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TMJ is the quick way of referring to your Temporomandibular Joint. Pardon the pun, but that’s quite a mouthful! What is this joint, what does it do, and, if your Dr. Kelly Peterson and our team have told you that you have a TMJ disorder, what can we do to help?

The Temporomandibular Joint

Your two temporomandibular joints are amazing works of anatomical design. These are the joints where the temporal bone in the skull meets the mandible bone of the jaw, and allow our mouths to open and close, move back and forth, and slide from side to side. Muscle, bone, and cartilage work together to provide easy movement and to cushion the joint. But sometimes, the joint doesn’t work as smoothly as it should, and this can lead to Temporomandibular Joint Disorder, or TMD.

When Should You Suspect You Have TMD?

You might have TMD if you experience any of these symptoms:

• Painful chewing
• Pain around your TMJ, or in your face or neck
• Earaches
• Changes in your bite
• Jaws that are limited in movement or lock open or shut
• Clicking, popping or grating noises when you open and shut your jaw

There are many conditions linked to TMD. If you grind your teeth at night, have arthritis in the jaw, have suffered an injury or infection in the area, or have problems with your bite, for example, you might be more likely to have TMJ problems. If you suspect you have TMD, or suffer from any of the symptoms listed above for an extended period, give us a call.

Treating TMD

During your visit to our Marysville, WA office, we will check your medical history, and examine your head and neck. We can take an X-ray or scan if needed for further examination of the joint. Because there is no real scientific agreement yet about the best way to treat TMJ disorders, a conservative treatment plan is often best. If you do show signs of TMD, we might first suggest relaxation techniques, over-the-counter pain relievers, or the use of ice packs or moist heat compresses. A change to a softer diet can help, and you should stop chewing gum and making any exaggerated jaw movements.

If these self-care practices aren’t effective, we might suggest a nightguard. This appliance is a comfortable and flexible mouthguard custom fitted for you, and will bring relief from teeth grinding when worn at night. If this treatment is not effective, talk to us about other options.

Luckily, most cases of TMD are temporary and don’t become worse over time. But any persistent discomfort is a good reason to visit us. Whether you have TMD, or any other problem causing you pain in the head or jaw, we want to help.

“Shouldn’t that be healthy gums,” you’re thinking? And, of course, you’re correct. Healthy gums are extremely important not only for our dental well-being, but for our overall physical health.

But that’s a subject for another blog! Today, we’re talking about healthy gum—chewing gum, that is. Because choosing the right chewing gum can actually improve your dental health.

Oral bacteria use the foods we eat, especially sugars and simple carbs, as fuel to produce acid. These acids attack our tooth enamel, gradually weakening the minerals in the tooth surface and allowing cavities to develop. Clearly, we want to reduce these acids to help prevent decay. Luckily, our bodies have a natural defense against acid attacks—saliva.

Saliva works to protect our enamel in three ways:

• It helps neutralize and wash away acids in the mouth.
• It rinses away the food particles which bacteria feed on.
• It strengthens teeth by providing the necessary minerals our enamel needs to “remineralize” after acids have weakened the tooth surface.

Studies have concluded that chewing sugarless gum for 20 minute after a meal can help prevent cavities. Why? Because chewing gum increases saliva production. You are actually reducing the effects of harmful acids, washing food particles away from your teeth, and strengthening weakened enamel with every stick! Some artificial sweeteners are even thought to inhibit the growth of the bacteria that lead to decay.

With all that in mind, it’s also healthy to know when you shouldn’t chew gum:

• When the gum contains sugar. Even with an increase in saliva production, bathing your teeth in sugar as you chew does your enamel no favors!
• When you wear braces. Gum can stick to your brackets and between your brackets and your wires. And while trying to clean gum from your appliance is no one’s idea of fun, an even more unpleasant possibility is the chance that gum might bend your wires out of shape. Sugarless gum is not quite as sticky as regular gum, but before you open that first pack, check with your orthodontist to see if you might be putting your orthodontic work at risk.
• When you have jaw problems such as TMD, TMJ or other temporomandibular concerns, or if you develop jaw pain while chewing gum.
• You should never give gum to a child too young to understand that it should not be swallowed. Beyond acting as a choking hazard, continual gum swallowing can lead to diarrhea, blockages, abdominal pain and other serious problems. Talk to your Dr. Kelly Peterson about the right age for chewing gum.

While chewing sugarless gum has the potential to improve dental health, remember it should never take the place of regular brushing and flossing—still the best way to prevent cavities at home. Talk to Dr. Kelly Peterson about the possible benefits of sugarless gum at your next visit to our Marysville, WA office, and we can make recommendations based on your individual dental history. Because whether it’s healthy gums or healthy gum, we’re here to help.

Many adults wonder if they should continue to receive fluoride treatments. Our team at Northwest Smile Design wants to set the record straight about the usefulness of fluoride treatment for adults.

There are several reasons fluoride treatments could be beneficial to you as a grownup. If you have a high risk for cavities, topical fluoride applications can cut down on that risk.

If you’re experiencing gum recession that’s softening your enamel, fluoride treatments can slow down that process. Fluoride treatments may also protect expensive restorative work on crowns or bridges that may be adversely affected by plaque.

