July 21, 2018
TMD is complex, but it's worth learning about it and understanding its nuances because TMD doesn't go away or get better on its own. In fact -- it will almost always get worse with time.
By the way, your dental insurance will not cover treatment of TMD.
What is TMD exactly?
The best definition of TMD is a broad one: TMD disorder is a condition involving pain or tenderness in the muscles and/or joint that control jaw movement (this joint is referred to as the TMJ, or temperomandibular joint) with the pain sometimes referring beyond these areas. This pain includes jaw pain, jaw popping or clicking, or pain in the face, eyes, neck, head, and pain when you chew or open wide. So everyone has the joint, "TMJ", but only some people have the pain associated with it, called TMD
Even though TMD is very common -- between 10 and 30 million Americans are affected -- it's generally treated inadequately. Many doctors don't fully understand the disorder, and many dentists can identify TMD, but have not been trained to treat it. Since TMD symptoms can involve the jaw, ear, nose, throat, face, neck, upper back, and even eyes, dentists and ENT doctors often pass TMD patients back and forth, misinterpreting their symptoms and passing on the diagnosis.
The TMJ is in a class of its own since it's both a hinging and a sliding joint. This is unique and accounts for the circular movement that is required to properly chew food. There is no other joint in the body like it. This movement allows the teeth to come together like a mortar and pestle does and efficiently initiates the beginning of the proper digestion of food.
You may not have noticed this before, but when you chew, you chew in a circular motion -- not just up and down -- and that's thanks to the translational movement of the temperomandibular joint. That circular chewing motion, I think, may have evolved to help humans digest our food better and give us more variation in spoken voice. It's not a simple hinging movement, it's more of a three dimensional (circular) movement, and because of that complexity, it can lead to problems or misalignment.
How do I know if I have TMD?
Try this test right now:
Place a finger over the joint in front of your ear.
Open your jaw slightly.
Then open wide until you can feel the joint move.
If you hear a grating, clicking, or crackling noise, or if it's tender when you press, you may have a temperomandibular joint disorder (TMD).
You might also have TMD if you have any of these symptoms:
Jaw pain under the ear
Pain in the face, jaw or neck
Stiffness in the jaw muscle
Not being able to open your jaw all the way, or your jaw getting "locked" open or closed
Some of the symptoms -- headache and ear pain, for example -- can be mistaken for migraines or ear infections, hence all the confusion among professionals.
Most of the time, you can find relief by reducing the amount of wear and tear to the joint. Stop chewing gum, eat softer foods, keep your dental appointments as short as possible, and wear a nightguard to give your jaw a break during the day and prevent clenching at night. Some people find relief with muscle relaxation techniques. Treat this condition as you would a muscle injury.
How is TMD diagnosed?
Because the exact causes and symptoms aren't clear, there isn't a standard test to diagnose TMD. ENT doctors and dentists are typically the ones to make a diagnosis, based on traditional symptoms, especially jaw pain.
No one dentist has the same approach, which is why it's very important to understand your treatment options and get a second opinion.
What causes TMD?
Experts aren't completely sure what causes the problem, but here are some of the possible causes:
Clenching or grinding of teeth
Trauma to the jaw. For example, a root canal (when you have to keep your mouth open wide for an extended period), getting hit in the head, or whiplash.
Arthritis can play a part
Growing up with an improper bite from a young age, which puts wear and tear on the jaw joint over time
The key with TMD is to understand the disorder and your treatment options as much as you can. The longer you live with this condition, the less likely it is you'll be able to reverse the damage to the joint.
The car analogy
Think of it like the tires on your car. If the wheel alignment of your car is off, then your tires will wear unevenly and the car will not steer properly down the road.
Occasionally, jaw pain doesn't indicate anything seriously wrong and the pain usually goes away with little or no treatment. A lot of dentists and doctors shy away from treating TMD because the treatment is not predictable and is highly litigious.
Dr. Coambs has completed advanced training to treat TMD through Occlusal Equilibration (bite balancing) and splint therapy.
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July 9, 2018
Lots of people these days use electric toothbrushes to keep their pearly whites nice and bright. But are they really better? Yes, say dentists, who overwhelmingly recommend them as the best means of keeping your teeth clean and free from plaque and its damaging effects. Yet simply purchasing an electric toothbrush doesn't guarantee great results. You also need to make sure you brush at least twice daily, spend at least two minutes a session brushing and use the proper brushing technique (yes, there's a technique to it).
