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Posts for category: Oral Health

By Cary J. Limberakis, DMD
March 22, 2020
Category: Oral Health
Tags: tmj disorders  
TryConservativeMeasurestoTreatingTMDBeforeMoreAggressiveOptions

After ruling out other possibilities for your constant jaw joint pain, your doctor has diagnosed you with a temporomandibular disorder (TMD). Now that you know what you have, what can you do about it?

Unfortunately, it's not always an easy answer. Ideas about treatment are almost as numerous as theories on the causes of TMD. By and large, though, we can classify treatment into two broad categories: conservative and aggressive.

The conservative approach is the result of many years of experimentation and application; it's also much less invasive than aggressive treatments. For most patients, though, these treatments can offer significant relief from pain and dysfunction.

Conservative treatments are based primarily on the philosophy that the temporomandibular joint is like any other joint, and should be treated that way. Treatments include thermal therapies like ice or heat packs applied to the jaw, physical therapy (gentle stretching, jaw exercise, and massage) and pain and muscle relaxant medication. In cases where teeth grinding may be a contributing factor, we might recommend a bite guard worn in the mouth to reduce biting pressure.

On the other end of the spectrum are treatments like altering the bite or the position of the jaw. The purpose of bite alteration is to change the dynamic when the jaws are in contact during chewing or clenching, and reduce pressure on the joints. This is often done by reshaping the teeth's biting surfaces, moving the teeth with orthodontics or performing crown and bridgework. Another possibility, actually modifying the lower jaw location, requires surgery. All of these aggressive treatments are done in order of less to more invasiveness.

These more aggressive treatments, especially jaw surgery, are irreversible. Furthermore, studies on results have not been encouraging — there's no guarantee you'll receive relief from your symptoms. You should consider the aggressive approach only as a last resort, after you've tried more conservative measures. Even then, you should get a second opinion before undergoing more invasive procedures.

Hopefully, you'll see relief from therapies that have made a significant difference for most TMD sufferers. And that's our goal: to reduce your pain and dysfunction and help you regain your quality of life.

If you would like more information on TMD causes and treatments, 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.”

WhatTaraLipinskiDoestoProtectOneofHerMostValuableAssets-HerSmile

Tara Lipinski loves to smile. And for good reason: The Olympic-gold medalist has enjoyed a spectacular career in ladies' figure skating. Besides also winning gold in the U.S. Nationals and the Grand Prix Final, in 1997 Lipinski became the youngest skater ever to win a World Figure Skating title. Now a sports commentator and television producer, Lipinski still loves to show her smile—and counts it as one of her most important assets. She also knows the importance of protecting her smile with daily hygiene habits and regular dental care.

Our teeth endure a lot over our lifetime. Tough as they are, though, they're still vulnerable to disease, trauma and the effects of aging. To protect them, it's essential that we brush and floss every day to remove bacterial plaque—that thin accumulating film on teeth most responsible for tooth decay and gum disease.

To keep her smile in top shape and reduce her chances of dental disease, Lipinski flosses and brushes daily, the latter at least twice a day. She also uses a tongue scraper, a small handheld device about the size of a toothbrush, to remove odor-causing bacteria and debris from the tongue.

Lipinski is also diligent about visiting the dentist for professional cleanings and checkups at least twice a year because even a dedicated brusher and flosser like her can still miss dental plaque that can then harden into tartar. Dental hygienists have the training and tools to clear away any lingering plaque and tartar that could increase your disease risk. It's also a good time for the dentist to check your teeth and gums for any developing problems.

The high pressure world of competitive figure skating and now her media career may also have contributed to another threat to Lipinski's smile: a teeth-grinding habit. Teeth grinding is the unconscious action—often while asleep—of clenching the jaws together and producing abnormally high biting forces. Often a result of chronic stress, teeth grinding can accelerate tooth wear and damage the gum ligaments attached to teeth. To help minimize these effects, Lipinski's dentist created a custom mouthguard to wear at night. The slick plastic surface of the guard prevents the teeth from generating any damaging biting forces when they clench together.

The importance of an attractive smile isn't unique to celebrities and media stars like Tara Lipinski. A great smile breeds confidence for anyone—and it can enhance your career, family and social relationships. Protect this invaluable asset with daily oral hygiene, regular dental visits and prompt treatment for disease or trauma.

If you would like more information about protecting your smile, please contact us or schedule an appointment. To learn more, read the Dear Doctor magazine articles “Tooth Decay” and “Teeth Grinding.”

By Cary J. Limberakis, DMD
February 21, 2020
Category: Oral Health
Tags: tooth decay  
PreventingDecayinPrimaryTeethPromisesBetterHealthNowandLater

True or false: there’s no cause for concern about tooth decay until your child’s permanent teeth erupt.

False—decayed primary teeth can lead to potentially serious consequences later in life.

Although “baby” teeth last only a few years, they’re essential to future dental health because they act as placeholders and guides for the incoming permanent teeth. If they’re lost prematurely due to decay, other teeth may drift into the empty space intended for the emerging permanent tooth. Because of this, inadequate space will crowd the out of proper alignment.

And because they have thinner enamel than permanent teeth, primary teeth are more susceptible to decay. Once decay sets in, it can spread rapidly in a matter of months.

Fortunately, we may be able to prevent this from happening to your child’s primary teeth with a few simple guidelines. It all begins with understanding the underlying causes of tooth decay.

