TMJ Issues – What You Need to Know

2020-06-11T13:21:55+00:00October 22nd, 2019|General, Oral Health|

If you’ve ever experienced acute jaw pain, you’re not alone. TMJ (temporomandibular joint) disorder is a common issue that currently affects over 10 million Americans. Women tend to be more prone to this disorder than men although researchers don’t yet fully understand why. The good news is that the majority of TMJ disorders do not indicate serious, long term issues and the associated pain is typically temporary in nature. Understanding what TMJ disorder is can help those suffering to better treat and manage any discomfort that might arise.

 

What is TMJ

Your temporomandibular joint is a complicated joint that works to connect your lower jaw to your skull. It acts like a sliding hinge and allows your mouth to move in various directions which, in turn, supports your ability to eat, yawn, smile and more. Due to its design and location within the body, the TMJ is one of the more difficult joints to access and treat. Disorders of the temporomandibular joint typically present in one of three ways:

  1. Pain or discomfort occurring in the tissues that control jaw function
  2. Injury or dislocation within the area of the jaw
  3. Arthritis or inflammation within the joint

Individual causes of TMJ disorder can be difficult to diagnose as there can be a mixture of reasons why a person experiences jaw pain.

 

Causes and Symptoms

While some cases of TMJ disorder can be initiated by injury, most causes are less evident and the origin unknown. Because the disorder is found to be more prevalent in women versus men, researchers are currently studying whether female hormones might play a potential role.

While teeth grinding and jaw clenching can potentially trigger TMJ pain, it isn’t considered to be a definitive cause. Braces and other methods of alignment have also not been proven to bring about TMJ disorder.

People who experience TMJ pain commonly suffer from one or more symptoms including:

  • Pain or discomfort when eating/chewing food
  • Pain in or around your ear (sometimes feels like a dull earache)
  • Inability to fully open and close your mouth
  • Pain traveling in and around the area of the face

 

Diagnosis and Treatment

As of today, there are no set methods for diagnosing TMJ disorder. When assessing the problem, your dentist will observe your jaw, feel in the area of the temporomandibular joint for any clicking or popping, and potentially order an x-ray if he/she feels additional observation is needed. It’s also a good idea to visit your family doctor in addition to your dentist to rule out alternative reasons you might be experiencing craniofacial pain.

Often times, the pain associated with TMJ disorder will go away on its own. However, if treatment is needed, there are a handful of options typically available to most patients.

  • Over the counter pain relievers and anti-inflammatories. Common medications such as ibuprofen and Tylenol will go a long way toward providing relief for most occurrences of TMJ disorder. However, if your case is more serious, your dentist may prescribe a clinical dose to help alleviate the pain.
  • Stabilization splints (Bite Guards). A bite guard is one of the more common solutions that a dentist can provide to help with the pain of TMJ disorder. This appliance fits over either the upper or lower teeth and is typically worn full-time for a short period followed by a short stint of wearing while eating and/or sleeping. While it is not fully understood why this appliance helps it is believed that stabilizing the muscles in the mouth can help to repair any potential damage that might have occurred over time within the temporomandibular joint.

There are also a number of ways that you can control the discomfort of TMJ disorder through specific methods of self-care.

  • Practice facial relaxation techniques. Tightness and pulling of the jaw muscles can aggravate and increase discomfort in your temporomandibular joint. When you begin to feel pain, be aware of whether or not you’re clenching. Practice releasing the tension in your jaw.
  • Avoid exaggerated or repetitive movements of the jaw. Activities such as gum chewing or excessive yawning/yelling can exacerbate TMJ pain and should be avoided if possible.
  • Stay away from hard food. Focusing on eating soft foods when experiencing TMJ pain can help to keep discomfort to a minimum.

 

While there is currently no hard and fast solution to the issues associated with TMJ, there are several ways that you can manage and control the discomforts associated with it. If you are concerned you might have TMJ disorder, don’t hesitate to contact your dentist for more information.

At Carolina’s Dental Choice, our dentists are experts in the management of TMJ disorder and are ready to answer any questions you might have. Feel free to call our office to learn more about the ways we can help.

 

Works Cited

“TMJ Disorders.” National Institutes of Health, National Institutes of Health, Sept. 2017, https://www.nidcr.nih.gov/sites/default/files/2017-12/tmj-disorders.pdf.

“TMJ Disorders.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 28 Dec. 2018, https://www.mayoclinic.org/diseases-conditions/tmj/diagnosis-treatment/drc-20350945.

 

 

 

 

 

 

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Managing Pain and Anxiety During Dental Visits

2020-06-11T13:38:58+00:00October 9th, 2019|Dental Trends, General|

It’s no secret that regular dental visits are an important tool for maintaining good oral health. Despite this, as much as 36% of the population fears a visit to the dentist and 1 in 25 suffers from dentophobia (extreme fear of dental visits). While there are many reasons people might have anxiety around a trip to the dentist, there are also a number of ways that both you and your dentist can help to alleviate those fears.

