TMJ Problems - What are your choices?

A guest post by:

David A. Torkko, DC

Tigard Family Chiropractic

Dr. Justin Marostica and I have teamed up to help you better understand TMJ issues and what your treatment choices are. The TMJ (temporomandibular joint) is the joint where your lower jaw hinges to your occiput (head). It is a fairly complex joint that has a disc pad for cushion and has many powerful muscles that attach to it for chewing and grinding of food. In this blog I will share the options and approaches that have proven successful in my practice.

Common problems affecting the TMJ can manifest as headaches, night/day grinding, clinching, neck pains, jaw and facial pains, popping and pain with chewing, tightness in the neck muscles and shoulders, stress and fatigue. If you have been diagnosed and feel that TMJ is an issue, Dr. Marostica and I have some great options to help you recover. 

What I do for TMJ as a chiropractor:

1st – Thorough evaluation of the cervical spine (neck):

a) Why look at the neck? Out of the cervical spine come the nerves that control and power the TMJ joint and attach muscles. Pain is carried through nerves so the spine (human fuse box) is an overlooked but essential element to assess in TMJ issues. Abnormal spinal vertebra alignment irritates and compresses the delicate spinal nerves and causes pain that can show up in the TMJ = referred pain.

b) The TMJ muscles are controlled by the cervical (neck) nerves and improper nerve impulses ultimately create imbalances in the jaw muscles that open and close the jaw. Over time it wears on the TMJ and causes chronic inflammation and pain. 

2nd – Thorough evaluation at the TMJ:

a) Palpation and range of motion evaluation at the TMJ helps me understand the quality of the joint movement and alignment. When or where the TMJ catches, locks, or becomes painful is important in the assessment process. 

3rd – Radiography:

a) X-rays may be required to better understand the dynamic relationship between the TMJ and the cervical spine. This process would also identify any biomechanical pathologies

4th – Treatment - I use a multifaceted approach for TMJ care. Here is a basic outline of protocols 

that have proven successful:

1. Gentle spinal care to regain proper nerve function to the TMJ and adjacent muscles.

2. Gentle functional alignment of the TMJ through the use of the ArthroStim to regain balance of motion in the jaw.

3. FDA approved cold laser; class 3B laser utilizing the Med-X Laser to heal and regenerate damage and inflamed tissues within the TMJ.

This functional treatment program along with TMJ splints or other treatment techniques Dr. Marostica may implement provides safe, effective, and conservative approach to TMJ management and healing.

For further questions, please contact our office at 503-595-6777 or go to our website at www.TigardChiropractic.com. I personally look forward to helping you in your healing journey!

Yours in health, 

David A. Torkko, DC

Back to Dental Basics!

I get asked the same question everyday… “How can I keep from getting cavities?”   This is a simple question that deserves a simple answer, so I have broken it down into 5 simple and easy steps that everyone should take to prevent tooth decay. 

1. Brush your teeth twice a day—in the morning after breakfast and at bedtime.  This removes plaque, which can lead to damaged teeth, gums, and surrounding bone.   
2. Floss at least once a day, preferably at bedtime.  Saliva flow that protects teeth during the day shuts down at night and any plaque that is left between the teeth becomes food for the bacteria that cause cavities.
3. Use toothpaste that contains fluoride, which helps prevent tooth decay and cavities.   Ask your dentist if you need a mouthwash that contains fluoride or one with ingredients that fight plaque.   Look for toothpastes that have been approved by the American Dental Association.  If you are prone to cavities or have lots of dental restorations, prescription- strength fluoride toothpaste is available and can be prescribed.
4. Avoid foods that contain a lot of sugar. Late night snacks are especially destructive because they supply bacteria sugar at a time when your teeth are most vulnerable.
5. Schedule regular trips to the dentist based on how often you need exams, x-rays, and cleaning. Every 6 months is typical.

Other helpful but less critical tips to avoid tooth decay are to have sealants placed on all permanent molars and premolars when they erupt into the mouth, have the sealants maintained properly, and use an electric toothbrush.

