GENERAL DENTISTRY

General dentistry refers to a wide array of dental services that we are proud to provide for our Brumbach Family Dentistry patients here in Post Falls.

We care greatly for your overall health! We want to help you address your dental and oral hygiene needs, discomforts, and other related issues so that you can get on your own path to happy, healthy, confident living! Dentures, restorations, TMJ treatment, and tooth extractions are just some of the services we offer at Brumbach Family Dentistry. Your oral health is our number one priority. To find additional information about the general dentistry treatments we provide, click on one of the links below.

Restorations

We utilize restorative dentistry in order to rehabilitate missing or decayed teeth. If you’ve had a root canal, filling, or veneers, you’ve already seen what amazing things restorative dentistry can accomplish.

Today’s dentists have many healthy ways to replace missing or repair decayed teeth. A beautiful and natural looking smile is accomplished with durable composite resins and ceramics. Whereas silver amalgam and gold alloy fillings have been the standard for many years, modern materials have replaced them.

Here is some additional information about the restorative treatments we provide for our patients:

Fillings

Fillings are used to treat cavities and to restore your tooth back to its full, functioning form. If you’ve had a cavity before, you are actually in the majority of the US adult population. Tooth Filling

According to the Centers for Disease Control (CDC) in 2012, approximately 91% of U.S. adults ages 20 to 64 have had a cavity. In most cases, luckily, the treatment for a cavity is as simple as a dental filling.

We utilize modern materials to “fill holes” in the tooth, commonly referred to as “cavities,” caused by decay. By closing the holes, this prevents the bacteria from spreading further into the tooth and damaging the inner root canal. If the infection penetrates the inner root canal, the tooth may require an additional root canal treatment.

Before we fill a tooth, we determine the severity of the decay by taking x-rays and performing an exam. Once we understand the extent of the decay, we determine the best method to restore the area. Oftentimes, a dental filling is the restorative method of choice. First, local anesthetic is given to anesthetize the area for comfort*. Then, we remove the decay from the tooth by utilizing a dental drill or another manual instrument. After the decay is completely removed, we clean the tooth thoroughly and carefully place the filling material to closely replicate the natural tooth.

*Typically, the anesthetic is in the form of an injection. Therefore, if injections give you anxiety, please tell Dr. Brumbach so he can find other means of providing comfort. Many sedative options are available at Brumbach Family Dentistry, including IV sedation if necessary.

What Types of Fillings to Choose From

Fillings are available in essentially two categories: natural (tooth-colored) or metal. There are advantages and disadvantages to each type, which we will go into further detail on below.

Metal Fillings

  • Amalgam — This is the traditional metal (silver-colored) filling that has been used for more than 100 years. Amalgam is an alloy metal, made up of a mixture of mercury, silver, tin and copper. The mercury stabilizes the other metals, making them safe for oral use. While these types of fillings may be cheaper than other options, they are also quite visible. Additionally, they require more tooth drilling in preparation for placement than other types of fillings. These are rarely placed in our office, and only by request.
  • Cast Gold — Cast gold contains a mixture of gold and other metals to create a strong, durable and long-lasting filling. This type of filling does not contain any mercury and is typically one of the most expensive but longest options we offer. These fillings are highly visible as well, but are considered the “Gold Standard”.

Tooth-Colored Fillings

  • Composite — The composite filling is made up of a combination of plastic and glass that is bonded to your tooth. Many people prefer this type of filling because it matches the color of the tooth and blends in well. The composite filling is built to last long-term, and requires less drilling than the amalgam filling.
  • Porcelain — Porcelain fillings have a natural appearance and are very durable. Additionally, they don’t take on stains or abrasions like normal teeth can. However, they can be more expensive because they require more technology to create them.
  • Glass Ionomer — The Glass Ionomers are known for being inexpensive and relatively hard to identify from the outside perspective. They are made up of acrylic and glass powders that release fluoride into the tooth to prevent further decay. However, the drawback is that these fillings may not be as long-lasting as other fillings options.

Each material has its strengths, weaknesses, and ideal circumstances for placement success. Dr. Brumbach will happily give you his professional recommendation.

Mercury Free Fillings

This filling matches the natural color of your teeth, doesn’t contain mercury, and does its job effectively. In fact, it might do the job better than other options! Consider mercury-free fillings an exceptional alternative.

