Q: What is TMJ?

A: TMJ stands for temporal-mandibular joint. Temporal, as in temple area of skull; mandibular as in mandible, or lower jaw; joint as in where the head and jaw meet. Problems in this joint may be caused by a misalignment of the teeth, trauma, or excess muscle tension. Aside from the two bones that meet there, cartilage buffers them and five muscles are involved in the area. If something goes wrong a good deal of trouble can result.

Problems in this area can cause:

  • Headaches
  • Earaches
  • Trouble/soreness in opening and closing the mouth
  • Clicking or popping of the jaw
  • Pain in the jaw muscles
  • Soreness in the area, sometimes extending to the face

Dental treatments for the condition can include replacing missing teeth, moving teeth, adjusting the bite, filling gaps between teeth, etc. There is no one solution that is right for all cases. Sometimes a plastic mouthpiece is used to prevent clenching or grinding that is contributing to the problem. If untreated and taken to extremes, surgery may be required to repair a badly damaged joint.

Q: Should I get checked for oral cancer regularly?

A: The Importance of Early Detection

We have recent good news about progress against cancer. It is now easier than ever to detect oral cancer early, when the opportunity for a cure is great. Currently only half of all patients diagnosed with oral cancer survive more than five years.

We have the skills and tools to ensure that early signs of cancer and pre-cancerous conditions are identified. Know the early signs and see us regularly.

You Should Know

  • Oral cancer often starts as a tiny, unnoticed white or red spot or sore anywhere in the mouth.
  • It can affect any area of the oral cavity including the lips, gum tissue, check lining, tongue and the hard or soft palate.
  • Other signs include:
    • A sore spot that bleeds easily or does not heal
    • A color change of the oral tissue
    • A lump, thickening, rough spot, crust or small eroded area
    • Pain, tenderness, or numbness anywhere in the mouth or on the lips
    • Difficulty chewing, swallowing, speaking or moving the jaw or tongue
    • A change in the way the teeth fit together
  • Oral cancer most often occurs in those who use tobacco in any form.
  • Alcohol use combined with smoking greatly increases risk.
  • Prolonged exposure to the sun increases the risk of lip cancer.
  • More than 25% of oral cancers occur in people who do not smoke and have no other risk factors.
  • Oral cancer is more likely to strike after age 40.
  • Studies suggest that a diet high in fruits and vegetables may prevent the development of potentially cancerous lesions.

Regular Dental Check-Ups Are Important

  • Regular dental check-ups, including an examination of the entire mouth, are essential in the early detection of cancerous and pre-cancerous conditions. You may have a very small, but dangerous, oral spot or sore and not be aware of it.
  • We will carefully examine all areas of your mouth. In about 10% of patients, we may notice a flat, painless, white or red spot or small sore. Although most of these are harmless, some are not. Harmful oral spots or sores often look identical to those that are harmless – testing can tell them apart. If you have a sore with a likely cause, we may treat it and ask you to return for a re-examination.
  • Dentists often will notice a spot or sore that looks harmless and does not have a clear cause. To ensure that spot or sore is not dangerous, we may recommend a simple test, such as a brush biopsy, which usually is painless and can detect potentially dangerous cells when the disease is still at an early stage.
  • If we notice something that looks very suspicious a biopsy may be recommended by a specialist. This usually requires local anesthesia.

Q: Which type of toothbrush should I use?

A: The brand of the toothbrush is not as critical as the type of bristle and the size of the head. A soft toothbrush is recommended because medium and hard brushes tend to cause irritation and contribute to recession of the gums. A small head allows you to get around each tooth more completely and is less likely to injure your gums. It’s unnecessary to “scrub” the teeth as long as you are brushing at least twice a day for two minutes and receiving dental check-ups as recommended by your dentist or dental hygienist.

Q: Is one toothpaste better than others?

A: Generally, no. However, it’s advisable to use a toothpaste containing fluoride to decrease the incidence of dental decay. We recommend our patients use what tastes good to them as long as it contains fluoride.

Q: How often should I floss?

A: Flossing of the teeth once per day helps to prevent cavities from forming between the teeth where your toothbrush can’t reach and also keeps the gums healthy.

Q: What’s the difference between a “crown” and a “cap”?

A: These are restorations to repair a severely broken tooth by covering all or most of the tooth after removing old fillings, fractured tooth structure, and all decay. The restoration material is made of gold, porcelain, composites, or even stainless steel. Dentists refer to all of these restorations as “crowns”, but the two terms are interchangeable.

Q: What’s the difference between a “bridge” and a “partial denture”?

A: Both bridges and partial dentures replace missing teeth. A bridge is permanently attached to adjacent teeth or, in some cases, implants. A partial denture is attached by clasps to the teeth and is easily removed by the patient. Patients are usually more satisfied with bridges than with partial dentures.

Q: What about “silver” fillings versus “white” fillings?

A: Although the U.S. Public Health Service issued a report in 1993 stating there is no health reason not to use amalgam (silver fillings), more patients today are requesting “white” or tooth-colored composite fillings. We also prefer tooth-colored fillings because they “bond” to the tooth structure and therefore help strengthen a tooth weakened by decay. However, “white” fillings cannot be used in every situation, and if a tooth is very badly broken-down, a crown will usually be necessary and provide better overall satisfaction for the patient.

Q: Do I need to have a root canal just because I have to have a crown?

A: No. While most teeth which have had root canal treatments do need crowns to strengthen the teeth and to return the teeth to normal form and function, not every tooth needing a crown also needs to have a root canal.