Patients who follow these 5 steps on a daily basis will avoid getting cavities and will find that their dental appointments will go smoothly and quickly!

By Dr. Andrew Thompson
TenderCare Dental - Portland, Oregon
http://www.facebook.com/TenderCareDental

HPV - Do you have a growing risk factor for oral cancer?

According to the CDC, more than 1,700 new cases of HPV-associated head and neck cancers are diagnosed in women and nearly 5,700 are diagnosed in men each year. 

Some Dentists are now offering a new, simple test of saliva that can determine your risk for oral cancer from the Human Papilloma Virus, more commonly known as HPV. The problem is, it costs $200, and the test is not covered by standard dental insurance. 

If you are an at risk patient, would you be willing to pay the entire cost of this test every few years?

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Halitosis (Bad Breath) FAQ’s Answered

What causes bad breath?

What you eat affects the air you exhale. Certain foods, such as garlic and onions, contribute to objectionable breath odor. Once the food is absorbed into the bloodstream, it is transferred to the lungs, where it is expelled. Brushing, flossing and mouthwash will only mask the odor temporarily. Odors continue until the body eliminates the food. Dieters may develop unpleasant breath from infrequent eating.

If you don't brush and floss daily, particles of food remain in the mouth, collecting bacteria, which can cause bad breath. Food that collects between the teeth, on the tongue and around the gums can rot, leaving an unpleasant odor. Dentures that are not cleaned properly can also harbor odor-causing bacteria and food particles.

One of the warning signs of periodontal (gum) disease is persistent bad breath or a bad taste in the mouth. Periodontal disease is caused by plaque, the sticky, colorless film of bacteria that constantly forms on teeth. The bacteria create toxins that irritate the gums. In the advanced stage of the disease, the gums, bone and other structures that support the teeth become damaged. With regular dental checkups, your dentist can detect and treat periodontal disease early.

Bad breath is also caused by dry mouth (xerostomia), which occurs when the flow of saliva decreases. Saliva is necessary to cleanse the mouth and remove particles that may cause odor. Dry mouth may be caused by various medications, salivary gland problems or continuously breathing through the mouth. If you suffer from dry mouth, your dentist may prescribe an artificial saliva, or suggest using sugarless candy and increasing your fluid intake.

Tobacco products cause bad breath, stain teeth, reduce one's ability to taste foods and irritate gum tissues. Tobacco users are more likely to suffer from periodontal disease and are at greater risk for developing oral cancer. If you use tobacco, ask your dentist for tips on kicking the habit.

Bad breath may be the sign of a medical disorder, such as a local infection in the respiratory tract (nose throat, windpipe, lungs), chronic sinusitis, postnasal drip, chronic bronchitis, diabetes, gastrointestinal disturbance, liver or kidney ailment. If your dentist determines that your mouth is healthy, you may be referred to your family doctor or a specialist to determine the cause of bad breath.

Eliminating periodontal disease and maintaining good oral health is essential to reducing bad breath. Schedule regular dental visits for a professional cleaning and checkup. If you think you have constant bad breath, keep a log of the foods you eat and make a list of medications you take. Some medications may play a role in creating mouth odors

Brush twice a day with a fluoride toothpaste to remove food debris and plaque. Brush your tongue, too. Once a day, use floss or an interdental cleaner to clean between teeth. If you wear removable dentures, take them out at night. Clean them thoroughly before replacing them the next morning.

Mouthwashes are generally cosmetic and do not have a long-lasting effect on bad breath. If you must constantly use a breath freshener to hide unpleasant mouth odor, see your dentist. If you need extra help in controlling plaque, your dentist may recommend using a special antimicrobial mouthrinse. A fluoride mouthrinse, used along with brushing and flossing, can help prevent tooth decay.

What can I do about bad breath?

Regular checkups will allow your dentist to detect any problems such as periodontal (gum) disease, a dry mouth or other disorders that may be the cause. Maintaining good oral hygiene, eliminating periodontal (gum) disease and scheduling regular professional cleanings are essential to reducing bad breath.