Placing a “silver” filling typically requires the dentist to remove adequate tooth structure in order to get it in the correct place. Not only that, but these types of fillings are very easy to see from an outside perspective. However, with tooth-colored fillings, the dentist does not have to remove as much tooth structure for placement. In addition, the filling matches the actual tooth. Most notably, there is no mercury involved whatsoever. These three benefits alone make tooth-colored fillings the most popular choice for the modern patient.

A blend of plastic resins and silica fillers combine to make up the “composite” (the tooth-colored filling). The composite is durable and translucent, similar to the feel of your natural teeth. Yet another advantage to the composite fillings is that they actually help strengthen the existing tooth structure.

Research shows that restorations (or fillings) that are tooth-colored are safe, effective, and aesthetically pleasing. They can generaly last long-term if properly taken care of.

We’ve laid out the many advantages of a tooth-colored, composite restoration. Now, let’s take a deeper dive into how we actually place these types of fillings and what you can expect after treatment.

The Process of Filling a Tooth

Cavities and chipping are two of the most common reasons we utilize fillings and restorations. Even though there are several materials that are used for these restorations, the process for all fillings is relatively uniform.

We start by numbing the area, typically by injection, and then remove existing decay in preparation for the filling placement. After thoroughly cleaning and drying the tooth, we place the composite filling directly onto the tooth structure. We then make sure that the filling is securely adhered to the tooth. Just like that, the treatment is finished!

There is one main contrast between placing a traditional silver filling and a composite filling. Basically, with silver fillings, healthy tooth structure will need to be eliminated in order to make room for the material to be placed securely. Over time, this can cause the tooth to be more susceptible to cracking or chipping. Composite resin fillings, however, are bonded directly to the tooth and salvage healthy tooth structure to provide full, long-term benefits.

What to Expect After Treatment

After we’ve placed the filling, we recommend that you avoid particularly hot or cold food and beverages until the numbness of the anesthesia wears off. Tooth-sensitivity to hot and cold is relatively normal for the first few weeks after treatment. However, if you experience significant discomfort or pain while eating or drinking, please contact Dr. Brumbach. Though rare, this could mean we need to adjust the placement of the filling or further examine the cause.

You should maintain your normal oral hygiene routine – brush and floss twice per day and see Brumbach Family Dentistry for your dental checkups semi-annually. Protecting your new filling and preventing future cavities is our priority, and the best prevention is good oral hygiene!

When Should You opt for a Tooth-Colored Filling?

We typically suggest composite resins for small to medium-sized restorations – which are the majority of restoration cases. As mentioned above, these resins are strong, resistant to chipping and cracking, and able to withstand everyday wear and tear. In most cases, the restoration can be completed in one visit to our office. However, if a restoration is larger than normal, we may need to send the material to a lab to be created. This process would add an additional office visit for the treatment.

If you have questions on whether a tooth-colored filling is the right fit for you, schedule a consultation with Brumbach Family Dentistry today. We can discuss all viable options for your specific case and educate you on the advantages and disadvantages of each treatment. Our highest priority is to provide you with a healthy lasting smile.

Inlays and Onlays

Sometimes a patient will need more than just a filling to remedy tooth decay. If the damage isn’t severe enough to warrant a crown, the answer may be an inlay or onlay.

Inlays and onlays are termed “indirect” fillings. This means that they are created externally by a dental lab, and then adhered to the tooth by Dr. Brumbach. “Direct” fillings, (see “Fillings”), are fabricated and applied by Dr. Brumbach all in one visit to our office.

An “inlay” fits within the confines of the cusp tips, or top edges of the premolar or molar. However, an “onlay” sits on top of one or more of the cusp tips of the tooth. Whether you are getting an inlay filling or an onlay, the process to place an indirect filling is the same. Ultimately, the needs of the tooth determine which process to use and are used conservatively in order to save original tooth structure.

The Procedure

If you’ve ever had a crown, then you’ll find the process of placing an inlay or onlay is very similar. The difference between the two procedures is that with an inlay or onlay, we remove less of your natural tooth structure than we do for a crown placement. We conserve as much of your existing tooth structure as we can with this type of treatment.

In order to place the inlay or onlay, we must start by removing the decay from the tooth. Before we begin removal, we typically numb the area with a local anesthetic for the patient’s comfort. Once the area is numb, we begin removing the tooth decay to prevent it from penetrating further into the tooth.

