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Posts for: May, 2019

By The Dental Connection
May 29, 2019
Category: Oral Health
Tags: tmj disorders   tmd   tmj  
AClearDiagnosisofJawPainisNeededtoDeterminetheRightTreatment

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.”


FanofSuperheroFilmBlackPantherBreaksSteelWirewithHerMouth

Some moviegoers have been known to crunch popcorn, bite their fingers or grab their neighbor’s hands during the intense scenes of a thriller. But for one fan, the on-screen action in the new superhero film Black Panther led to a different reaction.

Sophia Robb, an 18-year-old Californian, had to make an emergency visit to the orthodontic office because she snapped the steel wire on her retainer while watching a battle scene featuring her Hollywood crush, Michael B. Jordan. Her jaw-clenching mishap went viral and even prompted an unexpected reply from the actor himself!

Meanwhile, Sophia got her retainer fixed pronto—which was exactly the right thing to do. The retention phase is a very important part of orthodontic treatment: If you don’t wear a retainer, the beautiful new smile you’re enjoying could become crooked again. That’s because if the teeth are not held in their new positions, they will naturally begin to drift back into their former locations—and you may have to start treatment all over again…

While it’s much more common to lose a removable retainer than to damage one, it is possible for even sturdy retainers to wear out or break. This includes traditional plastic-and-wire types (also called Hawley retainers), clear plastic retainers that are molded to fit your teeth (sometimes called Essix retainers), and bonded retainers: the kind that consists of a wire that’s permanently attached to the back side of your teeth. So whichever kind you use, do what Sophia did if you feel that anything is amiss—have it looked at right away!

When Black Panther co-star Michael B. Jordan heard about the retainer mishap, he sent a message to the teen: “Since I feel partly responsible for breaking your retainers let me know if I can replace them.” His young fan was grateful for the offer—but even more thrilled to have a celebrity twitter follower.

If you have questions about orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Bonded Retainers.”


YourTeenagernotReadyforanImplantHeresWhatWeCanDoInstead

Losing a tooth can be traumatic, but a dental implant can dramatically turn that experience around. Providing functionality, life-like appearance and durability, implants stand out as the premier restoration for lost teeth.

For adults, that is. An older child or teenager with a missing tooth may need to wait a few more years for an implant. The reason: jaw development. A person's jaws, particular the upper jaw, continue to grow with most growth completed by early adulthood. Natural teeth with their periodontal attachments develop right alongside the jaw.

But because an implant attaches directly to the jawbone, its position is fixed: it won't change as the jaw grows and may gradually appear to sink below the gum line. That's why we wait to place an implant until most of jaw maturity has occurred after full jaw maturity. For females, we try to wait until 20 years of age and for males, usually 21 years of age. These are guidelines as some people mature faster and some slower, so a discussion with your dentist or surgeon is necessary to make an educated decision.

While we wait, we can install a temporary replacement for a child's or teenager's lost tooth, usually a partial denture or fixed modified ("Maryland") bridge. The latter affixes a prosthetic (false) tooth in the missing tooth space by attaching it to the back of natural teeth on either side with bonded dental material. It differs from a traditional bridge in that these supporting teeth aren't permanently altered and crowned to support the bridge.

During the time before implants we should understand that the area where the implant will be placed will undergo some bone deterioration, a common consequence of missing teeth. Forces generated as we chew travel through the teeth to stimulate renewing bone growth all along the jawbone. But with a lost tooth the chewing stimulation ceases at that part of the bone, slowing the growth rate and leading to gradual bone loss.

Fortunately, the titanium posts of dental implants stimulate bone growth as bone cells naturally grow and adhere to their surfaces. Before then, though, if the bone volume is diminished, we may need to graft bone material to stimulate bone growth that will enlarge the jaw bone enough for an implant to be placed.

It usually isn't a question of "if" but "when" we can provide your child with an implant for their missing tooth. In the meantime, we can prepare for that day with a temporary restoration.

If you would like more information on dental restorations for teenagers, 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 “Dental Implants for Teenagers.”