This section is dedicated to the latest information on oral health topics, culled from authoritative sources such as the American Dental Association.
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Poor dental hygiene can cause a host of problems outside your mouth-including your heart. Medical research has uncovered a definitive link between heart disease and certain kinds of oral infections such as periodontal disease. Some have even suggested that gum disease may be as dangerous as or more dangerous than other factors such as tobacco use. A condition called chronic periodontitis, or persistent gum disease, has been linked to cardiovascular problems by medical researchers.
In short, infections and harmful bacteria in your mouth can spread through the bloodstream to your liver, which produces harmful proteins that can lead to systemic cardiac problems. That's why it is critical to practice good oral hygiene to keep infections at bay-this includes a daily regimen of brushing, flossing and rinsing.
In some cases, patients with compromised immune systems or who fear an infection from a dental procedure may take antibiotics before visiting the dentist.
It is possible for bacteria from your mouth to enter your bloodstream during a dental procedure in which tissues are cut or bleeding occurs. A healthy immune system will normally fight such bacteria before they result in an infection. However, certain cardiovascular conditions in patients with weakened hearts could be at risk for an infection or heart muscle inflammation (bacterial endocarditis) resulting from a dental procedure.
Patients with heart conditions (including weakened heart valves) are strongly advised to inform our office before undergoing any dental procedure. The proper antibiotic will prevent any unnecessary complications.
Dentistry Health Care That Works: Tobacco
The American Dental Association has long been a leader in the battle against tobacco-related disease, working to educate the public about the dangers inherent in tobacco use and encouraging dentists to help their patients break the cycle of addiction. The Association has continually strengthened and updated its tobacco policies as new scientific information has become available.
Smoking and Implants
Recent studies have shown that there is a direct link between oral tissue and bones loss and smoking. Tooth loss and edentulism are more common in smokers than in non-smokers. In addition, people who smoke are more likely to develop severe periodontal disease.
The formation of deep mucosal pockets with inflammation of the peri-implant mucosa around dental implants is called peri-implantitis. Smokers treated with dental implants have a greater risk of developing peri-implantitis. This condition can lead to increased resorption of peri-implant bone. If left untreated, peri-implantitis can lead to implant failure. In a recent international study, smokers showed a higher score in bleeding index with greater peri-implant pocket depth and radiographically discernible bone resorption around the implant, particularly in the maxilla.
Many studies have shown that smoking can lead to higher rates of dental implant failure. In general, smoking cessation usually leads to improved periodontal health and a patient’s chance for successful implant acceptance.
If you experience ongoing pain in the area near your ear, your jaw or the muscles on the side of your face, possibly accompanied by a clicking or popping sound or restricted jaw movement, you may be suffering from TMD — an abbreviation for Temporomandibular disorders. Sometimes people incorrectly use the term TMJ to refer to these problems, when in fact TMJ is the abbreviation for the temporomandibular joint — or jaw joint — itself. So while you definitely have a TMJ (two of them in fact), you may or may not have TMD.
TMD, then, describes a group of conditions characterized by pain and dysfunction of the TMJ and/or the muscles surrounding it. It's not always so easy to figure out exactly what's causing these symptoms, but the good news is that most TMD cases resolve themselves with the help of conservative remedies that you can try at home. In fact, it's important to exhaust all such reversible remedies before moving on to anything irreversible, such as bridgework or surgery.
The two TMJs that connect your lower jaw, the mandible, to the temporal bone of the skull on either side, are actually very complex joints that allow movement in three dimensions. The lower jaw and temporal bone fit together as a ball and socket, with a cushioning disk in between. Large pairs of muscles in the cheeks and temples move the lower jaw. Any of these parts — the disk, the muscles or the joint itself — can become the source of a TMD problem. If you are in pain, or are having difficulty opening or closing your jaw, a thorough examination can help pinpoint the problem area; then an appropriate remedy can be recommended.
Causes of TMD
As with any other joint, the TMJ can be subject to orthopedic problems including inflammation, sore muscles, strained tendons and ligaments, and disk problems. TMD is also influenced by genes, gender (women appear to be more prone to it), and age. Physical and psychological stress can also be a factor. In some cases, jaw pain may be related to a more widespread, pain-inducing medical condition such as fibromyalgia (“fibro” – connective tissues; “myo” – muscle; “algia” – pain).
Signs and Symptoms of TMD
Clicking Sounds — Some people with TMD hear a clicking, popping or grating sound coming from the TMJ when opening or closing the mouth. This is usually caused by a shifting of the disk inside the joint. Someone standing next to you might even be able to hear it. Clicking by itself is actually not a significant symptom because one third of all people have jaw joints that click, studies show. However, if the clicking is accompanied by pain or limited jaw function — the jaw getting “stuck” in an open or closed position, for example — this would indicate TMD.
Muscle Pain — This can be felt in the cheeks (masseter muscles) and temples (temporalis muscles), where the two big pairs of jaw-closing muscles are located. If you feel soreness and stiffness upon waking up in the morning, it's often related to habits such as clenching and/or grinding the teeth at night. If you have this type of nocturnal habit, a custom-made nightguard should be very helpful in decreasing the force applied to your teeth, which will in turn allow your muscles to relax and relieve pressure on your jaw joints. Other self-care remedies are discussed below (please see Relieving the Pain).
Joint Pain — Pain that's actually coming from one or both jaw joints technically would be described as arthritis (“arth” – joint; “itis” – inflammation) of the TMJ. Radiographs (x-ray pictures) show that some people have arthritic-looking TMJs but no symptoms of pain or dysfunction; others have significant symptoms of pain and dysfunction but their joints look normal on radiographs. There is no cure for arthritis anywhere in the body, but medication can sometimes help relieve arthritic symptoms.
Relieving the Pain
Once you have been examined, a strategy for treating your condition and managing your pain can be developed. Sometimes a temporary change to a softer diet can reduce stress on the muscles and joints. Ice and/or moist heat can help relieve soreness and inflammation. Muscles in spasm can also be helped with gentle stretching exercises. Non-steroidal anti-inflammatory medications and muscle relaxants can also provide relief.
Other Treatment Options
Severe TMD cases may require more complex forms of treatment, which might include orthodontics, dental restorations like bridgework, or minor procedures inside the joint such as cortisone injections or lavage (flushing) of the joint. It's rare for major surgery ever to be necessary in a case of TMD. Again, it's important to try the wide range of conservative, reversible treatments available, and give them enough time to work as they almost always prove effective. The first step is an examination at the dental office. To learn more about available treatment options, view this Chart on TMD Therapy
TMD – The Great Impostor This “chameleon” of dental disorders manifests in a variety of ways, including joint pain, sinusitus, ear pain, tooth and headaches. Dear Doctor magazine examines the causes of TMD, its signs and symptoms and what can be done to treat this common disorder... Read Article
Seeking Relief From TMD TMD, or Temporomandibular Disorders, is an umbrella term for various painful conditions that affect the jaw joints. There are different treatment approaches to TMD problems, but not all are based on science. It's important to be up on the latest information and to be an educated consumer. In this comprehensive article, Dear Doctor magazine provides state-of-the-art information and guidance on what you should know, whom you should see, and what you should ask... Read Article