My Dentistry Blog
Chronic pain can turn your life upside down. While there are a number of disorders that fit in this category, two of them—fibromyalgia and temporomandibular disorders (TMD)—can disrupt your quality of life to the extreme. And it may be the two conditions have more in common than similar symptoms—according to one study, three-fourths of patients diagnosed with fibromyalgia show symptoms of TMD.
To understand why this is, let’s take a closer look at these two conditions.
Fibromyalgia presents as widespread pain, aching or stiffness in the muscles and joints. Patients may also have general fatigue, sleep problems, mood swings or memory failures. TMD is a group of conditions that often result in pain and impairment of the temporomandibular joints that join the jaw with the skull. TMD can make normal activities like chewing, speaking or even yawning painful and difficult to do.
Researchers are now focusing on what may, if anything, connect these two conditions. Fibromyalgia is now believed to be an impairment of the central nervous system within the brain rather than a problem with individual nerves. One theory holds that the body has imbalances in its neurotransmitters, which interfere with the brain’s pain processing.
Researchers have also found fibromyalgia patients with TMD have an increased sensitivity overall than those without the conditions. In the end, it may be influenced by genetics as more women than men are prone to have either of the conditions.
Treating these conditions is a matter of management. Although invasive techniques like jaw surgery for TMD are possible, the results (which are permanent) have been inconclusive in their effectiveness for relieving pain. We usually recommend patients try more conservative means first to lessen pain and difficulties, including soft foods, physical therapy, stretching exercises and muscle relaxant medication. Since stress is a major factor in both conditions, learning and practicing relaxation techniques may also be beneficial.
In similar ways, these techniques plus medication or cognitive-behavioral therapy that may influence neurotransmission can also help relieve symptoms of fibromyalgia. Be sure then that you consult with both your physician and dentist caring for both these diseases for the right approach for you to help relieve the effects of these two debilitating conditions.
If you would like more information on managing TMD or fibromyalgia, 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.”
During pregnancy, your body isn’t the only part of your life that changes. Instead of “me,” you’re now thinking about “us”—you and the new person growing inside you. Because of this change in focus you may be re-examining your current habits to see if any could adversely affect your baby.
If you’re concerned your regular dental visits might be one of these, don’t be. Both the American Congress of Obstetricians and Gynecologists (ACOG) and the American Dental Association (ADA) recommend continuing regular dental exams and cleanings even during pregnancy.
In fact, professional dental care is often more important during pregnancy. Because of hormonal changes, you may develop food cravings for more carbohydrates like sugar. Unfortunately, eating more sugar could increase your risk for dental diseases like tooth decay and periodontal (gum) disease.
These same hormonal changes can also make you more prone to gum disease. There’s even a specific form of it known as pregnancy gingivitis that often occurs in expectant mothers. You may also experience “pregnancy tumors,” large, reddened areas of swelling on the gums.
To decrease your risk of pregnancy-related dental disease, you should certainly keep up your regular dental visits—and more if you begin to notice signs like swollen or bleeding gums. And although it’s usually best to postpone elective procedures like cosmetic dental work, you should be able to safely undergo any essential treatment for disease even if it requires local anesthesia. But do discuss any proposed dental work with both your dentist and obstetrician to be sure.
There are also things you can do for yourself during pregnancy that support your dental health. Be sure you’re practicing good oral hygiene habits like daily brushing and flossing. And by all means eat a well-balanced diet and restrict your sugar intake if at all possible. Taking care of these things will help you avoid dental problems and help make this memorable time in your life as joyous as possible.
If you would like more information on caring for your teeth during pregnancy, 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 Care During Pregnancy.”
Although tooth decay is a major problem to watch for in your child’s teeth, it isn’t the only one. As their teeth transition from primary (“baby”) to permanent, you should also be on the lookout for a developing poor bite or malocclusion.
Although the signs can be subtle, you may be able to detect an emerging malocclusion, starting usually around age 6, if you know what to look for. Here are 4 signs your child may be developing a poor bite.
Excessive spacing. This is something that might be noticeable while the child still has their primary teeth. If you notice an excessive amount of space around the front teeth, the sizes of the jaws and the teeth may be disproportional.
Abnormal overlapping. The upper teeth normally just cover the bottom teeth when the jaws are closed. But a malocclusion may be forming if the lower teeth cover the upper (underbite), the upper teeth extend too far over the lower (deep bite) or there’s space between the upper and lower front teeth (open bite).
Different overlapping patterns. Watch as well for some of the teeth overlapping normally while others don’t, a sign of a cross bite. For example, the back upper teeth may cover their counterparts in a normal fashion while the lower front teeth abnormally overlap the top front. The roles here between front and back teeth can also be reversed.