 

Pain and Anxiety Management

Fear of pain is the number one reason people are afraid to visit the dentist. And while having your teeth worked on won’t necessarily be something you look forward to, it also doesn’t have to be something you fear. Technology has come a long way when it comes to anxiety and pain management. Here is a list of some of the tools you and your dentist have at your disposal to combat any fears that might arise.

 

Pain-Free Shots –  Let’s just say it. Shots are scary. For all of us. No one likes to be poked with needles, especially in their mouths. However, dentists have multiple options at their disposal to help make the experience of getting a shot much easier and a whole lot less scary. If they aren’t already, ask your dentist to use an anesthetic gel or rinse to help numb your mouth before administering the shot. This will desensitize the area and lessen pain significantly.

Studies have also shown that the speed at which a shot is administered can affect the level of discomfort a person experiences. The general rule of thumb is “the slower the better” when it comes to administering numbing medication. If your doctor gives you novocaine, expect it to take approximately 60-90 minutes to wear off after the procedure depending on the amount given.

 

Providing distraction – Oftentimes dentists will offer various forms of distraction that can help to lessen a person’s anxiety and make it easier to get through a procedure. Some of these distractions include tv’s on the ceiling, movie headsets that immerse you in a world outside of your current situation and soothing aromatherapy scents such as orange and lavender. Some dentists even go so far as to have a spa-like atmosphere that provides perks such as a manicurist and reflexologist to be available during procedures.

 

Oral Pain Relief – If an alternative to a shot is needed, there are various oral solutions that can be considered. The first option is the use of nitrous oxide (N2O). We all know nitrous oxide from our childhood by its informal name of “laughing gas”. N2O works to relax you and provide you with a more pleasurable emotional feeling. Pain is intensified when we are stressed or anxious so allowing yourself to relax can be an effective method of management. In addition, N2O is considered safe and effective because it begins to work quickly and the effect is completely reversible with no long-lasting effects. When used for a dental procedure, you will recover quickly enough afterward to be able to drive yourself home.

Another oral method used to help people alleviate the fear of a trip to the dentist is a pill called Halcion. Halcion is a member of the Valium family and is usually administered an hour or two before work is done. Some dentists will also provide a pill the night before to ensure the patient has a full night’s sleep. When this pill is used, patients can feel sleepy and relaxed but are still able to communicate with the dentist.

 

Electronically Delivered Pain Relief – An alternative to injection, this type of pain relief is commonly known as transcutaneous electrical nerve stimulation or TENS for short. TENS uses low voltage electricity to help alleviate pain. Your dentist will place adhesive pads on your face in the area where they are working and send a low current through in order to achieve numbness. TENS can help to relax your jaw and facial muscles, a commonly tense area when people experience anxiety.

 

Laser Drills – While not yet formally approved by the American Dental Association, the organization says that they are cautiously optimistic about how this technology can influence the future of dentistry. Laser drills provide an alternative to traditional drills by using the energy from light to cut or vaporize infected tissues. This form of treatment is less invasive and less painful than traditional methods currently being used. A few examples of how lasers can be used in dentistry include treating tooth decay, remedying issues associated with gum disease, performing biopsies and whitening teeth.

 

IV Sedation – If more moderate sedation is needed, a dentist will sometimes use IV sedation. One advantage to this form of sedation is that the dentist has direct control over the levels you are given and can quickly adjust to meet your individual needs.

 

Additional Sedation Options – While family dentists don’t perform deep sedation or general anesthesia, sometimes when you are referred to a specialist, you may encounter these options. In order to administer deep sedation, providers need to complete a program through CODA (Commission on Dental Accreditation) focusing on deep sedation and general anesthesia. Typically this accreditation is completed by oral surgeons and dental anesthesiologists.

 

Post Dental Pain – What to Expect

While pain management during dental treatment is important, understanding pain post-treatment is equally as important. Having the ability to discern between what type of pain is normal versus when it is necessary to contact a professional can be a huge advantage for someone who is anxious about their recovery. Here are a few examples of different types of pain you might experience after a visit to the dentist.

 

Jaw Soreness/Tenderness – This type of pain is one of the more common types experienced after a dental procedure. It occurs because of your mouth being held open for an extended period of time. The muscles in your mouth are no different from the muscles in any other part of your body. Use them more than they’re used to being used and they’ll become sore and tired. One way to remedy the pain is to ask your dentist if he has a bite block available for you to use. A bite block will allow your jaw to rest while still allowing the dentist to perform dental work. If you do experience this type of pain, it will typically clear up after a day or two depending on the procedure. For people who grind their teeth, it may take slightly longer as grinding is also a major cause of jaw soreness.

