Fibromyalgia is a chronic condition that produces widespread pain and stiffness in the muscles and joints. The pain, muscle spasms and tingling it causes can disrupt sleep, alter moods and impair memory function.
Dealing with just this one condition can be overwhelming. But did you know 3 out 4 fibromyalgia patients also develop chronic pain and dysfunction involving their jaw joints? Known collectively as temporomandibular joint disorders (TMD), these jaw joint problems cause pain, muscle spasms and difficulty moving the jaws that can interfere with eating and speaking. TMD can also contribute to headaches and earaches.
Many researchers believe this prevalence of TMD among fibromyalgia patients stems from both conditions originating from the same primary cause—a malfunction within the central nervous system. In both cases, the brain and spinal cord may not be able to process pain signals in a normal fashion. This malfunction could also be generating and amplifying pain signals even when nerves are receiving no stimulation.
For decades now, the most effective treatment strategy for TMD has been to manage the symptoms with physical therapy and exercises, thermal therapy or medications. Relief for fibromyalgia has depended on medication and relaxation techniques like biofeedback therapy. But with the evidence of some connection between the two conditions, it may be helpful to coordinate treatment for both with a team approach involving all your healthcare providers, rather than treat them separately.
To that end, make sure both your dentist or physician treating you for TMD and your physician treating your fibromyalgia each know about the other condition. Consulting together, your healthcare team may find treatments (like certain drugs that counteract neurotransmitter imbalances) that might help reduce symptoms in both conditions. And cognitive-behavioral therapy, meditation and other therapeutic pain management techniques can help you cope with the pain.
Continued research into these two debilitating conditions and the possible links between them may have an effect on how we treat both. A holistic approach to treating them could be the wave of the future.
If you would like more information on the links between TMD and other chronic pain conditions, 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 “Fibromyalgia and Temporomandibular Disorders.”
Root canal treatments have suffered a bad rap over the years—and undeservedly. While we applaud root canal therapy for the millions of decayed teeth the procedure has saved, the worn-out cliché that it's painful still lingers on.
So, let's set the record straight: a root canal treatment doesn't cause pain, it most often relieves it. Let's look a little closer at what actually happens before, during and after this tooth-saving treatment.
Before: a tooth in crisis. Tooth decay can damage more than a tooth's outer enamel. This aggressive bacterial infection can work its way into a tooth's interior, destroying the nerves and blood vessels in the pulp, before moving on to the roots and supporting bone through the root canals. Untreated, this devastating process can lead to tooth loss. A root canal treatment, however, can stop the invading decay and save the tooth.
During: stopping the disease. The dentist first numbs the tooth and surrounding gum tissues with local anesthetic—the only thing you might normally feel during treatment is a slight pressure. They then drill into the tooth to access the inner pulp and root canals and remove all diseased tissue. Once the interior spaces of the tooth have been disinfected, the dentist then fills the empty pulp chamber and root canals with a pliable filling called gutta percha to prevent future infection.
After: preventing re-infection. With the filling complete, the dentist then seals the access hole. There may be some minor soreness for a few days, similar to the aftermath of a routine filling, which can usually be managed with over-the-counter pain relievers like ibuprofen. Sometime later, the dentist will normally finish the treatment with a new crown on the tooth. This accomplishes two things: It helps strengthen the tooth against stress fracturing and it provides another layer of protection against future decay.
Root canal treatments have an exceptional track record for giving diseased teeth a second chance. There's nothing to fear—and everything to gain for your troubled tooth.
If you would like more information on root canal treatment, 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 “Root Canal Treatment: What You Need to Know.”
A lot of cosmetic dental procedures focus on how teeth look: whether they're stained, chipped or otherwise disfigured. But a true smile makeover requires looking beyond individual teeth appearance and asking if they're properly aligned. Your teeth may be beautiful in and of themselves, but they could detract from your smile if they're not straight.
Orthodontics—the dental specialty dedicated to correcting poor bites—can be just as important to your smile appearance as veneers, crowns or other restorations. Cosmetic enhancement, though, isn't an orthodontist's only priority: a poor bite can interfere with dental function and oral hygiene, so repairing it and making sure the teeth "bite" together correctly is just as important to your health.
Your first step is to undergo a comprehensive orthodontic exam. Its purpose is two-fold: to diagnose the nature of your particular bite problem; and to determine if your mouth is healthy enough to undergo the necessary treatment to correct it. From here, your orthodontist will propose a treatment plan to correct your particular bite problem.
Although a number of orthodontic appliances may be used, the most likely tools employed will be either fixed braces or removable clear aligners. Both of these use the mouth's natural ability to move teeth by applying subtle pressure on the teeth and supporting periodontal structures for a period of time.
