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Posts for: April, 2019

By Michael W Shields DDS
April 20, 2019
Category: Oral Health
Tags: tmd   tmj disorders   tmj  
ClickingJawWhenShouldYouBeConcerned

Have you noticed a clicking, popping, or grating sound when you open or close your jaw? As many as 36 million U.S. adults experience this phenomenon in one or both of the joints that connect the lower jaw (mandible) to the skull.

While the sounds may be disconcerting, there’s generally no cause for concern in the absence of other symptoms. They’re most likely caused by a harmless shift in the position of the disk inside each temporomandibular (jaw) joint, and it can diminish or disappear entirely over time. But, if you’re also experiencing persistent discomfort, severe pain, or limited function in your jaw (which can include getting it “stuck” in an opened or closed position), then you may be suffering from a temporomandibular joint disorder — part of a complex set of conditions affecting one or both jaw joints, muscles and/or other surrounding tissues. (You may have heard the condition called TMJ, which is actually the abbreviation for the temporomandibular joint itself. Health care professionals prefer TMJD or TMD.)

Depending on the severity, TMD can interfere with your ability to speak, chew and even make facial expressions. The cause is unclear, but genes, gender, environment, stress and behavior are believed to play a role. It can also be symptomatic of a larger medical problem, such as fibromyalgia, which can produce pain all over the body.

Management Options for TMD

TMD traditionally was viewed as a bite problem (malocclusion) requiring mechanical correction — e.g., through orthodontic braces or surgery. But the current therapeutic model approaches TMD as an orthopedic problem (joint inflammation, muscle soreness, strained tendons and ligaments, and disk damage) and favors a sequence of conservative, reversible procedures — hot or cold compresses in the jaw area, soft foods, physical therapy/massage, medication, and/or a bite guard to decrease pressure on jaw joints from tooth clenching and grinding — prior to more aggressive, irreversible treatment alternatives.

If you would like more information about TMD, please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine articles “Seeking Relief from TMD” and “Chronic Jaw Pain and Associated Conditions.”


ThereareGoodReasonstoCheckYourBloodPressureDuringDentalVisits

There are a lot of opportunities to have your blood pressure checked: your doctor's office, of course; your local pharmacy; health fairs; and the dentist's office. The last one might surprise you, but blood pressure monitoring before a dental examination or office visit has become quite routine.

Why all this attention to blood pressure? Because chronic high blood pressure (hypertension) is a major cause for cardiovascular disease (CVD), a family of life-threatening conditions that affects 80 million people in the United States. And, you may not even be aware you have it.

That's why avenues for blood pressure screening are on the rise, and the dental office is a prime opportunity. Since you see us regularly for cleanings and checkups (you do, don't you?), there's a good chance we might help you become aware you have a problem if we perform blood pressure readings.

One study published by the Journal of the American Dental Association, for example, followed a group of dental patients with no previous risk factors of CVD, and who had not seen a doctor in the previous twelve months. Through blood pressure screening at their dental visits, 17% discovered they had high blood pressure and at risk for a cardiovascular event.

Your blood pressure can also have an effect on your oral health, especially if you're taking medication to control it. Some medications can cause reduced saliva flow, which could drastically increase your chances of developing tooth decay or periodontal (gum) disease. We would also need to exercise care during dental procedures with certain local anesthetics: some may cause both your pulse and blood pressure to rise.

Although we're primarily focused on your dental care, we also know it's only one aspect of your overall health. By simply including blood pressure checks during your checkup, we may help you identify a problem before it causes you greater health problems in the future.

If you would like more information on blood pressure and dental 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 “Monitoring Blood Pressure.”