 

Pulpitis – Pulpitis is caused by an inflammation of the pulp within the tooth. It can feel like the sudden onset of a toothache. Pulpitis can also cause hot and cold temperature sensitivity within a tooth. This type of pain can occur after any dental procedure where a tooth has been worked on from a filling to the repair of a cracked or chipped tooth. There is both reversible and irreversible pulpitis. With reversible pulpitis, you won’t feel pain unless something comes in contact with the tooth to affect its sensitivity. However, irreversible pulpitis is a constant pain that typically requires a root canal to remedy. Irreversible pulpitis is not a common side effect of performed dental work, rather, it is typically a sign that dental work may be necessary.

 

Referred Pain – Referred pain is when you feel pain in other areas of your body than where the pain originated. So, for example, while you might have had a root canal on your molar, your eye sockets or ears may experience pain as a result. Referred pain can be experienced from any traumatic event and can sometimes be a sign of something more serious. If you experience referred pain that doesn’t go away within a week of your procedure, be sure to check in with your dentist and let him know about the symptoms you are experiencing.

 

Methods for Addressing Post Dental Pain

While there may be no sure-fire method to completely escape the discomfort that comes after a dental procedure, there are ways to lessen the pain and make recovery a more pleasant experience. A few suggestions for improved recovery time are listed below.

  • Eat an anti-inflammatory diet before you go to the dentist. Focusing on foods that help combat inflammation will improve your overall recovery time.
  • For those with TMJ/TMD, focus on relaxing your jaw before your procedure. Consciously working to relax and stretch your jaw muscles will help reduce pain post-procedure.
  • Check for a bite block. As stated above, asking if your dentist has a bite block available can lead to a lot less pain and discomfort after the work is over.
  • Relax! While this tactic is obviously easier said than done, it’s a known fact that stress will tense your muscles and cause a longer recovery as a result. Practicing mindfulness and focusing on your breathing can go a long way towards bringing down the levels of stress associated with a dental procedure.

Of course, taking an anti-inflammatory such as ibuprofen or acetaminophen is also a perfectly acceptable way to deal with pain after a procedure. If your dentist prescribes medication, be sure to follow all the directions associated with it and never share a prescription with someone else. If for any reason, your pain doesn’t diminish or feels like it’s getting worse, call your dentist and set up an appointment to check and make sure everything is healing the way it should.

 

Pain isn’t fun for anyone. The good news is that there are several tools at your dentist’s disposal that they can use to help you through a procedure with a minimal level of discomfort. While the dentist’s chair can sometimes seem like a scary place, remember that first and foremost, they are there to help you maintain a strong, healthy smile. They have their teeth worked on the same as you and, like you, they also desire an outcome that doesn’t leave pain in its wake.

 

Our dentists are sensitive to your needs and are always happy to speak with you about the options we provide when it comes to pain control. Please feel free to call anytime during office hours and we’ll be happy to set up a consultation for you to learn more.

 

 

 

 

Works Cited

 

Boge, Emily. “Dental Phobia, Fear of Dentist & Anxiety: Colgate Oral Care.” Dental Phobia, Fear of Dentist & Anxiety | Colgate Oral Care, https://www.colgate.com/en-us/oral-health/basics/dental-visits/how-dental-phobia-develops-and-what-offices-do-to-help-0515.

Collins, Sonya. “Do You Dread the Dentist?” WebMD, WebMD, https://www.webmd.com/oral-health/features/dentist-anxiety#1.

“Controlling Anxiety and Pain at the Dentist’s Office.” WebMD, WebMD, https://www.webmd.com/oral-health/controlling-dental-pain#1.

DDS, Mark Burhenne. “Pain After a Dental Visit: What’s Normal, and What’s Not.” Ask the Dentist, 30 Aug. 2019, https://askthedentist.com/pain-dental-visit/.

Garret-Bernardin, Annelyse, et al. “Pain Experience and Behavior Management in Pediatric Dentistry: A Comparison between Traditional Local Anesthesia and the Wand Computerized Delivery System.” Pain Research & Management, Hindawi Publishing Corporation, 2017, https://www.ncbi.nlm.nih.gov/pubmed/28293129.

Kasat, Vikrant, et al. “Transcutaneous Electric Nerve Stimulation (TENS) in Dentistry- A Review.” Journal of Clinical and Experimental Dentistry, Medicina Oral S.L., 1 Dec. 2014, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4312687/.

“Laser Use in Dentistry.” WebMD, WebMD, https://www.webmd.com/oral-health/guide/laser-use-dentistry.

“Sedation Dentistry: Can You Really Relax in the Dentist’s Chair?” WebMD, WebMD, https://www.webmd.com/oral-health/sedation-dentistry-can-you-really-relax-in-the-dentists-chair#1.

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