Posts for: December, 2012
The term TMD means “Temporomandibular Disorder.” But if you suffer from this disorder, it means pain. The pain can be mild or severe, acute or chronic, and it can appear to be centered in different locations, making it difficult to diagnose.
People who clench or grind their teeth because of stress often experience the pain of TMD. They might not even know they are engaging in these habits, because they do them subconsciously, for example when driving in traffic or engaging in vigorous exercise. Another cause of TMD might be an injury such as a blow to the jaw.
You can feel your temporomandibular joints working if you place your fingers in front of your ears and move your lower jaw up and down. On each side the joint is composed of an almond shaped structure at the end of the lower jaw, called the condyle, which fits neatly into a depression in the temporal bone (the bone on the side of your skull near your ear). A small disc between the two bones allows the lower jaw to move forward and sideways. The joints are stabilized by ligaments and moved by muscles.
TMD pain is the result of a process that begins when a stimulus such as psychological stress or an injury to the joint causes spasms (involuntary muscle contractions) in the muscles that move the joint. Blood vessels in the muscle begin to accumulate waste products, causing chemical changes and lactic acid buildup in the muscle. Nerves in the muscle then signal the brain to stop the movement of the jaw by registering pain.
TMD pain can appear to originate from various locations in your jaw, head, or neck. This is why it's important to make an appointment with our office for a professional assessment and diagnosis.
Treatment aims to relieve the symptoms of pain and discomfort and to prevent them from recurring in the future. Treatment can include heat, mild painkillers, muscle relaxants, soft diet, and simple jaw exercises, as well as education regarding the causes of TMD. To prevent further pain you may be provided with a “bite guard,” or referred to relaxation training with a licensed therapist. A bite guard is designed to prevent the lower teeth from biting hard into the upper teeth. It is commonly worn at night, but can also be worn during the day if clenching and grinding are apparent.
If these simpler treatments do not solve the problem, we may recommend more complex procedures such as bite adjustment or, as a last resort, surgical treatment may be needed.
Nolan Gould of the hit TV show Modern Family has an uncommon gift for comedy, but he also has a very common orthodontic problem: too many teeth for the size of his mouth, which often results in “crowding.”
“My teeth used to be pretty messed up,” Nolan recently told Dear Doctor magazine in an exclusive interview. “I had two extra teeth when I was born. They hadn't come out (erupted) yet. And all the other teeth that were already there were starting to point backwards because it was getting so crowded in my mouth. They had to remove those two (extra) teeth,” he said.
Although being born with extra teeth is somewhat unusual, needing to have teeth extracted for orthodontic reasons is not. In fact, orthodontic treatment often involves removing teeth to relieve crowding. It makes sense when you think about it: When there are too many teeth for the size of the dental arches (upper and/or lower jaws) or the teeth are larger in size than the dental arch can accommodate, there may not be enough space to align them properly. The necessary space can be created by removing teeth.
The teeth most frequently extracted for orthodontic reasons are the first bicuspid teeth. These are the ones right between the cuspid, or eyeteeth (under the eyes) and the molars (biggest back teeth). Once there is enough space, the orthodontist can choose from a variety of orthodontic appliances to align the teeth, depending on the specific needs of the individual.
In Nolan's case, it was the extra two teeth he was born with that were removed. Afterwards, the young actor's orthodontist was able to shift Nolan's remaining teeth into proper alignment using orthodontic appliances called Crozats. Made of metal wires, Crozats go around the back teeth and behind the front teeth, making them virtually invisible.
“You can remove them, which is really good for acting, especially because you can't see them,” Nolan explained. “I can wear them 24/7 and nobody will ever notice.”
Nolan's orthodontic appliances may not be noticeable, but his fabulous smile certainly is!
If you would like to learn more about improving tooth alignment with orthodontics, please contact us today to schedule an appointment for a consultation. If you would like to read Dear Doctor's entire interview with Nolan Gould, please see “Nolan Gould.” Dear Doctor also has more on “Tooth Removal for Orthodontic Reasons.”