By Jennifer L. McCoy, DDS, Cosmetic & Family Dentistry
May 16, 2019
Category: Oral Health
Tags: tmj disorders   jaw pain  
JawJointDisordersandFibromyalgiaIsThereaConnection

Every May, the National Fibromyalgia & Chronic Pain Association asks people around the world to spread awareness of fibromyalgia and other chronic pain conditions. Anyone with fibromyalgia and its associated joint and muscle pain knows all too well how chronic pain can disrupt everyday life. And as we see frequently in the dental office, people contending with the jaw pain and dysfunction associated with a temporomandibular joint disorder (TMD) can equally relate.

But here’s the kicker—if you’ve been diagnosed with either TMD or fibromyalgia, there’s a good chance you’re also dealing with both conditions. For example, in one recent survey of over a thousand TMD patients, two-thirds reported also having fibromyalgia or similar kinds of health issues. Researchers are looking intently at possible connections between TMD and fibromyalgia since understanding any potential link between the two might open the door to new ways of treatment.

Fibromyalgia patients experience frequent muscle spasms and fatigue throughout their bodies, coupled with other problems like sleeplessness and memory difficulties. Most researchers today believe it’s caused by a malfunction within the central nervous system (CNS) to process pain. Those working with TMD research are also considering whether the same type of malfunction contributes to jaw joint pain and dysfunction.

TMD is an umbrella term for various disorders involving the jaw joints and associated muscles. When you come to the dental office, it is important that we know about any TMD pain you may be experiencing because this can affect your dental visits. For example, people with TMD may have trouble holding their mouth open for an extended period of time, so we can adjust dental exams and treatments accordingly. Also, we will want to look for underlying dental conditions that may have contributed to your TMD.

If you’re experiencing both TMD and fibromyalgia symptoms, be sure you let us as well as your rheumatologist know the various symptoms you’re experiencing with each condition, the treatments you’re undergoing and the medications you’re taking.

For TMD in particular, here are a few things you can do to reduce its impact on your daily life:

  • Avoid foods that require heavy chewing or jaw widening;
  • Use thermal therapies like warm compresses or ice packs to ease jaw stiffness and pain;
  • Practice relaxation techniques to reduce stress in your life;
  • Ask about muscle relaxants or other medications that might help.

You may find that some of these practices, particularly stress reduction, are also helpful in managing fibromyalgia. And if there is a deeper connection between TMD and fibromyalgia, unraveling the mystery could hopefully lead to even greater relief for both.

If you would like more information about managing your symptoms, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Chronic Jaw Pain and Associated Conditions” and “Fibromyalgia and Temporomandibular Disorders.”

By Jennifer L. McCoy, DDS, Cosmetic & Family Dentistry
May 06, 2019
Category: Oral Health
Tags: x-rays  
HowDentistsProvideYourChildtheBenefitofX-RaysasSafelyasPossible

X-ray imaging is such an intricate part of dentistry, we usually don't think twice about it. Without it, though, the fight against dental disease would be much harder.

At the same time, we can't forget that x-rays are a form of electromagnetic radiation that can penetrate human tissue. It's that very quality and the difference in the absorption rate between denser bone and teeth and softer diseased tissue that makes disease diagnosis possible.

But this same penetrative power can potentially harm the tissues it passes through. For that reason when practicing any form of x-ray diagnostics, dentists follow a principle known as ALARA, an acronym for "As Low As Reasonably Achievable." In lay terms ALARA means getting the most benefit from x-rays that we can with the lowest dose and exposure time possible.

While practicing ALARA with x-rays is important for patients of any age, it's especially so for children who are more sensitive to radiological energy given their smaller size and anatomy. We can't use the same settings, dosages or exposure times with them as with an adult.

To protect children, dentists have developed techniques and protocols that lessen their exposure time and rate, while still providing usable images for diagnosing disease. The bitewing is a good example of safe and effective pediatric x-ray imaging.

A bitewing is a plastic device holding exposable film that patients bite down on and hold in their mouth while x-raying. The x-rays pass through the teeth and gums and expose the film behind them on the bitewing. Using a bitewing we can capture a set of two to four radiographs to give us a comprehensive view of the back teeth, while exposing the child less radiation than they normally receive daily from background environmental sources.

This and other advances in equipment and digital imaging greatly reduce the amount of radiation patients receive during x-rays. If, though, you're still concerned about your child's x-ray exposure, talk with your dentist who can explain in more detail the x-ray safety protocols they follow. Just like you, they want your child to be as safe as possible while still benefiting from the diagnostic power of x-rays.

If you would like more information on safety precautions using x-rays with children, 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 “X-Ray Safety for Children.”

By Jennifer L. McCoy, DDS, Cosmetic & Family Dentistry
April 26, 2019
Category: Oral Health
Tags: oral health  
E-CigsCouldbeJustasHazardousforYourTeethandGumsasCigarettes

More than 20 million people in the United States use electronic cigarettes or e-cigs as an alternative to tobacco smoking. While many users believe "vaping" is a healthier alternative to regular cigarettes, recent research into the health effects of e-cigs could put a damper on that belief. There's particular concern among dentists that this popular habit could harm users' dental health.

E-cigs are made with a chamber that holds the liquid vaping solution and a heating mechanism to heat the liquid and vaporize it. Users inhale the vapor, which contains nicotine and flavorings, as they would a traditional cigarette.

The nicotine alone can be problematic for dental health as we'll see in a moment. But the vapor also contains aerosols that some research indicates could damage the inner skin linings of the mouth in a similar fashion to the smoke of traditional cigarettes. One study by researchers with the Université Laval in Quebec, Canada found evidence that e-cig vapor increased the death rate of mouth cells, and led to greater cell irregularities over time.