Before you rush out to buy an electric toothbrush, do a little research. First, electric toothbrushes aren't the same as battery-powered toothbrushes, which are similar to manual brushes but use a AA battery to make the bristles vibrate a little, thus providing some extra cleaning. True electric toothbrushes are rechargeable units that plug into the wall. You change the brush heads every three to six months and keep the handle, which receives the charge. The heads comes in different shapes and sizes and work differently. They may oscillate, vibrate, rotate or use sonic technology [source: Oral B].
Electric brushes also come with various features, such as special modes for sensitive teeth, gum massage and whitening. Some come with pressure sensors that let you know if you're brushing too hard, or feature digital reminders to replace your brush head. Most are packaged with extras such as toothbrush holders and travel chargers [source: Oral B].
The major drawback to electric toothbrushes, in many people's opinions, is the cost; starter kits are generally $50 to $75, although you can purchase some for less than $25 or more than $100. In the long run, however, they may not cost much more than manual brushes, as they need to be replaced far less often [sources: Go Ask Alice, Oral B].
Still not sure? Read on for five benefits to going electric.
5 - They clean your teeth more thoroughly.
Electric toothbrushes win hands down over manual brushes when it comes to cleaning ability. The electric version's whirring bristles remove plaque better and faster, for starters. Their more advanced designs are also able to get at hard-to-clean areas like the backs of molars and the gum line, thus helping to prevent cavities and gingivitis. Not surprisingly, then, both the American Journal of Dentistry and the British Dental Journal support the use of electric toothbrushes [source: Electric Toothbrush Reviews
But don't just listen to the sages at dental journals. Regular folks are big electric toothbrush fans, too. In a survey of 16,000 patients published by the American Dental Association, more than 80 percent said they improved their oral cleanliness after switching from their manual toothbrushes to an electric version [source: Electric Toothbrush Reviews
]. It's hard to argue with that!
4 - They keep you from brushing too hard.
It's ironic -- you try so hard to get your teeth nice and clean that you wind up brushing too hard. Most often, this means you injure your gums, possibly even causing some gum recession. (And gum tissue never grows back.) Brushing too vigorously can also remove enamel from the tooth surface, causing sensitivity to cold, heat and other stimuli [source: Mama's Health
One of the major benefits of electric toothbrushes is that it's nearly impossible to brush too hard with them because you shouldn't really be doing the brushing. With an electric toothbrush, you simply hold the brush and let its moving bristles do the work. You do reposition the brush over different parts of your mouth, but you're not supposed to be vigorously moving the brush back and forth, and you definitely shouldn't be applying pressure.
Some models even have sensors that will automatically reduce the power if you start brushing too hard [source: Electric Toothbrushes
]. This is a great option for those who are prone to using a little too much force when they brush.
3 - They're easier to use for people with dexterity issues.
The American Dental Association (ADA) says people who have physical conditions (such as arthritis, limited mobility in their hands or arms or manual dexterity problems) that make it difficult to use a manual toothbrush should consider using an electric toothbrush. Why? Electric toothbrushes have larger handles, which are easier to grip. Plus, their powered brushes do the cleaning for you, especially in the tricky areas that require fine motor skills to get at, such as the backs of molars and behind your upper and lower front teeth [source: ADA
2 - They have built-in timers so you brush the proper amount of time.
Did you know you're supposed to brush your teeth at least 2 minutes at a time, spending at least 30 seconds in each of your mouth's four quadrants (upper right and left sides and lower right and left sides)? You probably think you easily brush your teeth for that amount of time, but if you timed yourself, you might be quite surprised at how little time you actually do brush. The average brushing time for Americans is a measly 31 to 65 seconds per session, depending on sex and age [source: Radius Toothbrush
One of the more helpful attributes of electric toothbrushes is that most come with timers that beep when two minutes are up. If you haven't heard the beep, keep brushing! Others additionally emit a beep after 30 seconds, so you know it's time to switch to another section of your mouth [source: Electric Toothbrushes
1 - They're greener.
There's some debate about whether electric toothbrushes are less harmful to the environment than manual toothbrushes. Those who say yes note that you would go through a lot of "regular" toothbrushes (the heads of which aren't recyclable) before you dispose of an electric brush, most of which use replaceable heads. In fact, according to the environmental experts at Green Your, it takes between 14 and 42 toothbrush replacement heads to equal the amount of plastic in one manual toothbrush [source: Green Your
Of course, you do eventually throw out your electric toothbrush body, because at some point it stops taking and holding a charge [source: Green Hands USA
]. Still, many people feel electric toothbrushes are more environmentally friendly.
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Oral B Genius Electric toothbrush with bluetooth technology --
featuring an app to monitor your brushing and free oral care goodies.