Chronic pain can turn your life upside down. While there are a number of disorders that fit in this category, two of them—fibromyalgia and temporomandibular disorders (TMD)—can disrupt your quality of life to the extreme. And it may be the two conditions have more in common than similar symptoms—according to one study, three-fourths of patients diagnosed with fibromyalgia show symptoms of TMD.
To understand why this is, let’s take a closer look at these two conditions.
Fibromyalgia presents as widespread pain, aching or stiffness in the muscles and joints. Patients may also have general fatigue, sleep problems, mood swings or memory failures. TMD is a group of conditions that often result in pain and impairment of the temporomandibular joints that join the jaw with the skull. TMD can make normal activities like chewing, speaking or even yawning painful and difficult to do.
Researchers are now focusing on what may, if anything, connect these two conditions. Fibromyalgia is now believed to be an impairment of the central nervous system within the brain rather than a problem with individual nerves. One theory holds that the body has imbalances in its neurotransmitters, which interfere with the brain’s pain processing.
Researchers have also found fibromyalgia patients with TMD have an increased sensitivity overall than those without the conditions. In the end, it may be influenced by genetics as more women than men are prone to have either of the conditions.
Treating these conditions is a matter of management. Although invasive techniques like jaw surgery for TMD are possible, the results (which are permanent) have been inconclusive in their effectiveness for relieving pain. We usually recommend patients try more conservative means first to lessen pain and difficulties, including soft foods, physical therapy, stretching exercises and muscle relaxant medication. Since stress is a major factor in both conditions, learning and practicing relaxation techniques may also be beneficial.
In similar ways, these techniques plus medication or cognitive-behavioral therapy that may influence neurotransmission can also help relieve symptoms of fibromyalgia. Be sure then that you consult with both your physician and dentist caring for both these diseases for the right approach for you to help relieve the effects of these two debilitating conditions.
If you would like more information on managing TMD or fibromyalgia, 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 “Fibromyalgia and Temporomandibular Disorders.”
During his former career as a professional footballer (that's a soccer star to U.S. sports fans) David Beckham was known for his skill at “bending” a soccer ball. His ability to make the ball curve in mid-flight — to avoid a defender or score a goal — led scores of kids to try to “bend it like Beckham.” But just recently, while enjoying a vacation in Canada with his family, “Becks” tried snowboarding for the first time — and in the process, broke one of his front teeth.
Some fans worried that the missing tooth could be a “red card” for Beckham's current modeling career… but fortunately, he headed straight to the dental office as soon as he arrived back in England. Exactly what kind of treatment is needed for a broken tooth? It all depends where the break is and how badly the tooth is damaged.
For a minor crack or chip, cosmetic bonding may offer a quick and effective solution. In this procedure, a composite resin, in a color custom-made to match the tooth, is applied in liquid form and cured (hardened) with a special light. Several layers of bonding material can be applied to re-construct a larger area of missing tooth, and chips that have been saved can sometimes be reattached as well.
When more tooth structure is missing, dental veneers may be the preferred restorative option. Veneers are wafer-thin shells that are bonded to the front surface of the teeth. They can not only correct small chips or cracks, but can also improve the color, spacing, and shape of your teeth.
But if the damage exposes the soft inner pulp of the tooth, root canal treatment will be needed to save the tooth. In this procedure, the inflamed or infected pulp tissue is removed and the tooth sealed against re-infection; if a root canal is not done when needed, the tooth will have an increased risk for extraction in the future. Following a root canal, a tooth is often restored with a crown (cap), which can look good and function well for many years.
Sometimes, a tooth may be knocked completely out of its socket; or, a severely damaged tooth may need to be extracted (removed). In either situation, the best option for restoration is a dental implant. Here, a tiny screw-like device made of titanium metal is inserted into the jaw bone in a minor surgical procedure. Over time, it fuses with the living bone to form a solid anchorage. A lifelike crown is attached, which provides aesthetic appeal and full function for the replacement tooth.
So how's Beckham holding up? According to sources, “David is a trooper and didn't make a fuss. He took it all in his stride." Maybe next time he hits the slopes, he'll heed the advice of dental experts and wear a custom-made mouthguard…
If you have questions about restoring damaged teeth, please contact our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Children's Dental Concerns and Injuries.”
Did you ever brush your teeth and find that your gums were bleeding slightly? This unwelcome discovery is more common than you might think — and it might have something to tell you about your oral health. Here are five things you should know about bleeding gums.
- As much as 90% of the population occasionally experiences bleeding gums. It happens most often while brushing — and it’s often a sign of trouble, indicating that your gums are inflamed and/or you aren’t brushing or flossing optimally.
- Bleeding gums can be an early warning sign of gum disease. In its earliest stages, this malady is called gingivitis, and it’s quite common. About 10 to 15 percent of people with gingivitis go on to develop a more serious form of gum disease, called periodontitis. If left untreated, it can lead to gum recession, bone loss, and eventually tooth loss.
