Posts for: July, 2021
There's still much about the underlying nature of chronic jaw joint dysfunction we have yet to unravel. Treating these conditions known as temporomandibular joint disorders (TMDs) may therefore require some experimentation to find what works for each individual patient.
Most TMD therapies are relatively conservative: eating softer foods, taking anti-inflammatory pain relievers or undergoing physical therapy. There have been some surgical techniques tried to relieve jaw pain and dysfunction, but these have so far had mixed results.
Recently, the use of the drug Botox has been promoted for relieving jaw pain, albeit temporarily. Botox contains tiny amounts of botulinum toxin type A, a poisonous substance derived from the bacterium Clostridium botulinum, which can cause muscle paralysis. It's mainly used to cosmetically smooth out small wrinkles around facial features.
Because of these properties, some physicians have proposed Botox for TMD treatment to paralyze the muscles around the jaw to reduce pain and discomfort. While the treatment sounds intriguing, there are a number of reasons to be wary of it if you have TMD.
To begin with, the claims for Botox's success in relieving jaw pain have been mainly anecdotal. On the other hand, findings from randomized, double-blind trials have yet to show any solid evidence that Botox can produce these pain-relieving effects.
But even if it lived up to the claims of TMD pain relief, the effect would eventually fade in a few weeks or months, requiring the patient to repeat the injections. It's possible with multiple Botox injections that the body will develop antibodies to fight the botulinum toxin, causing the treatment to be less effective with subsequent injections.
Of even greater concern are the potential side effects of Botox TMD treatment, ranging from headaches and soreness at the injection site to more serious muscle atrophy and possible facial deformity from repeated injections. There's also evidence for decreased bone density in the jaw, which could have far-reaching consequences for someone with TMD.
The best approach still seems to lie in the more conservative therapies that treat TMD similar to other joint disorders. Finding the right combination of therapies that most benefit you will help you better manage your symptoms.
If you would like more information on treatments for TMD, 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 “Botox Treatment for TMJ Pain.”
Accidents do happen, especially if you or a family member has an active lifestyle. One such risk, especially for someone playing a contact sport, is having a tooth knocked out.
But as extreme as this injury can be, it doesn't necessarily mean the tooth is lost forever. Gum (or periodontal) cells remaining on the tooth root can regenerate and regain their attachment with the periodontal ligament that holds teeth in place. But you have to act quickly—the longer the tooth is out of the socket, the more likely these cells will dry out and die.
So, by doing the following within 5-20 minutes of the injury (and the earlier the better), that knocked-out tooth has a reasonable chance of survival.
Locate and clean the tooth. Your first priority is to find the missing tooth and clean it of any debris with clean water. Be sure not to touch the root of the tooth and only handle the tooth by the crown (the visible part of a tooth when it's in the mouth).
Insert the root end into the empty socket. Still holding the tooth by the crown, insert the opposite root end into the empty socket. Orient the crown properly, but don't worry about getting it in just right—the follow-up with the dentist will take care of that. You will, however, need to apply some pressure to get it to seat firmly.
Secure the tooth. Place a piece of clean gauze or cloth between the reinserted tooth and its counterpart on the other jaw. Then, have the person bite down on the cloth and hold it. This will help secure the tooth in place while you travel to the dentist.
Seek dental care immediately. It's important to see a dentist immediately to adjust the tooth's position and to possibly splint the tooth to better secure it while it heals. If a dentist isn't available, then visit a local emergency room instead.
Taking these actions on the scene could mean the difference between saving and losing a tooth. But act quickly—the sooner you initiate first aid for a knocked-out tooth, the better its chances for long-term survival.
If you would like more information on what to do during dental emergencies, 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 a Tooth is Knocked Out.”
If you're a fan of former NFL player and current host of Good Morning America Michael Strahan, then you're well aware of his unique smile feature—a noticeable gap between his front teeth. So far, Strahan has nixed any dental work to correct the gap, often saying it was part of "who I am."
But if you follow him on Twitter, you may have been shocked by a video he posted on March 30th of him sitting in a dentist's chair. Calling it a "moment fifty years in the making," Strahan said, "Let's do it." After some brief video shots of a dental procedure, Strahan revealed a new gapless smile.
But some of his Twitter fans weren't buying it—given the timing, they sniffed an elaborate April Fool's Day ruse. It turns out their spider senses were on target: Strahan appeared once again after the video with his signature gap still intact, grinning over the reaction to his successful prank.
The uproar from his practical joke is all the more hilarious because Strahan has let it be known he's truly comfortable with his smile "imperfection." But it also took him awhile to reach that point of acceptance, a well-known struggle for many people. On the one hand, they want to fix their dental flaws and improve their smile. But then again, they're hesitant to part with the little "imperfections" that make them unique.
If that's you, here are some tips to help you better navigate what best to do about improving your smile.
See a cosmetic dentist. A cosmetic dentist is singularly focused on smile enhancement, and particularly in helping patients decide what changes they want or need. If you're looking for such a dentist, seek recommendations from friends and family who've changed their smiles in ways you find appealing.
Get a "smile analysis." Before considering specific cosmetic measures, it's best to first get the bigger picture through an examination called a "smile analysis." Besides identifying the defects in your smile, a cosmetic dentist will use the analysis to gauge the effect any proposed improvements may have on your overall facial appearance.
Embrace reality. A skilled cosmetic dentist will also evaluate your overall oral health and assess how any cosmetic procedures might impact it. This might change your expectations if it whittles down the list of enhancement possibilities, but it may help determine what you can do to get the best improved smile possible.
A great cosmetic dentist will work diligently with you to achieve a new smile that's uniquely you. Even if, like Michael Strahan, you decide to keep a trademark "imperfection," there may still be room for other enhancements that will change your appearance for the better.