Abnormal eruptions. Permanent teeth normally follow a pattern when erupting, but certain factors could disrupt the process. For example, a jaw that’s developed too small can cause crowding as incoming teeth vie for space; as a result, some permanent teeth may erupt out of their proper position. Likewise, if a baby tooth is out of its normal position or prematurely lost, the permanent tooth may erupt out of position too.
The good news with each of these developing bite problems is that we can correct them or at least minimize their future effect if caught early. So if you notice any of these signs or anything else out of the ordinary, see an orthodontist as soon as possible. It’s also a good idea to have your child undergo a thorough orthodontic evaluation around age 6.
If you would like more information on bite problems in children, 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 “Problems to watch for in Children Ages 6 to 8.”
Everyone knows that in the game of football, quarterbacks are looked up to as team leaders. That's why we're so pleased to see some NFL QB's setting great examples of… wait for it… excellent oral hygiene.
First, at the 2016 season opener against the Broncos, Cam Newton of the Carolina Panthers was spotted on the bench; in his hands was a strand of dental floss. In between plays, the 2105 MVP was observed giving his hard-to-reach tooth surfaces a good cleaning with the floss.
Later, Buffalo Bills QB Tyrod Taylor was seen on the sideline of a game against the 49ers — with a bottle of mouthwash. Taylor took a swig, swished it around his mouth for a minute, and spit it out. Was he trying to make his breath fresher in the huddle when he called out plays?
Maybe… but in fact, a good mouthrinse can be much more than a short-lived breath freshener.
Cosmetic rinses can leave your breath with a minty taste or pleasant smell — but the sensation is only temporary. And while there's nothing wrong with having good-smelling breath, using a cosmetic mouthwash doesn't improve your oral hygiene — in fact, it can actually mask odors that may indicate a problem, such as tooth decay or gum disease.
Using a therapeutic mouthrinse, however, can actually enhance your oral health. Many commonly available therapeutic rinses contain anti-cariogenic (cavity-fighting) ingredients, such as fluoride; these can help prevent tooth decay and cavity formation by strengthening tooth enamel. Others contain antibacterial ingredients; these can help control the harmful oral bacteria found in plaque — the sticky film that can build up on your teeth in between cleanings. Some antibacterial mouthrinses are available over-the-counter, while others are prescription-only. When used along with brushing and flossing, they can reduce gum disease (gingivitis) and promote good oral health.
So why did Taylor rinse? His coach Rex Ryan later explained that he was cleaning out his mouth after a hard hit, which may have caused some bleeding. Ryan also noted, “He [Taylor] does have the best smelling breath in the league for any quarterback.” The coach didn't explain how he knows that — but never mind. The takeaway is that a cosmetic rinse may be OK for a quick fix — but when it comes to good oral hygiene, using a therapeutic mouthrinse as a part of your daily routine (along with flossing and brushing) can really step up your game.
We breathe every moment of every day and we’re hardly aware of it most of the time. But if you take the time to focus, you’ll find two possible pathways for your breath: through the nose or through the mouth.
While either pathway provides the air exchange needed to live, nose breathing offers better health benefits. Air passes through the nasal passages, which filter out many harmful particles and allergens. The mucous membranes in the nose also humidify the air and help produce heart-friendly nitric oxide.
Nose breathing also plays a role in your child’s facial and jaw development: the tongue rests on the roof of the mouth (the palate) and becomes a kind of mold around which the developing upper jaw can form. With chronic mouth breathing, however, the tongue rests just behind the lower teeth, depriving the upper jaw of its normal support. This could result in the development of a poor bite (malocclusion).
To avoid this and other undesirable outcomes, you should have your child examined if you notice them breathing mostly through the mouth, particularly at rest. Since chronic mouth breathing usually occurs because of an anatomical obstruction making nose breathing more difficult, it’s usually best to see a physician or an ear, nose and throat (ENT) specialist first for evaluation and treatment.
It’s also a good idea to obtain an orthodontic evaluation of any effects on their bite development, such as the upper jaw growing too narrowly. If caught early enough, an orthodontist can correct this with a palatal expander, a device that exerts gradual outward pressure on the jaw and stimulating it to grow wider.
Another bite problem associated with chronic mouth breathing is misalignment of the jaws when closed. An orthodontist can address this with a set of removable plates worn in the mouth. As the jaws work the angled plates force the lower jaw forward, thus encouraging it to grow in the direction that best aligns with the upper jaw.
Any efforts to correct a child’s breathing habits can pay great dividends in their overall health. It could likewise head off possible bite problems that can be both extensive and costly to treat in the future.
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