After the decay has been completely removed, we get an impression by digitally scanning or taking a mold of the tooth. The impression is sent to the dental lab to create the inlay or onlay. The lab can create the filling out of gold, tooth-colored ceramic, or resin. Typically, the patient will decide prior to sending the impressions to the lab.

Applying the Restoration

While the lab is creating the filling, we place a temporary filling on the tooth in order to protect the tooth and prevent further decay. Once your inlay/onlay is ready, you will come back to the office and the filling will be permanently adhered to the tooth. To adhere the filling, we utilize a resin that’s cured under a special light, or use a strong, dental cement.

These are a great option for restoring decay-damaged teeth because they are durable, strong, and provide long-term results. Best of all, they are low maintenance. Inlays and onlays are maintained just like your other teeth – by brushing and flossing twice daily!

Inlays and onlays are also used for cosmetic enhancements. If you’re interested in finding out more about the procedure, please call our dental office!

Sealants

Cavities occur most often in the back teeth, known as the premolars and molars. Typically, these have grooves and pits that are difficult to reach with brushing alone.

Premolars and molars contain tiny grooves, commonly referred to as “pits and fissures,” that assist in chewing and grinding food. Unfortunately, these grooves can also collect and trap bacteria and food particles. These grooves are so small that the toothbrush bristle cannot clean them. This makes the back teeth more susceptible to tooth decay, and often the first place a tooth will develop a “cavity”.

Even more concerning is that when a child’s permanent teeth are coming in, they are typically even more susceptible to tooth decay. This is because the enamel that is supposed to protect the tooth needs time to grow stronger. Even so, while the presence of fluoride in toothpastes and drinking water can aid in strengthening of the enamel, it can still be difficult to effectively penetrate those surfaces in the back of the mouth regularly. This is where dental sealants come in.

These white, plastic resin coatings are placed on top of the grooves to essentially smooth out the surface of the tooth. Ultimately, this makes it harder for bacteria and food particles to get trapped inside. At the end of the day, a tooth that is sealed is less susceptible to develop tooth decay and cavities.

The Sealant Process

A sealant resembles a small plastic filling that smooths out the top surface of the tooth. Placing a sealant is not the same as having a cavity filled. Placement of the sealant is virtually painless and does not require any anesthetic because there are no nerves involved, only tooth enamel.

Before placing a sealant, we will first determine if there is any decay present in or around the tooth. If there is, we will make sure to remove it completely and clean the tooth thoroughly before proceeding. Next, we cover the tooth with an abrasive that makes the surface rougher and helps the sealing solution adhere to the tooth more effectively. We rinse the tooth again with water and make sure it is completely dry before applying the sealant. Though the sealant will harden quickly (about one minute), we usually utilize a special light that helps cure the sealant faster. That’s it!

Concerns About BPA?

Before moving on, we would like to address some concerns about BPA (bisphenol-A):

The sealant material we use does NOT contain the chemical known as BPA, which can be found in some dental resins. A study was published in 2012 that attributed trace amounts of the chemical to behavioral problems in children. The authors of the study maintained that while they found a correlation, they could not prove that the BPA in the resins was the actual cause of behavioral problems.

Research published in the ADA Professional Product review shows that food, drinks, sunscreen, shampoo, body wash and other cosmetics actually contain more amounts of BPA than what is used in dental sealants (1). The ADA continues to believe that dental sealants offer tremendous oral health benefit and are safe for continued use in routine preventative services.

We have found a sealant material that is strong and bioactive. It employs new technology that allows it to pick up calcium and other minerals from our diets that are good for teeth. Then, it slowly releases it back into the teeth to keep them strong and healthy.

(1) source: https://www.ada.org/en/publications/ada-news/2016-archive/august/bpa-in-dental-sealants-safe

Properly Caring for Sealants

Sealants don’t require additional care beyond your normal routine. Your routine should include brushing and flossing your teeth daily, dental checkups, and cleanings with Dr. Brumbach twice per year. During semi-annual visits, we examine the sealants to make sure that they are secure and intact. If maintained properly, sealants last many years while providing you or your child protection from tooth decay.

Dentures


The risks associated with full or partial tooth loss are more than just cosmetic. Tooth loss can increase the chances of developing nutritional deficiencies, loss of facial and lip support, and other health problems.