While braces are effective, if you're an adult or teenager and nothing in your bite situation would preclude their use, you may choose clear aligners. Aligners are a sequence of plastic mouth trays that are computer-generated based on the patient's mouth impression. Patients wear the trays in succession, each slightly smaller than the previous one, until they complete the series.
People often prefer aligners over braces for a couple of reasons. Unlike fixed braces, you can take them out of your mouth for eating, cleaning or special occasions. And because they're clear, they're nearly invisible to others and so less embarrassing than metal braces.
Whichever method, you'll be under the supervision of a trained dentist or orthodontist who will monitor your progress and make treatment adjustments as necessary to keep you on course. It takes a lot of skill to make sure the bite fits together correctly. Remember, the plastic aligner is always between your teeth. Making sure your teeth come together is something a dentist must supervise or else it may not allow your teeth to fit together properly. In the end, you could have an entirely new smile that's healthier and more attractive—let's just make sure the bite is correct as well.
If you would like more information on gaining a straighter, more attractive smile, 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 “The Magic of Orthodontics: The Original Smile Makeover.”
Calling someone "long in the tooth" is an unflattering way of saying they're getting old. The phrase refers to the effects of gum recession, in which the gums pull away from the teeth and cause them to appear longer. The problem, which makes the teeth vulnerable to disease as well as look unattractive, is a common problem for older people.
The most common cause for gum recession is periodontal (gum) disease. Bacteria and food particles, which make up dental plaque, trigger an infection. The deposits of plaque and calculus (hardened plaque) continue to fuel the infection as it continues to weaken gum tissue attachments.
As a result, the gums begin to lose their attachment to the teeth and pull away, exposing the root areas normally covered by the gums. Unlike the enamel-protected crowns (the parts of teeth you can see), the root is covered by a thin layer of material called cementum.
Although cementum offers less protection than enamel, this normally isn't a problem because the gums also act as a barrier against bacteria and other harsh aspects of the mouth environment. But without gum coverage, the root area becomes vulnerable to disease and is more prone to painful sensitivity.
Because gum disease is the main culprit, you can reduce your chances of gum recession by keeping your teeth clean of plaque through brushing and flossing, and regularly undergoing professional cleanings. If gum disease does occur, it's important to seek treatment as soon as possible: The earlier it's treated the more likely that any recessed gum tissues can regenerate.
If the recession is extensive, however, you may need clinical intervention to assist with its regrowth. This can be done by grafting tissue at the site that then serves as scaffold for new tissue to grow upon. Though effective, these microsurgical techniques are quite complex and involved.
So, if you suspect you have gum disease or recession, see your dentist as soon as possible for a full examination. It may be possible to restore your gums and enhance your smile.
If you would like more information on protecting your gum 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 “Gum Recession.”
First the bad news: Those nightly hair-raising sounds are indeed coming from your child’s bedroom—from your child. It’s the result of them grinding their teeth while they sleep.
But here’s the good news: the only likely harm is a lack of sleep members of your household might experience because of it. Teeth grinding is so prevalent among pre-teen children that many healthcare professionals consider it normal. But that doesn’t mean it can’t become a problem, so it’s worth monitoring.
Teeth grinding is part of a family of dental habits known as bruxism. It involves any involuntary movement of the teeth and jaws outside of their intended functions not associated with chewing, speaking or swallowing. Our main concern with any bruxism is the possibility for generating stronger biting forces than normal that could damage teeth and gums and contribute to jaw joint problems.
Teeth grinding can occur in adulthood, with stress seeming to be the major trigger for it. With children, though, it’s believed to be mainly caused by an immaturity of the child’s neuromuscular process that controls chewing. As this matures, most children will tend to outgrow the habit none the worse for wear.
But there are pediatric cases in which the generated biting forces are strong enough to cause damage. Teeth grinding is also prevalent in children who snore or breathe through their mouths, which could be a sign of a serious health condition called obstructive sleep apnea. And certain medications used to treat depression and attention deficit disorder (ADHD) may also contribute to teeth grinding.
Most of the time we can simply let the habit run its course. If, however, the child begins to experience abnormal tooth wear, headaches, jaw pain or other issues believed caused by teeth grinding, we may need to intervene. This could include a plastic night guard the child wears during sleep that prevents the teeth from making solid contact during grinding episodes. And children with signs of airway obstruction should be evaluated by an ear, nose and throat specialist.
It can be irritating or even distressing. But your child’s teeth grinding doesn’t mean you should be alarmed—only that you should keep your eye on it.
If you would like more information on teeth grinding and similar habits, 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 “When Children Grind Their Teeth.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.