 “Removable Partial Dentures.”
Dental crowns are an essential means for restoring damaged or unattractive teeth. A well-crafted crown not only functions well, it looks and blends seamlessly with the rest of the natural teeth.
Crowns are artificial caps that cover an entire visible tooth, often used for heavily decayed or damaged teeth or as added protection after a root canal treatment. Most crowns are produced by a dental lab, but some dentists are now creating them in-office with computer-based milling equipment. On the whole, the various crowns now available function adequately as teeth—but they can vary in their appearance quality.
In the early to mid 20th Century the all-metal crown was the standard; but while durable, it could be less than eye-pleasing. Although more life-like dental porcelain existed at the time, it tended to be brittle and could easily shatter under chewing stress.
Dentists then developed a crown that combined the strength of metal with the attractiveness of porcelain: the porcelain fused to metal or PFM crown. The PFM crown had a hollow, metal substructure that was cemented over the tooth. To this metal base was fused an outer shell of porcelain that gave the crown an attractive finish.
The PFM reigned as the most widely used crown until the mid 2000s. By then improved forms of porcelain reinforced with stronger materials like Lucite had made possible an all-ceramic crown. They’re now the most common crown used today, beautifully life-like yet durable without the need for a metal base.
All-ceramics may be the most common type of crown installed today, but past favorites’ metal and PFM are still available and sometimes used. So depending on the type and location of the tooth and your own expectations, there’s a right crown for you.
However, not all crowns even among all-ceramic have the same level of aesthetic quality or cost—the more life-like, the more expensive. If you have dental insurance, your plan’s benefits might be based on a utilitarian but less attractive crown. You may have to pay more out of pocket for the crown you and your dentist believe is best for you.
Whatever you choose, though, your modern dental crown will do an admirable, functional job. And it can certainly improve your natural tooth’s appearance.