Jaw Joint Disorder Treatments

The jaw joints, otherwise known as the temporomandibular joints (TMJs) are the most complex joints in the human body. They are acted on by the bodies strongest and most dense muscles and whilst chewing are subject to enormous forces in a multitude of different directions. It is perhaps a little surprizing then that most of the problems associated with these joints have nothing to do with eating.

Most frequently these problems emerge as a result of clenching or grinding the teeth. This can result from stress, head injuries, sleep apnoea, certain prescription medications (most notably a sub type of antidepressant medication, known a SSRIs – like Prozac, Zoloft, cyprimil, Lexapro etc, but also appetite suppressants like duromine, and stimulants like dexaphetamine) and also illicit drugs like ice, speed and ecstasy.

The pain associated with disorders of the TMJ can be intense, unrelenting and like most pain in the head and neck region, can refer to other parts of the head and face, making diagnosis at times quite tricky. Headaches are often associated with either the joints themselves or the muscles that act on them. In addition, in the immediate vicinity of the joints in the human skull, is the machinery for balance (middle ear) and hearing (outer ear), so it is not uncommon to have dizziness or tinnitus (ringing in the ear) associated with jaw dysfunction.

As a general rule, treatments for jaw joint problems can be pretty hit and miss. A long-time staple of dental treatment for jaw joint problems is a device known as an occlusal splint, which is effectively a wedge of plastic that keeps the jaws separated at night (usually). It is ultra-effective at protecting the teeth from damage, but nowhere near as predictable in relieving the jaw pain.

The unpredictability of the occlusal splint in treating the TMJ comes down to a number of factors. The anatomy of the individual is one. Given the enormous variety in shape of the human jaw, it’s not all that surprising that a one design fits all approach won’t necessarily work.

One feature common to almost all of the causes of TMJ disorders, is the excess tension in the chewing muscles. Tension in these muscles pushes the lower jaw into the joint, effectively squashing the disk and cartilage, and causing inflammation and pain.

Strategic use of our products can relieve the tension in these muscles, take pressure off the joints and allow them heal, no matter what the cause.

31st May : No Tobacco Day

Smoking and the effects on your dental health:

No tobacco day is the perfect opportunity to start minimising the amount you smoke and ultimately quit smoking!

The Centres for Disease Control and Prevention (CDC) reports that smoking is the leading preventable cause of death and disease in the United States. (https://www.colgate.com/en-us/oral-health/basics/threats-to-dental-health/what-you-need-to-know-about-smoking-and-oral-health-0814 )
People who smoke generally have a much higher rate of gum disease , complications after having teeth extracted and developing oral cancers.
The risk of tobacco related dental disease depends on how long you have smoked and the amount of cigarettes smoked daily however there are no healthy levels of exposure , even second hand smoke.

There are numerous benefits of stopping smoking not only for your dental health, but your overall health and wellbeing.

Dental Disease/ Complications Caused by Tobacco:

1: Oral Cancer :

Oral cancer is cancer of the mouth , including tongue, cheek , palate , floor of the mouth and lips. – Around 80% of oral cancer patients use tobacco.

Oral cancers are particularly dangerous due to the fact they are often not diagnosed until the later stages when it has metastasized to other parts of the body. Thus making it much more difficult to treat.
Symptoms include:

  • Swellings, thickness, lumps on lips, gums, tongue / other area of the mouth that to not go away.
  • White/ red patches in the mouth.
  • Unexplained bleeding.
  • Persistent sores on the face, neck, or mouth that bleed easily and do not heal.
  • Difficulty chewing, swallowing , speaking or moving the jaw.

2: Periodontal Disease:

Periodontal (gum) disease is disease that effects, the gums, ligaments and bone supporting the teeth. Build up of plaque and bacteria creates an immune response that causes inflammation of the gums and attacks the bone and supporting structures.
As gum diseases progresses more bone is lost from around the teeth ultimately causing them to become loose.