In addition, fluoride can also protect teeth in adults who have orthodontic braces or who sometimes neglect to keep up with daily oral hygiene regimens such as flossing and using mouthwash.

Do you have sensitive teeth? Consuming foods that are highly acidic or using teeth-whitening products can lead to irritated gums. Fluoride treatments remineralize your enamel and reduce sensitivity.

If you’ve undergone radiation treatment for cancer, fluoride can help restore any dry-mouth damage that may have developed during that time. Saliva acts as a buffer against the foods we eat, and without enough of it you may be more likely to get cavities.

In general, fluoride treatments are not always necessary for adults, but they can be beneficial to your overall oral hygiene depending on your situation. If you fall into one of the general areas listed above, ask about a fluoride treatment during your next visit at our Marysville, WA office.

We can also go over your options to treat other issues you may experience in terms of your oral health. Until then, make sure to take care of your teeth properly and use toothpaste or mouthwash that contains fluoride on a regular basis.

From the time you were small, you’ve been warned about the dangers of plaque. Why? Because:

• It’s an unappealing film that sticks to your teeth
• It causes cavities
• It causes gum disease

And really, do we need to know much more than this to motivate us to brush? But if you’re in a curious mood, you might be wondering just how this soft, fuzzy film accomplishes all that damage. Let’s take a closer look at the sticky problem of plaque.

How does plaque form?

We live with hundreds of species of oral bacteria, most of which are harmless, and some of which are actually beneficial. But when our oral ecosystem gets out of balance, problems can occur. For example, without regular and thorough brushing and flossing, we start to build up plaque.

Plaque starts forming within hours of your last brushing. And even though plaque fits the very definition of “seems to appear overnight,” this biofilm is actually a complex microbial community with several different stages of development.

• It starts with saliva.

Saliva is vital to our oral health, because it keeps us hydrated, washes away food particles, neutralizes acids in the mouth, and provides minerals which keep our enamel strong. Saliva also contains proteins, which help form a healthy, protective film on the tooth surface. This film is called a pellicle.

• Bacteria attach to the pellicle.

There are species of oral bacteria that are able to attach themselves to the pellicle film within hours of its formation. As they become more firmly attached, they begin to grow and divide to form colonies, and are known as the early colonizers of the plaque biofilm.

• A complex biofilm forms.

If you’ve skipped brushing for a few days (please don’t!), you’ll notice a fuzzy, sometimes discolored film on your enamel—that’s a thriving plaque community, and it only takes a matter of days to go from invisible to unpleasant.

If you’re not removing plaque regularly, it can harden further and become tartar. And once you have tartar buildup, you’ll need the care of a dental professional to remove it.

• What happens if we ignore plaque and tartar?

We get cavities and gum disease.

How does plaque cause cavities?

• The bacteria in plaque, like all organisms, need nutrients.

Our normal oral environment and the food in our everyday diets provide the nutrients plaque needs. And, as we mentioned above, certain types of oral bacteria convert these nutrients into acids. Foods such as carbohydrates, starches, and sugars are most easily converted into acids, which is why we recommend that you enjoy them in moderation.

• The biofilm promotes acid production.

Within the plaque film, anaerobic bacteria (bacteria which don’t use oxygen) convert sugars and starches into acids. As the plaque film becomes denser, it blocks acid-neutralizing saliva and oxygen from reaching these bacteria close to the tooth’s surface, creating an ideal environment for the bacteria to produce their acid waste products.

• Acids attack enamel.

The sticky nature of plaque keeps these acids in contact with tooth enamel, where, over time, acids dissolve minerals in enamel, weakening the mineral structure of the tooth.

How does plaque cause gum disease?

• Bacteria cause inflammation and gingivitis.

The bacteria in plaque irritate the delicate tissue of the gums, which causes an inflammation response which can leave your gums swollen, red, bleeding, or tender. This early form of gum disease is gingivitis. Fortunately, good dental care and careful brushing and flossing can usually prevent and even eliminate gingivitis.

• Plaque and tartar can lead to periodontitis.

When plaque and tartar build up around and below the gumline, the gums pull away from the teeth, leaving pockets where bacteria collect, leading to infection as well as inflammation. Infections and constant inflammation not only harm gum tissue, they can destroy the bone supporting the teeth. This serious gum condition is periodontitis, and should be treated immediately to avoid further infection and even tooth loss.

How do we fight plaque?

From the time you were small, you’ve learned how to fight plaque:

• Brush at least twice a day for two minutes, and be sure to brush all of your tooth surfaces and around the gumline.
• Floss to remove plaque from between the teeth and near the gumline.
• Visit our Marysville, WA office for a thorough professional cleaning.

Be proactive. If you have any questions, talk to Dr. Kelly Peterson about the best way to keep plaque at bay. We can show you the most effective ways to brush and floss, recommend anti-plaque toothpastes and rinses, even suggest plaque-revealing tablets if you’re missing some trouble spots.

We’ve only brushed up on some plaque basics, because there is a lot more to discover about this complex biofilm. Happily, even with all there is to learn about plaque’s growth and development, it’s reassuring to know that getting rid of it is quite simple—with just a soft-bristled brush, some dental floss, and a few minutes of your time each day, you’re on the way to a healthy, happy, plaque-free smile.