Posts for: April, 2020

By Iris L. Shields, DDS
April 29, 2020
Category: Dental Procedures
Tags: tmj disorders   jaw pain  
ThinkTwiceBeforeConsideringBotoxforChronicJawPainRelief

Chronic jaw pain can be an unnerving experience that drains the joy out of life. And because of the difficulty in controlling it patients desperate for relief may tread into less-tested treatment waters.

Temporomandibular disorders (TMDs) are a group of conditions affecting the joints connecting the lower jaw to the skull and their associated muscles and tendons. The exact causes are difficult to pinpoint, but stress, hormones or teeth grinding habits all seem to be critical factors for TMD.

The most common way to treat TMD is with therapies used for other joint-related problems, like exercise, thermal (hot and cold) applications, physical therapy or medication. Patients can also make diet changes to ease jaw function or, if appropriate, wear a night guard to reduce teeth grinding.

These conservative, non-invasive therapies seem to provide the widest relief for the most people. But this approach may have limited success with some patients, causing them to consider a more radical treatment path like jaw surgery. Unfortunately, surgical results haven't been as impressive as the traditional approach.

In recent years, another treatment candidate has emerged outside of traditional physical therapy, but also not as invasive as surgery: Botox injections. Botox is a drug containing botulinum toxin type A, which can cause muscle paralysis. Mostly used in tiny doses to cosmetically soften wrinkles, Botox injections have been proposed to paralyze certain jaw muscles to ease TMD symptoms.

Although this sounds like a plausible approach, Botox injections have some issues that should give prospective patients pause. First, Botox can only relieve symptoms temporarily, requiring repeated injections with increasingly stronger doses. Injection sites can become painful, bruised or swollen, and patients can suffer headaches. At worst, muscles that are repeatedly paralyzed may atrophy, causing among other things facial deformity.

The most troubling issue, though, is a lack of strong evidence (outside of a few anecdotal accounts) that Botox injections can effectively relieve TMD symptoms. As such, the federal Food and Drug Administration (FDA) has yet to approve its use for TMD treatment.

The treatment route most promising for managing TMD remains traditional physical and drug therapies, coupled with diet and lifestyle changes. It can be a long process of trial and error, but your chances for true jaw pain relief are most likely down this well-attested road.

If you would like more information on treating jaw disorders, 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.”


EvenCelebritiesHaveAccidentsSeeWhatTheyDotoRestoreTheirChippedTeeth

Chipped a tooth? Don't beat yourself up—this type of dental injury is quite common. In fact, you probably have a favorite celebrity who has chipped one or more of their teeth. The list is fairly long.

Some chipped a tooth away from the limelight, such as Tom Cruise (a hockey puck to the face as a teen), Jim Carrey (roughhousing on the playground) and Paul McCartney (a sudden stop with a moped). Others, though, chipped a tooth while “on the job.” Taylor Swift, Hillary Duff and Jennifer Lopez have all chipped a tooth on stage with a microphone. And chipped teeth seem to be an occupational hazard among professional athletes like former NFL star, Jerry Rice.

Since smiles are an indispensable asset to high-profile celebrities, you can be sure these stars have had those chipped teeth restored. The good news is the same procedures they've undergone are readily available for anyone. The two most common restorations for chipped teeth are dental bonding and veneers.

The least invasive way to fix a chipped tooth is bonding with a material known as composite resin. With this technique, resin is first mixed to match the tooth color and then applied to the chipped area or applied in layers of color to get just the right look. After a bit of shaping, curing and adjustment, we're done—you can walk out with a restored tooth in one visit.

Bonding works well with slight to moderate chips, but it could be less durable when there is more extensive damage. For that, you may want to consider porcelain veneers. Veneers are thin wafers of dental porcelain that are bonded to the front of teeth to mask blemishes like stains, slight gaps or, yes, chips. Veneers can be so lifelike that you won't be able to tell the veneered tooth from your other teeth. They are fashioned to match the color and shape of an individual's teeth. Because of the time and design detail involved, veneers are more expensive than bonding, yet still within an affordable range for many.

Teeth require some alteration before applying traditional veneers because otherwise the teeth can appear bulky when the veneer is bonded to the existing tooth. To compensate, we remove a little of the tooth enamel. Because this loss is permanent, you'll need to wear veneers or have some other form of restoration for the tooth from then on. For many people, though, that's a small price to pay for a smile without chips.

Your first step to repairing a chipped tooth is to come in for an examination. From there, we'll recommend the best option for your situation. And regardless of which, bonding or veneers, we can change your smile for the better.

If you would like more information about restoring injured teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Whitening” and “Porcelain Veneers: Strength and Beauty as Never Before.”


OralCancerIsDeadly-ButYouCanLowerYourRiskWithaHealthyLifestyle

An estimated 50,000 Americans are expected to be diagnosed this year with some form of oral cancer. Five years from now, if current survival rates still apply (57%), a little more than half will still be alive. That's why the Oral Cancer Foundation designates each April as Oral Cancer Awareness Month to call attention to this serious disease, and what you can do to lower your risk of contracting it.

Oral cancer has one of the lowest survival rates among known cancers, mainly because it easily goes undetected until its later stages when known treatments aren't as effective. Patients don't always have overt symptoms or they mistake cancerous lesions for everyday mouth sores. On the other hand, early detection and treatment dramatically improve survivability.

Here are some things you can do to reduce your risk for oral cancer or improve your odds for early detection.

Don't use tobacco. If you're a smoker, you're five to nine times more likely to develop oral cancer than a non-smoker. Using smokeless snuff or chewing tobacco is also risky—four times the risk of non-users. And preliminary evidence suggests that e-cigarettes increase the risk of cancer as well.

Make better food choices. A diet heavy in processed foods, especially nitrites used in curing meats and other products, can damage cellular DNA and lead to cancer. On the other hand, natural foods like fresh fruits and vegetables contain nutrients that lower cancer risk. A nutritious diet also contributes to healthier teeth and gums.

Practice safer sex. While older adults have traditionally accounted for most oral cancer cases, there has been a recent, unsettling rise among younger people. Most researchers tie this to the Human Papilloma Virus (HPV 16), which is sexually transmitted. You can reduce your risk for contracting HPV 16 and subsequent oral cancer by following safe sex practices.

Undergo oral cancer screenings. Your semi-annual dental visits to clean your teeth are also a prime opportunity to check for oral abnormalities, especially if you're older. During an oral cancer screening we visually inspect your face, neck, lips and the inside of your mouth for any suspicious sores or discolorations. Early detection leads to better outcomes.

You should also modify your alcohol consumption—moderate to heavy drinkers have three to nine times greater risk for oral cancer than light or non-drinkers. And, you can further lower your risk of lip cancers by limiting your exposure to the sun and wearing protective sunscreen.

Oral cancer is a dangerous condition that could threaten your life. Regular dental care and healthy lifestyle practices can help lower your risk for encountering this deadly disease.

If you would like more information about oral cancer, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Diet and Prevention of Oral Cancer.”




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