Tooth decay begins with bacteria: As a result of their digestion, these microorganisms secrete acid that at high levels can erode tooth enamel. The higher the population of bacteria in the mouth, the higher the acidity and potential threat to the teeth.

The first objective then in preventing decay is to remove dental plaque, the thin film of bacteria and food particles on tooth surfaces, through daily brushing and flossing. And because bacteria feed on sugar as a primary food source, you should reduce your child’s sugar consumption by restricting it to only meal times and not sending your child to bed with a bottle filled with a sugary liquid (including formula or breast milk).

To help boost your child’s protection, we can also apply sealants and fluoride to teeth to help protect and strengthen their enamel from acid attack. Because we’ll also monitor for signs of decay, it’s important to begin regular dental visits beginning around age one. If we do detect decay, we can then treat it and make every effort to preserve your child’s primary teeth until they’ve completed their normal life cycle.

By taking these steps, we can help make sure your child’s early teeth go the distance. Their current and future dental health will certainly benefit.

If you would like more information on prevention and treatment of tooth decay, 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 “Do Babies Get Tooth Decay?

By Cary J. Limberakis, DMD
February 11, 2020
Category: Oral Health
Tags: loose tooth  
ALooseToothisaSignofDeeperDentalTrouble

A loose primary (“baby”) tooth is often a cause for celebration. A loose permanent tooth, however, is a cause for concern. A permanent tooth shouldn't even wiggle.

If you have a loose tooth, it's likely you have a deeper dental problem. Here are the top underlying causes for loose teeth.

Gum disease. Teeth are held in place by an elastic tissue called the periodontal ligament. But advanced periodontal (gum) disease, a bacterial infection usually caused by film buildup on teeth called dental plaque, can damage the ligament and cause it to detach. If it's not treated, it could lead to tooth loss.

Bite-related trauma. A normal bite helps balance out the forces generated when we chew so they don't damage the teeth. But if a misaligned tooth protrudes higher from the jaw, the opposing tooth will likely create more downward pressure on it while chewing. This can stress the tooth's supporting ligament to the point of looseness.

Self-inflicted trauma. While they may be trendy, tongue jewelry can cause dental damage. A wearer who clicks the “barbell” of a tongue stud against their teeth could be creating conditions conducive for gum damage and bone loss, which can cause tooth looseness. Similarly, taking orthodontics into your own hands could also damage your teeth, especially if you have undiagnosed gum disease.

Genetics. Although you can't prevent it, the type of resistance or susceptibility you inherited from your parents (as well as your dental anatomy) can cause you dental problems. Thinner gum tissues, especially around the roots, can make you more susceptible to gum disease or dental trauma, which in turn could contribute to tooth looseness.

There are things you can do to lessen your chance of loose teeth. Brush and floss every day to remove disease-causing bacterial plaque and see a dentist regularly for cleanings to reduce your risk of gum disease. If you have any misaligned teeth, consult with an orthodontist about possible treatment. And avoid oral jewelry and DIY orthodontics.

If you do notice a loose tooth, see us as soon as possible. We'll need to diagnose the underlying cause and create a treatment plan for it. We may also need to splint the tooth to its neighbors to stabilize it and reduce your risk of losing it permanently.

If you would like more information on tooth mobility, 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 “When Permanent Teeth Become Loose.”

By Cary J. Limberakis, DMD
February 01, 2020
Category: Oral Health
Tags: sleep apnea   snoring  
AnOralApplianceforSleepApneamaybetheRightOptionforYou

Daily fatigue or complaints of your snoring from family have led you to see your doctor about the problem. After an exam and a test session in a sleep lab, your problem now has a name — obstructive sleep apnea.

This common sleep-related breathing disorder (SRBD) occurs when the soft tissues in the back of the throat over-relax during sleep. The relaxed tissues obstruct air flow to the trachea (windpipe) and cause “apnea,” where you cease to breathe. The lack of oxygen causes you to wake, even for a micro-second, to begin breathing again. This may occur multiple times throughout the night, diminishing the quality of your sleep and leading not only to drowsiness and daily fatigue but also contribute to cardiovascular disease or other systemic conditions.

The most effective treatment for sleep apnea is the use of a Continuous Positive Airway Pressure (CPAP) machine while you sleep. The machine delivers pressurized air to a face mask you wear while you sleep; the additional pressure keeps the airway open. However, a CPAP machine does have a few disadvantages, including discomfort while attached to the machine, nasal congestion and dryness, or claustrophobia. These effects can be so pronounced for some patients, they’re unable to adjust themselves to the machine.

If you have mild to moderate sleep apnea, there may be an alternative — a custom-fitted oral appliance we manufacture for you to wear in your mouth while you sleep. The appliance pulls the lower jaw forward resulting in a wider opening of the airway. In addition to being less cumbersome than a CPAP mask, an oral appliance is easier to wear, compact in size for easy travel and doesn’t require electricity.

While an oral appliance is an effective alternative to a CPAP machine for many patients, it does have a few disadvantages including problems with saliva flow (too much or too little), muscle or teeth soreness and minor tooth or jaw movement. Still, an oral appliance might be the right solution to relieve your sleep apnea over the long-term.

If you would like more information on treatments for sleep apnea, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Sleep Disorders & Dentistry” and “Sleep Apnea FAQs.”



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