Posts for: May, 2019
Teeth can take a lot of force over a lifetime of biting and chewing, thanks to enamel, their outer layer made of the strongest substance in the human body. Unfortunately, they’re not invincible: it’s even possible for you to break or “fracture” a tooth while biting or chewing normally.
Although such a fracture might seem to occur out of the blue, it’s usually related to a condition known as cracked tooth syndrome. It usually occurs in three stages: in the first, miniscule cracks in the outer enamel known as craze lines develop. They’re not immediately dangerous since they only involve the enamel surface; but left untreated they could deepen and progress to the next stage, a larger crack that penetrates the tooth’s underlying dentin.
If allowed to grow, this crack in turn can lead to the third stage, a full fracture that could extend down to the root. A fracture can put the tooth in danger of loss, especially if its inner pulp becomes exposed. To avoid this worst case, it’s best to treat the tooth at the earliest stage possible when craze lines are just developing.
There is a difficulty, though, with detecting craze lines — they’re small, too small to detect normally with x-rays. We, therefore, rely on other methods such as using an instrument called an explorer to feel for cracks, having the patient bite on a stick or rubber pad to replicate pain symptoms or using fiber-optic lighting with special dye stains to highlight possible cracks. Endodontists, specialists in root canals, can use microscopic equipment that’s quite adept at detecting craze lines.
There are also some signs you can be on alert for that might indicate a craze line or crack. If you feel a short, sharp pain — a “wince” — when chewing and releasing food, you could have a crack that hasn’t yet affected the nerves. If a true fracture occurs, the pain will intensify and you may notice pieces of the tooth coming off. If the crack extends to the root, the pain will become greater and more chronic.
It’s important then that you see us for any recurring pain symptoms as soon as possible. If it’s a crack, the sooner it’s treated the better your tooth’s chances for survival.
If you would like more information on cracked tooth syndrome, 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 “Cracked Tooth Syndrome.”
On the big screen, Australian-born actress Margot Robbie may be best known for playing devil-may-care anti-heroes—like Suicide Squad member Harley Quinn and notorious figure skater Tonya Harding. But recently, a discussion of her role in Peter Rabbit proved that in real life, she’s making healthier choices. When asked whether it was hard to voice a character with a speech impediment, she revealed that she wears retainers in her mouth at night, which gives her a noticeable lisp.
“I actually have two retainers,” she explained, “one for my bottom teeth which is for grinding my teeth, and one for my top teeth which is just so my teeth don't move.”
Clearly Robbie is serious about protecting her dazzling smile. And she has good reasons for wearing both of those retainers. So first, let’s talk about retainers for teeth grinding.
Also called bruxism, teeth grinding affects around 10 percent of adults at one time or another, and is often associated with stress. If you wake up with headaches, sore teeth or irritated gums, or your sleeping partner complains of grinding noises at night, you may be suffering from nighttime teeth grinding without even being aware of it.
A type of retainer called an occlusal guard is frequently recommended to alleviate the symptoms of bruxism. Typically made of plastic, this appliance fits comfortably over your teeth and prevents them from being damaged when they rub against each other. In combination with stress reduction techniques and other conservative treatments, it’s often the best way to manage teeth grinding.
Orthodontic retainers are also well-established treatment devices. While appliances like braces or aligners cause teeth to move into better positions, retainers are designed to keep teeth from moving—helping them to stay in those positions. After active orthodontic treatment, a period of retention is needed to allow the bite to stabilize. Otherwise, the teeth can drift right back to their old locations, undoing the time and effort of orthodontic treatment.
So Robbie has the right idea there too. However, for those who don’t relish the idea of wearing a plastic appliance, it’s often possible to bond a wire retainer to the back surfaces of the teeth, where it’s invisible. No matter which kind you choose, wearing a retainer can help keep your smile looking great for many years to come.
If you have questions about teeth grinding or orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “The Importance of Orthodontic Retainers.”
Eating is one of the pleasures — and necessities — of life, but people who suffer from temporomandibular joint disorders (TMD) may find eating no pleasure at all — and they may not be eating the right nutritional balance of foods.
TMD is a collection of conditions that affect the jaw joints, connecting muscles and other related facial structures. If you've been diagnosed with TMD, you're probably not only acquainted with severe pain, but also difficulty opening your jaw as widely as normal. This can make it difficult to chew certain foods.
There are a number of effective treatments for TMD, including thermal therapy (hot or cold packs), joint exercise, medication or surgery (as a last resort). But these treatments often take time to make a noticeable difference. In the meantime, you may still need to change what and how you eat to ensure you're getting the nutrients your body needs.
The overall strategy should be to soften and reduce the chewing size of your food. With fruits and vegetables, you'll want to peel and discard any hard or chewy skins, and then chop the fruit flesh into smaller pieces. Steam or cook vegetables like greens, broccoli or cauliflower until they're soft and then chop them into smaller portions. You might also consider pureeing your fruit (and some vegetables) to make smoothies with ice, milk or yogurt, or vegetable-based soups.
Treat meat, poultry or seafood in much the same way, especially biting sizes. Besides cooking meats to tenderness, include moisteners like broths, gravies or brazing liquids to further make them easier to chew.
Dairy foods are an important source of nutrition: eat milk-based products like yogurt or cheese as much as you can handle. If you have problems with these or also nut butters, then consider meal replacement beverages like instant breakfast or whey protein beverages.
And don't forget whole grains. Although some can be hard to chew, you can prepare them in hot cereal form (like oatmeal) to tenderize them. You can also prepare thin bread toast and cut into smaller pieces.
Hopefully, your treatment will bring your TMD symptoms under manageable control. Until then (and after, if need be) adjust your diet to eat the foods that keep you healthy.