- A professional exam is the best way to tell if you have gum disease. Your dentist or hygienist may use a small hand-held instrument called a periodontal probe to check the spaces between your teeth and gums. When gum tissue becomes detached from the teeth, and when it bleeds while being probed, gum disease is suspected.
- Other symptoms can confirm the presence of gum disease. These include the presence of pus and the formation of deep “pockets” under the gums, where gum tissues have separated from teeth. The pockets may harbor harmful bacteria, and need to be treated before they cause more damage.
- Several factors may influence the health of your gums. How effectively you brush and floss has a major impact on the health of your gums. But other factors are important too: For instance, women who are pregnant or taking birth control pills sometimes have bleeding gums due to higher hormone levels. Diabetics and people with compromised immune systems often tend to have worse problems with periodontal disease. Certain drugs, like aspirin and Coumadin, may cause increased bleeding; smoking, by contrast, can mask the presence of gum disease by restricting blood flow.
It’s never “normal” to have bleeding gums — so if you notice this problem, be sure to have an examination as soon as you can. If you have questions about bleeding gums or periodontal disease, contact us or schedule a consultation. You can read more in the Dear Doctor magazine article “Assessing Risk For Gum Disease.”
Mention “bacteria” and people begin looking for the germicide. The truth is, though, only a few strains cause disease — the rest are benign or even play a beneficial role.
This may shock you, but your body both inside and out is home to around 100 trillion single-celled organisms, exceeding the number of your native cells by 10 to 1. You won't notice them, though: bacteria are so small they only make up 1 to 3% of your total body mass. And each of us has a unique “microbiome” of micro-organisms: they influence a variety of processes like digestion and metabolism, and some even “teach” our immune systems to distinguish between helpful and harmful bacteria.
Of the 10,000 or more species of bacteria that inhabit the body, perhaps the most studied and understood are in the mouth. We even have a database that catalogs the gene sequences of oral bacteria. And what we've learned has enlarged our understanding of dental disease and how to prevent or treat it.
This new knowledge, for example, confirms that many of our modern lifestyle habits adversely affect oral health. For example, researchers have found higher concentrations of Streptococcus mutans, the bacteria most responsible for tooth decay, in current samples of biofilm than in those from preindustrial eras. The culprit seems to be the modern diet rich with carbohydrates like sugar that bacteria eat. Cigarette smoking can also make the mouth friendlier to disease-causing bacteria.
On the bright side, our growing knowledge of oral bacteria is helping us devise better prevention and treatment strategies. One example is the use of antibiotics to reduce the populations of disease-causing oral bacteria.
The broad, traditional approach kills not only malevolent bacteria, but beneficial strains as well. The approach may also be helping bad bacteria become resistant to common antibiotics. A newer approach targets specific bacteria with custom-designed antibiotics that won't kill other bacteria. There's also increased focus on ways to re-balance a person's normal microbiome if it's become skewed.
As we come to understand bacteria better — both good and bad species — these and other dental care efforts will benefit. With our increasing knowledge of these microorganisms that surround us the future looks bright for better oral health.
If you would like more information on the role of bacteria in 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 “New Research Shows Bacteria Essential to Health.”
For some time now you've noticed a painful, burning sensation in your mouth for no apparent reason. It doesn't matter what you eat or drink — or whether you eat or drink — the dry, tingling sensation seems to stay with you.
You may have Burning Mouth Syndrome (BMS). You feel as if your mouth is scalded or burning generally or in a certain area like the lips, tongue or inside of the cheeks. Regardless, the discomfort (which seems to grow as the day wears on) can contribute to irritability, anxiety or depression.
It's not always easy to lock in on the specific cause. BMS has been linked, among other things, to diabetes, vitamin deficiencies, or cancer therapy. It's common among women around the age of menopause, so there's some speculation it could be affected by hormonal changes. It could also be connected with dry mouth (brought on by age or medications), an allergic reaction to toothpaste ingredients, acid reflux or autoimmune disorders.
While there's no single proven treatment for BMS, there are some things you can do to lessen its effects. First, stop habits that cause dry mouth like smoking, drinking alcohol or coffee and eating hot and spicy foods. Second, keep your mouth moist by frequently drinking water or using products that stimulate saliva flow.
You might also try toothpastes without sodium lauryl sulfate (a detergent that can cause skin peeling in some people), whiteners or strong flavorings like cinnamon. If you have chronic dry mouth, speak with your physician about any medications you're taking that might be causing it and seek alternatives. And because stress seems to magnify your symptoms, try to reduce it in your life through relaxation techniques, exercise or group support.
In some cases, BMS may resolve itself over time. In the mean time, making these lifestyle changes could help ease your discomfort.
If you would like more information on burning mouth syndrome, 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 “Burning Mouth Syndrome: A Painful Puzzle.”
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