People who smoke less than 10 cigarettes daily are two times more likely to develop gum disease. This increases to four to five times more likely in heavier smokers.

Smokers are also at high risk of developing acute necrotising ulcerative gingivitis, also known as trench mouth- a painful gum condition which looks, smells and tastes terrible.

Smokers are also much less responsive to treatment of gum disease due to the bodies decreased ability to repair itself, encouragingly once people cease smoking the positive response to treatment increases.

Symptoms include:

  • Red , swollen, bleeding gums
  • Pain or tenderness of the gums
  • Discharge/ pus coming from the gums
  • Loose gums that fall away from the teeth
  • Bad breath/ bad taste
  • Loose teeth
  • Spaces opening up between teeth

3: Bad Breath/ Halitosis

With the increased incidence of gum disease also comes increased incidence of bad breath (halitosis).

Often smokers are not aware of the smell caused by excess tobacco. This will usually subside and improve once smoking has ceased.

4: Stained Teeth

The nicotine in tobacco will quickly cause the teeth to darken or go yellow, this will occur whether you smoke or chew tobacco. While staining is not detrimental to the health of the teeth it can often be difficult to remove as the tar settles into the small cracks and grooves of the teeth.

5: Black Hairy Tongue

Black hairy tongue is a harmless oral condition that gives the tongue a dark furry appearance. Although being harmless black hairy tongue can be quite unsightly.

Hairy tongue occurs from a build up of dead skin cells on the surface of the tongue that contains papillae (taste buds). Tobacco is one of the main contributing factors .

usually black hairy tongue can be resolved by eliminating the contributing factors as well as good dental hygiene.

Dental Care for Smokers:

If you are a smoker there are a few important things to remember when looking after your oral health;

  • Try to stop smoking ; this is the number one biggest factor in improving the health of your mouth, teeth and gums. Your doctor or Quitline are available for help and support.
  • If stopping completely is too hard; At the very least try to reduce the amount you are smoking daily.
  • Thoroughly brushing with fluoridated tooth paste twice a day. Do not use an abrasive (Smokers) toothpaste as it will damage the gums and roots of your teeth.
  • Use dental floss or interdental brushes to clean in between your teeth.
  • Visit your Dentist/ Hygienist regularly for preventive dental care.
  • Drink plenty of water.
  • Limit alcohol intake.

Where To Get Help on Your Journey to Quitting:

  • Your Doctor
  • Dentist or Healthcare professional
  • Australian Dental Association Tel. (03) 8825 4600
  • QUITLINE: Tel. 13 7848 (13 QUIT)

Floss the teeth you want to keep!

Every time you go to see your dentist or hygienist you probably dread those four little words, ‘have you been flossing?’ Let me assure you it is always asked with good intentions.

So why do we care so much about flossing?

As health professionals we aim to have your best interest at heart – your general health. Over the years research has come a long way and there is more evidence to support the links between oral health and general health. With that in mind you should be eager to learn ways that will help to prevent tooth decay, gum disease or better yet heart disease!

The bristles of your tooth brush (despite ‘flossing action’ toothbrushes) do not go into those tiny little spaces between your teeth. Brushing alone is not sufficient to prevent tooth decay or gum disease.

It is becoming more and more common for people to present to our surgery with incipient (early) lesions between the teeth. This is easily prevented with flossing and the right home care.

When should I floss?

Flossing once a day is recommended. It only takes 48 hours for plaque to calcify making it impossible for your toothbrush or floss to remove the calcified plaque – tartar.

Research shows that flossing is most effective if carried out of a night time before bed.
We know that bacteria naturally resides in the mouth making it like a feeding ground for the bacteria to grow if not removed within a timely manner.
During the day our saliva plays a vital role in removing plaque. This is significantly reduced overnight.
If not removed plaque is highly acidic. This leads to a break down in tooth enamel and furthermore tooth decay.

We always encourage our patients to brush thoroughly before bed. Not brushing or flossing prior to bed means that the bacteria thrive and basically have a party in your mouth while you sleep!