According to other studies, there's evidence that e-cig vapor may disrupt the balance of the oral microbiome, the communities of both beneficial and harmful bacteria that normally live in the mouth. The imbalance in favor of more harmful bacteria could increase the risk for dental disease, particularly periodontal (gum) disease.

Finally, nicotine from e-cigs seemed to create similar conditions in the mouth as it does with tobacco. Nicotine in any form can constrict blood vessels and reduce the body's ability to fight infection and to heal. Research indicates both forms of nicotine increase the risk for dental disease and make treatment more difficult.

These findings only identify conditions created by e-cigs that could be problematic for future dental health. Although we don't fully understand the long-term health effects of this new habit, based on the evidence so far the mouth may not fare so well. It's looking like e-cigs may be no safer for your teeth and gums than the cigarettes they replace.

If you would like more information on the health risks of electronic cigarettes, please contact us or schedule an appointment for a consultation.

By Jennifer L. McCoy, DDS, Cosmetic & Family Dentistry
April 16, 2019
Category: Oral Health
InTodaysNFLOralHygieneTakesCenterStage

Everyone knows that in the game of football, quarterbacks are looked up to as team leaders. That's why we're so pleased to see some NFL QB's setting great examples of… wait for it… excellent oral hygiene.

First, at the 2016 season opener against the Broncos, Cam Newton of the Carolina Panthers was spotted on the bench; in his hands was a strand of dental floss. In between plays, the 2105 MVP was observed giving his hard-to-reach tooth surfaces a good cleaning with the floss.

Later, Buffalo Bills QB Tyrod Taylor was seen on the sideline of a game against the 49ers — with a bottle of mouthwash. Taylor took a swig, swished it around his mouth for a minute, and spit it out. Was he trying to make his breath fresher in the huddle when he called out plays?

Maybe… but in fact, a good mouthrinse can be much more than a short-lived breath freshener.

Cosmetic rinses can leave your breath with a minty taste or pleasant smell — but the sensation is only temporary. And while there's nothing wrong with having good-smelling breath, using a cosmetic mouthwash doesn't improve your oral hygiene — in fact, it can actually mask odors that may indicate a problem, such as tooth decay or gum disease.

Using a therapeutic mouthrinse, however, can actually enhance your oral health. Many commonly available therapeutic rinses contain anti-cariogenic (cavity-fighting) ingredients, such as fluoride; these can help prevent tooth decay and cavity formation by strengthening tooth enamel. Others contain antibacterial ingredients; these can help control the harmful oral bacteria found in plaque — the sticky film that can build up on your teeth in between cleanings. Some antibacterial mouthrinses are available over-the-counter, while others are prescription-only. When used along with brushing and flossing, they can reduce gum disease (gingivitis) and promote good oral health.

So why did Taylor rinse? His coach Rex Ryan later explained that he was cleaning out his mouth after a hard hit, which may have caused some bleeding. Ryan also noted, “He [Taylor] does have the best smelling breath in the league for any quarterback.” The coach didn't explain how he knows that — but never mind. The takeaway is that a cosmetic rinse may be OK for a quick fix — but when it comes to good oral hygiene, using a therapeutic mouthrinse as a part of your daily routine (along with flossing and brushing) can really step up your game.

If you would like more information about mouthrinses and oral hygiene, contact us or schedule a consultation.

By Jennifer L. McCoy, DDS, Cosmetic & Family Dentistry
April 06, 2019
Category: Oral Health
Tags: oral hygiene  
The3TopIngredientsThatMakeYourToothpasteaSuperPlaqueBuster

Human beings have known for millennia the importance of keeping teeth clean. Although we've only come to more fully understand dental plaque's role in dental disease in the last century, our ancestors seemed to know instinctively this gritty biofilm on teeth had to go.

People from the past once used a variety of substances like ground oyster shells or leftover fire ashes to remove plaque from their teeth. Today, most of the world has replaced these substances with toothpaste, a mainstay of daily oral hygiene.

So, why is toothpaste better than other substances used in the ancient past? Besides the many other ingredients found in the typical tube of toothpaste, here are the top 3 that make it the ultimate tooth cleaner.

Abrasives. While your toothbrush does most of the mechanical work loosening plaque, toothpaste has ingredients called abrasives that give an added boost to your brushing action. The ideal abrasive is strong enough to remove plaque, but not enough to damage tooth enamel. If you look at your toothpaste's ingredient list, you'll probably see an abrasive like hydrated silica (made from sand), hydrated alumina, calcium carbonate or dicalcium phosphates.

Detergents. Your toothpaste's foaming action is a sign of a detergent, which helps loosen and break down non-soluble (not dissolvable with plain water) food substances. While similar to what you may use to wash your clothes or dishes, toothpaste detergents are much milder, the most common being sodium lauryl sulfate found in many cosmetic items. If you have frequent canker sores, though, sodium lauryl sulfate can cause irritation, so look for a toothpaste with a different detergent.

Fluoride. The enamel strengthening power of fluoride was one of the greatest discoveries in dental care history. Although not all toothpastes contain it, choosing one with fluoride can improve your enamel health and help protect you from tooth decay.

These and other ingredients like binders, preservatives and flavorings, all go in to make toothpaste the teeth-cleaning, disease-fighting product we've all come to depend upon. Used as part of daily oral hygiene, toothpaste can help brighten and freshen your smile, and keep your teeth and gums healthy.

If you would like more information on using the right toothpaste, 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 “Toothpaste: What's in It?





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