Regardless of what may be the cause, good oral hygiene is essential. Brush twice a day and clean between your teeth daily with floss or interdental cleaners. Brush your tongue, too. If you wear dentures, be sure to remove them at night and clean them thoroughly before replacing them the next morning.

What is the treatment for bad breath?

If your dentist determines that your mouth is healthy and that the odor is not of oral origin, you may be referred to your family physician or to a specialist to determine the cause of the odor and for treatment. Of course, if the odor is of oral origin, as it is in the majority of cases, your dentist can treat the cause of the problem.

If the odor is due to periodontal (gum) disease, your general dentist can either treat the disease or refer you to a periodontist, a specialist in treating gum tissues. Periodontal (gum) disease can cause gum tissues to pull away from the teeth and form pockets. When these pockets are deep, only a professional periodontal cleaning can remove the bacteria and plaque that accumulate. Sometimes more extensive treatment is necessary.

If you have extensive build-up of plaque, an invisible layer of bacteria, your dentist may recommend using a special antimicrobial mouthrinse. Your dentist may also recommend that when you brush your teeth, you also brush your tongue to remove excess plaque.


Guest Post By:
Justin Marostica, DMD

Teeth Whitening FAQ’S Answered

There are many causes of tooth staining.  Certain medications, tooth trauma, root fillings, and foods and beverages can cause tooth discoloration over time.  Some discolorations are superficial while others are more internal.  Both can be effectively treated by a dentist; professional whitening is the best option to safely whiten discolored teeth.

HOW DOES WHITENING WORK?

click to enlarge

The whitening process is possible due to the ability of whitening agent (carbamide peroxide and/or hydrogen peroxide) to freely pass through enamel and dentin and to permeate all parts of the tooth.  These peroxides break down into oxygen radicals, which migrate between the enamel prisms, breaking down any colored molecules that result in tooth discoloration.  The structure of the tooth is not altered.  The internal tooth color is simply made lighter

Whitening agents break down into tiny molecules and move in all directions so even if the entire tooth is not covered with bleach, the entire tooth is whitened.
Numerous studies have proven the effectiveness of peroxides in whitening teeth.  Enamel, dentin, existing fillings, and bonding materials are not affected by the whitening agents, nor are they harmed by the whitening materials.

HOW LONG DOES THE WHITENING LAST?

Whitening results are very stable, but depending on the patient’s nutrition and lifestyle habits, the procedure may need to be redone periodically.  Due to the safety of the whitening agents, this should not concern the dentist or patient.

WILL WHITENING CAUSE TOOTH SENSITIVITY?

Tooth sensitivity is a relatively common side effect of whitening.  If sensitivity occurs, it is transient and disappears after the completion of the whitening.  However, most whitening products contain desensitizing agents like potassium nitrate and fluoride for additional comfort.  Research has shown that just as hydrogen peroxide penetrates through the enamel and dentin into the pulp, so does potassium nitrate.  Potassium nitrate acts more like an analgesic or anesthetic by keeping the nerve of the tooth from sending pain signals to the brain.  Fluoride acts primarily as a dentin tube blocker, plugging the holes and slowing down the fluid flow that causes sensitivity.

WILL WHITENING WEAKEN THE TOOTH’S ENAMEL?

Findings presented at the American Association of Dental Research confirm that whitening will actually minimize sensitivity, provide anti-caries benefits, increase enamel microhardness, and improve overall enamel health.

WILL OVER-THE –COUNTER  WHITENING PRODUCTS WORK AS WELL AS PROFESSIONAL WHITENING?

Self-treatment with the use of over-the –counter (OTC) products often does not provide the results desired.  Professional tooth whitening treatments are safe if they are used appropriately and with the correct materials.  This includes an initial diagnosis, professional teeth cleaning, briefing on the chosen whitening process, and monitoring the patient during the treatment phase.

By Dr. Andrew Thompson
TenderCare Dental - Portland, Oregon
http://www.facebook.com/TenderCareDental

Dental Implant Cost: Comparison of a Three-Unit Bridge -vs- Single Dental Implant

Tooth implants are considered the ultimate dental restoration solution for tooth replacement, especially when only a single tooth needs to be replaced.