Is there anything else I can use to clean in between my teeth?

Yes! When you attend our practice for your regular preventative care appointment we will show you alternate devices for cleaning in between your teeth. We know that not everyone finds flossing to come naturally.

These can include: flossettes, interdental brushes, or even water flossers.

My gums bleed everytime I floss

We hear this phrase day in day out. When we see you for your dental check up we will revise the technique with you. More often than not bleeding is not caused by flossing incorrectly.

Inflammation of the gums, otherwise known as gingivitis is what causes bleeding of the gums. As a general rule if you notice bleeding when flossing it is usually a good indication that you need to floss more regularly.

Flossing takes up to much time

The most common excuse we hear on a regular basis when it comes to flossing is: ‘I just don’t have enough time.’ So basically what you are trying to tell us is that for two minutes in a 24 hour period that you don’t have time to floss? If that is the case why not floss whilst watching TV?
With practice flossing takes less than one minute to go around the whole mouth.

Medical conditions that rely on good oral health

When your mouth is healthy, chances are your overall health is good too. On the other hand, if you have poor oral health, you may have other health problems. The most common diseases linked with oral health include, but are not limited to:

  • Diabetes
  • Heart disease
  • Immune disorders

Just remember, a healthy mouth equals a healthy body and if you would like to keep your teeth for the rest of your life then simply ‘floss the teeth that you would like to keep!’

Oil Pulling and Oral Health

Oil pulling for dental health is a practice originating almost 3000 years ago from traditional Ayurvedic and Hindu medicine.
The practice involves swishing the oil through the mouth for approximately twenty minutes a day, the idea is that by swishing/ pulling the oil through the mouth the bacteria involved in causing plaque, gingivitis and decay bind to the oil before being expelled. Some people also believe this practice can whiten the teeth in the process.

Is there any scientific proof?

Oil pulling is an ancient method for maintaining oral health used well before tooth brushes and tooth paste. Science has shown the oral micro-organisms inhabiting the mouth are single celled with a lipid (fatty) membrane – this fatty membrane will bind to fat/ oil. Coconut oil has risen in popularity due to the fact it is 50% lauric acid. Lauric acid is known to inhibit strep mutants, the primary bacteria involved in tooth decay.

However, technology has advanced well past this so there are more efficient hygiene methods.
Scientists have developed detergents and abrasives such as calcium carbonate and hydrated silica which are much more effective in the removal of plaque whilst also protecting the enamel of the tooth from erosion.
While oil pulling can help expel some oral bacteria, it does not possess the same benefits to the teeth as fluoride contained in toothpaste.
Most modern toothpaste has from 1000 to 5000 parts per million fluoride which has been scientifically proven to provide numerous benefits to the health of the teeth; including prevention of tooth sensitivity, reversing the signs of early tooth decay and remineralisation of weakened tooth structure.

The American Dental Association has noted there is not enough current scientific evidence to support the practice of oil pulling as an ideal dental therapy alone, but can be used to reduce oral bacteria in conjunction with traditional dentistry, toothbrushing, fluoridated tooth paste and regular flossing.
Reducing the amount of sugars consumed in the diet will further reduce the rate of decay and acid producing bacteria in the mouth.
In terms of whitening the teeth, there is no evidence to support oil pulling as an effective method. Perhaps people have noticed an improvement in extrinsic tooth staining due to the reduction of yellowish plaque and bacteria. Hydrogen peroxide products are the most effective for teeth whitening and improving the intrinsic colour of the teeth.

Overall, if oil pulling is a practice you have been considering incorporating into your daily routine it won’t do you any harm and can possibly reduce harmful oral bacteria. However, we would remind you that the most important oral health practices are brushing, using fluoridated toothpaste , flossing and regular preventive dental visits . Oil pulling would be the lowest priority for oral health but does have some merit!

