My Blog

Posts for: March, 2018

By Aaron J. Grier, DDS, PC
March 27, 2018
Category: Oral Health
Tags: tmd   tmj disorders   tmj  
TreatingTMDLikeOtherJoint-RelatedProblems

After ruling out other causes for your jaw pain, your doctor or dentist has made a diagnosis: a temporomandibular joint disorder (TMD). With TMD, your pain symptoms and other dysfunctions are due to a problem associated with the temporomandibular joint (TMJ) that connects your lower jaw (mandible) to your upper skull (cranium).

There are a number of treatment options, but most can be classified as either aggressive or conservative. Aggressive treatments are more interventional and target problems with the teeth such as bite problems or jaw relationships as they relate to the bite, which are thought to be underlying causes for TMD. Such treatments include orthodontics to realign teeth, crown or bridgework, or surgical treatment to the jaw or joint itself. These treatments are controversial and irreversible — with no guarantee of symptom relief.

It’s thought by many to be appropriate, then, to start with more conservative treatments. Many of these are based on treating the TMJ — which is a joint, a moveable bony structure connected by muscles and tendons — with an orthopedic approach, using treatments similar to those used for other joint problems.

Here, then, are some of those conservative therapies that may relieve your TMD pain and other symptoms.

Physical Therapy. Commonly used to treat pain and dysfunction in other joints, physical therapies like manual manipulation, massage, alternating hot and cold packs or exercises can be used to relax, stretch or retrain the muscles that operate the TMJ while reducing pain and inflammation.

Medications. Medications may be incorporated into the treatment plan to relieve pain, reduce inflammation or relax tense muscles. Besides prescription drugs, over-the-counter anti-inflammatory drugs (such as ibuprofen or acetaminophen) are also commonly used.

Bite Appliances. If night-time teeth grinding or clenching habits are a primary cause for the TMD, you may benefit from wearing an occlusal bite guard while you sleep, designed to specifically fit your upper teeth. Because the lower teeth can’t grip the guard’s smooth plastic surface when biting down, they’ll more likely produce less force. This gives the jaw muscles a chance to relax during sleep.

Diet changes. Changing to softer foods, which don’t require strenuous chewing, and eliminating the chewing gum habit will further help reduce stress on the TMJs and also give your muscles a chance to relax and heal.

If you would like more information on TMD and treatment options, 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 “Seeking Relief from TMD.”


By Aaron J. Grier, DDS, PC
March 12, 2018
Category: Dental Procedures
Tags: wisdom teeth  
ExtractingWisdomTeethNowMayPreventDentalProblemsLater

The reason for extracting a tooth may be all too obvious — the tooth is too decayed or damaged to attempt saving. The reason for extracting a wisdom tooth, on the other hand, may not be so apparent: from the perspective of pain or reduced function, you may not notice a thing. Our recommendation to remove a wisdom tooth is based primarily on what may be occurring out of view below the gum line and its potential threat to adjacent teeth.

Teeth grow and develop below the gum line in the jaw, and then push their way through the gums as they appear in the mouth (eruption). After a normal eruption, the enamel-covered crown is visible above the gum line; the remaining tooth root (about two-thirds of the tooth’s length) resides below the gum line. Because wisdom teeth, or third molars, erupt rather late between ages 17 and 25, they may lack the room to erupt properly due to crowding from other teeth that have already erupted. This can cause the wisdom tooth not to erupt fully through the gums, leaving the crown trapped below the gum line, a condition known as impaction. For the tooth, impaction increases the chances of infection, cyst formation and gum disease around it.

An impacted wisdom tooth can also cause problems for the adjacent teeth as well. The impacted tooth may begin to press against the roots of other teeth; the resulting pressure can damage the other roots, increasing the risk for disease or future tooth loss. A person may not even know they have this problem since there’s often little to no noticeable pain or symptoms.

It may seem counterintuitive, but the best time to remove a wisdom tooth is when it’s not causing immediate problems. There will be, however, signs found during examination (particularly x-rays or CT scan) that future problems are in the making. By extracting an impacted wisdom tooth at the appropriate time, we can avoid more serious problems in the future and improve oral health.

If you would like more information on wisdom teeth and your oral health, 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 “Removing Wisdom Teeth.”


WhytheBottledVarietyMightnotbeYourBestChoiceforCleanDrinkingWater

In recent decades civilization's millennia-long search for clean, safe drinking water has become much easier with modern purification methods. Today, there are few places in the United States without adequate access to potable water. And about three-fourths of the nation's tap water systems add fluoride, credited with helping to reduce tooth decay over the past half century.

But in recent years some have voiced concerns about the safety of tap water and popularizing an alternative: bottled water. Manufacturers of bottled water routinely market their products as safer and healthier than what comes out of your faucet.

But is that true? A few years ago a non-profit consumer organization called the Environmental Working Group (EWG) performed a detailed, comprehensive study of bottled water. Here's some of what they found.

Lack of transparency. It's not always easy to uncover bottled water sources (in some cases, it might actually begin as tap water), how it's processed, or what's in it. That's because unlike water utilities, which are rigorously monitored by the Environmental Protection Agency (EPA), the Food and Drug Administration (FDA) oversees bottled water production with less strenuous guidelines on labeling. Eight out of the top 10 selling brands were less than forthcoming about their water's contents in EWG's investigation.

Higher cost. According to the EPA, the average consumer cost in the last decade for tap water was $2.00 per 1,000 gallons (0.2 cents per gallon). The retail cost for even bulk bottled water is exponentially higher. It can be a costly expenditure for a family to obtain most of their potable water by way of bottled—while still paying for tap water for bathing and other necessities.

Environmental impact. Bottled water is often marketed as the better environmental choice. But bottled water production, packaging and distribution can pose a significant environmental impact. EWG estimated the total production and distribution of bottled water consumes more than 30 million barrels of oil each year. And disposable plastic water bottles have become one of the fastest growing solid waste items at about 4 billion pounds annually.

While there are credible concerns about tap water contaminants, consumers can usually take matters into their own hands with an affordable and effective household filtering system.  EWG therefore recommends filtered tap water instead of bottled water for household use.

If you would like more information on drinking water options, 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 “Bottled Water: Health or Hype?