Traditionally, the best dental restoration for a single missing tooth was a three-tooth bridge, better known as a three-unit bridge. This type of restoration worked by linking three crowns together. The middle tooth was used to bridge the gap. Even though this type of dental restoration was considered state-of-the-art for many years, it had its limitations.


For instance, the fabrication of a three-unit bridge required the teeth on both sides of the gap to be whittled down to allow for the false teeth to be slipped over the top of the teeth. Because the three teeth were linked together, they could not be cleaned in the same way as normal teeth. In addition, they required special dental cleaning tools in order to maintain healthy gum tissue.


Today, dental implants are the first choice to replace missing teeth and dental restoration. In the case of a single missing tooth, a tooth implant can be placed by the implant dentist in the area of the missing tooth. The implant will serve as a replacement for a tooth root and an individual dental crown. The total apparatus is referred to as a single-tooth implant crown.


Once in place, the dental implant crown will look, feel and function like your natural teeth. They are cleaned and flossed just like your natural teeth, and best of all, they do not require any special tools to clean around them, like bridges. Although tooth implants will not decay, they require that you maintain impeccable oral hygiene.

Does a Dental Implant Crown Last Forever?

Even though dental scientists are developing advanced materials to create a more durable crown, the old adage "nothing lasts forever" also applies to dental implant crowns. Because each patient is different, dental implant crowns last a varied amount of time depending on the patient.
Dental crowns that were thought to last only 3 to 5 years can last 10 to 20 years if meticulously cared for. On the other hand, dental crowns that should last for ten or more years can last only two years in a mouth that is neglected.
The bottom line is that no one can tell you how long a tooth implant will last, but if you take excellent care of your mouth and see your dentist every six months, you stand a better chance of extending the life of your dental implant and other dental restorations.

How Does the Cost of a Dental Implant Crown Compare to a Three-Unit Bridge?

The cost of a three-unit bridge can range from $3,000 to $3,500. The cost of single tooth implants is approximately $3,500 to $4,000. If teeth associated with a dental bridge fail due to recurrent decay or periodontal disease, ordinarily, dental restoration must be done on the entire dental bridge and possibly add a new filling or build-up of the teeth.


The cost of any foundations under a new dental bridge will add to the dental restoration and tooth replacement cost. If and when a dental implant crown has to be reconstructed, most likely, it would be due to the wearing away of the dental crown material.


By Dr. Andrew Thompson
TenderCare Dental - Portland, Oregon
http://www.facebook.com/TenderCareDental

Replace a Missing Tooth With a Dental Implant

Patients ask me about dental implants all the time, so I thought I would take some time to explain what a dental implant is and how it is different than other traditional tooth replacement options

Compared to previous generations when tooth loss was common, modern dentistry has made it possible for people to keep their teeth healthy and attractive for their entire lives. But for people who have experienced tooth loss, there are 3 basic replacement options:

1. A bridge
2. A partial or full denture
3. A dental implant

But bridges and dentures have drawbacks.   Teeth adjacent to the missing tooth or teeth must be altered in order to place a bridge or partial denture.  Food gets caught under bridges, partials, and dentures with resulting sore gums. Or a denture can loosen and cause embarrassment.

Today, dental implants can replace missing teeth. Although the concept of a tooth implant is not new, advances in technology have improved the treatment process and the longevity of implants.

Modern day dental implants are made of pure titanium and are surgically inserted in the jawbone. The tooth implant is covered with gum tissue and allowed to heal for three to six months. During this time, the titanium meshes with the bone (osseointegration), becoming part of the jawbone itself. After the gums are healed, the implants are uncovered and permanent tooth replacements are attached to the implants.

Dental implants can be used for single tooth replacements, support for a permanent bridge, or as attachments to anchor a full denture securely to the jaw.

If you think a tooth implant could help you or someone you know chew more comfortably, speak more clearly, or look better, call our dental office for more details.

By Dr. Andrew Thompson
TenderCare Dental - Portland, Oregon
http://www.facebook.com/TenderCareDental