Links between Oral Health and your General Health

In today’s day and age there are more valid reasons why we need to brush, floss and see our dentist or hygienist on a regular basis (and that is not just for a healthy mouth). There are an increasing amount of studies that show the strong link between oral health and serious chronic diseases, these are providing more and more information on how our oral health is essential to our general health and well being.

When you lay back and look at the T.V. in one of our rooms with your mouth wide open, our dental professionals are checking for much more than just cavities. Your mouth tells us many things, particularly the health of your gums. There are a number systemic conditions that can show signs in your mouth before you even feel any symptoms, this can range from stress, the flu, vitamin deficiencies, diabetes to oral cancers.

We have complied a small list of medical conditions which have a close relationship with our oral health.

Medical conditions are linked to oral health

The health of your mouth can contribute to various diseases and conditions, some of the most commonly known links include:

  • Endocarditis – An infection of the inner lining of the heart. This typically occurs when bacteria from your mouth enter the bloodstream and attach to damaged areas of the heart.
  • Cardiovascular disease – Bacteria in the mouth not only causes inflammation in the mouth but can also cause inflammation throughout the whole body, including the arteries. Research shows that inflammation due to bacteria plays a role in clogged arteries and blood clots
  • Stroke – Usually an obstruction or clot within a blood vessel which supplies blood to brain. Commonly a condition developed by fatty deposits lining the vessel walls in turn causing hardening of the arteries. There is a significant association between periodontal disease (gum disease) and stroke. Poor dental hygiene and periodontal disease can cause bacteria to enter the blood, this means that the risk associated with stroke is directly proportional to the amount of inflammation and infection in the mouth.
  • Pregnancy and birth – Infections and inflammation in the body play a role in premature birth rates. There is strong support that shows the association between periodontal disease and premature birth and low birth weight. Maintaining a healthy mouth will help grow a healthy baby, it is important to see your dental professional before and during pregnancy.
  • Diabetes – Being a diabetic increases the risk of developing gum disease but chronic gum disease may actually make diabetes more difficult to control, this is because consistent infection can cause insulin resistance, in turn disrupting blood sugar control.
  • Respiratory diseases – There is a clear association between respiratory conditions and oral health with many studies showing good evidence that improved dental hygiene and regular professional care help to reduce the risk and progression of many respiratory diseases, especially for adults living in nursing homes.
  • Dementia – Impaired delayed memory and early stage Alzheimer’s disease have been shown to be associated with periodontal disease. There is a growing amount of research showing links between Dementia, Alzheimers and impaired memory.
  • Osteoporosis – Medications used for the treatment of osteoporosis can cause rare but severe damage to the jaw bone. This damage is known as osteonecrosis, it can occur spontaneously but can also occur after dental procedures, it is imperative that you tell you dental professional if you are taking any bisphosphonate medication.
  • Crohn’s Disease – inflammatory disease that can affect any region of the gastrointestinal tract including the mouth. Often the oral manifestation appears the same as in the intestine. Examples of oral signs are swelling of the lips or tongue and recurrent ulcers. Some of the medications for crohn’s disease can contribute to a dry mouth making you more susceptible to dental decay and infections.

Medical conditions that first show signs or symptoms in the mouth can include:

  • Diabetes
  • Autoimmune Diseases such a Crohn’s Disease
  • Anemia
  • Depression and Stress
  • Leukemia
  • Oral Cancer
  • Pancreatic Cancer
  • Heart Disease
  • Kidney Disease

The evidence is stacking up when it comes to the links between the health of our mouth and our overall full body health and wellness, but still many people are unaware of the importance of healthy teeth and gums and the importance of regular check ups and preventative appointments with your dental practitioner. Here at Riverside Dental Spa we pride ourselves in working towards the prevention of gum disease and tooth decay because we know that the health of our mouth is a key element to our overall health and well being. All of our practitioners attend regular continuing education seminars to ensure that our techniques and knowledge are up to date. This allows us to be confident and competent in providing high quality dental health care and broadens our awareness and knowledge in the signs, symptoms and implication of these common medical conditions and oral health.