The profession of dentistry has experienced an amazing evolution over its lifetime. References to tooth decay can be found in various ancient texts. At one time, a local barber would provide haircuts and pull troublesome teeth in the same shop. Dentistry evolved from these humble beginnings to what we know today: a structured medical discipline where patients benefit from evidenced-
On the list of common reasons people avoid the dentist, cost is usually near the top. It is a fact — some dental treatments are expensive. However, you have some control in working to avoid pricey dental procedures. Two of the best ways to avoid needing expensive dental treatments are to visit a dentist regularly for an exam and cleaning and following proper dental hygiene advice every day.
The National Sleep Foundation estimates over 18 million adults in the United States, or about one in every 15 people, suffer from sleep apnea. Obstructive sleep apnea is a sleep disorder that interrupts breathing, resulting in disruptive sleep. Individuals suffering from obstructive sleep apnea will experience a repetitive (partial or complete) airway collapse throughout their sleep, which prevents air from reaching the lungs.
Have you ever experienced tenderness in your jaw area? Facial pain is a rather common issue in the general population, with 15 percent to 20 percent of people reporting symptoms. While some only suffer temporarily, others find their discomfort lingers for a longer period or reaches a level that significantly diminishes their quality of life. This type of pain can greatly affect chewing, biting and even speech. When the discomfort lingers or reaches severe levels, it will often prompt a doctor visit to address the issue.
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DIAGNOSING AND TREATING JAW PAIN - A VARIETY OF FACTORS CAN LEAD TO TMD ISSUES
- clicking sounds when chewing or just opening and closing the mouth;
- popping in the jaw joint;
- general trouble or pain when biting or chewing;
- a jaw that feels stuck or locked or moves out of place; and
- headaches that relate to jaw function.
A variety of factors can lead to TMD issues. While certain malocclusions, or bad bites, can lead to them, this is not the most common cause. Injury to the jaw is another factor that can prompt TMD issues. Frequently, however, the culprit is bruxism, or excessive clenching and/or grinding of the teeth. Often people are unaware they are clenching and/or grinding their teeth because this activity frequently takes place during sleep. That is why it is called nocturnal bruxism. While doctors previously believed nocturnal bruxism was caused by a bad bite, now we generally believe the behavior is just a result of brain activity and is also possibly linked to stress, the use of certain medications and even genetic factors.
During an examination, in addition to asking a variety of questions about symptoms and where the pain seems to be located, a doctor will typically confirm how a person’s jaw works, test his or her bite and check the facial muscles.
Doctors may also elect to take X-
Common conservative approaches to treating TMD pain generally include allowing the jaw to rest to reduce the pressure on it as well as the joint and muscles. Other recommendations include:
- switching to soft foods and skipping hard, crunchy or overly chewy items;
- chewing slower and taking smaller bites of food;
- avoiding unnecessary biting or chewing (pencils, fingernails, etc.); And
- not chewing gum.
Individuals may also be encouraged to take ibuprofen or aspirin to address pain. Applying moist heat or cold packs to the face can help reduce pain. Additionally, a doctor may discuss wearing a dental appliance, similar to a retainer, during sleep to put the jaw in a more favorable position. Treatment plans depend on whether activity related to the pain is taking place during the daytime or during sleep, since the management of nighttime and daytime muscle activity differs. If stress is playing a role, techniques to recognize stress and reduce jaw muscle activity during stressful periods may be discussed.
If a patient does not find relief after implementing these approaches, additional measures, such as minor dental procedures or orthodontic treatment, can be discussed. Additionally, the use of physical therapy techniques or trigger-
TMD symptoms can range from annoying to disabling, but help in determining the type and cause of pain is available. Resolving pain related to TMD generally takes patience and diligence as a person works with his or her doctor to find the best way to treat or manage the condition.
DR. JEFFREY OKESON
Dr. Jeffrey Okeson is a professor at the University of Kentucky College of Dentistry, and also serves as chief of the college’s Division of Orofacial Pain and program director of the Orofacial Pain Clinic located in the Kentucky Clinic on UK’s campus. His interests include orofacial pain and temporomandibular joint disorders. More information on UK Dentistry is available at www.ukhealthcare.uky.edu/dentistry.
more articles by dr Jeffrey Okeson
Have you ever experienced tenderness in your jaw area? Facial pain is a rather common issue in the general population, with 15 percent to 20 percent of people reporting symptoms. While some only suffer temporarily, others find their discomfort lingers for a longer period or reaches a level that significantly diminishes their quality of life. This type of pain can greatly affect chewing, biting and even speech. When the discomfort lingers or reaches severe levels, it will often prompt a doctor visit to address the issue.
You may hear people describing these types of pain using terms such as “TMJ” or “TMD.” TMJ stands for temporomandibular joint, which is the joint that connects the jaw to the temporal bones in the skull. TMD stands for temporomandibular joint disorder, a term used to describe problems involving the jaw area of the face. It is not uncommon for people to use both terms to describe this type of facial pain.
TMD symptoms can mimic other conditions, so a clinical examination by a dentist is necessary to make a proper diagnosis of the issue and pursue the best treatment plan to relieve any pain. Should symptoms be the result of another type of condition, different treatments may be required to help alleviate the discomfort. Signs that are more common for TMD pain include:
- pain in one or more areas, including the face, jaw and even the ear, similar to pain felt with an ear infection;