Dentistry has multiple solutions to this problem:

  1. Dental implants
  2. Full or partial dentures
  3. Some combination of the two

While dentures are just one of the many viable options for replacing missing teeth, it’s important to consider the advantages and disadvantages of each method. If you do determine that dentures are right for you, then you will also need to decide on what specific type of denture would work best. Your options include partial dentures all the way to implant-supported overdentures. During your denture consultation, Dr. Brumbach will give you his professional recommendations. He will work with you to decide which option would be best suited for your individual circumstance.

What are Removable Dentures?

Dentures are made of an acrylic resin that is used to form a gum-colored base that holds the prosthetic teeth. The base is placed over the bony ridge of the missing teeth, and is created to look and function like a normal set of teeth. The dentures are held in place by fitting close to and even suctioning against the ridges. This is why it is vital that dentures are fitted specifically for the patient. The fit and look of dentures are completely custom made for each patient!

It takes time to become accustomed to wearing dentures. Some users may experience a little bit of trouble talking and eating at first. But over time, the muscles, nerves, and ligaments inside of your mouth will work together to adapt to the new dentures. The user will soon become acclimated to the feel of the dentures and may even see improvements in their own facial skeleton and soft tissue, creating a younger-looking appearance.

What Types of Full Dentures Are Available To You?

Immediate Dentures: Immediate dentures are given to you immediately after teeth are removed and are considered temporary. The muscles will need time to adapt, and your gum’s jaw bone will always shrink after tooth extraction. It is best to let your mouth completely heal after the extraction before permanent dentures. Immediate dentures serve the purpose of giving you new teeth immediately and to help you acclimate to the look and feel of wearing dentures.

Conventional Full Dentures: After your adjustment and healing period, we create permanent dentures that will accurately fit your mouth. The dentures are uniquely constructed and designed to achieve whatever aesthetic look you are hoping for. As we build the dentures over several visits, we discuss the smile you would like (I.e. bigger, whiter, younger).

Implant-Supported Overdentures: Some patients may need additional support for lower or upper dentures. If this is the case, we may be able to anchor the dentures to dental implants. The number of implant anchors depends on how much additional stabilization is needed for the upper or lower denture.

There are many variations that all provide peace of mind. Each denture option gives you the additional security, improved functionality and comfort that you need. Schedule an appointment with Dr. Brumbach to discuss the options that may be best for you.

What Types of Partial Dentures are Available?

Transitional Partial Dentures: These temporary, plastic dentures act as a tooth replacement and space-saver while your mouth heals from tooth removal. Once your mouth has healed entirely, we can place the dental implants. These are a relatively inexpensive means of helping you to adapt to the new feeling of wearing dentures.

Removable Partial Dentures (RPDs): RPDs are made out of vitallium and are constructed to be durable and last a very long time. Because they are metal-based, they are lighter, more comfortable, and provide a better, more customized fit. However, they are a bit more expensive than its plastic counterparts.

How We Create and Fit Your Dentures

We follow an extensive, meticulous process to create a unique set of dentures for each patient. To start, we make a mold of the top and bottom of your mouth in order to capture the pattern of the alveolar ridges. Next, the mold is sent to the dental laboratory so that they can make the base of the denture. The lab and the dentist consult with each other and pick from a variety of sizes and shapes of prosthetic teeth – choosing the set that will give each patient the most natural-looking teeth. Once the dentist and the patient have agreed on how they look and feel in wax (a temporary phase) the permanent dentures are created.

The last step is one of the most important – Dr. Brumbach will have to “balance” your bite, meaning that he makes sure that the upper and lower dentures fit together in order to naturally stabilize each other. This will allow you to speak and eat normally after a brief adjustment period, and allow the dentures to perform their function effectively.

What You Can Expect Over Time

After you experience tooth loss, bone loss and gum shrinkage can occur. As a consequence, it may seem like your immediate dentures don’t fit as well as you’d like. If that is the case, there are two options:

1) re-line your immediate dentures by adding to the existing denture base to better fit the areas where you’ve lost tissue; or

2) upgrade to a set of conventional full dentures. We find that option two – moving to a set of conventional full dentures – is more comfortable, functional, and economical for our patients. If taken care of properly, these dentures can prove to be durable and long-lasting for our patients.

Tooth Extractions

Brumbach Family Dentistry believes that preserving our patients’ natural teeth and helping them maintain a healthy mouth for a lifetime is our number one priority.

Unfortunately, we can’t save every tooth. In some instances, we may have to remove one or multiple teeth due to a multitude of reasons. Whatever the case, for most patients, the actual procedure for extracting the tooth is routine. Any deviations just depend on where the soon-to-be removed tooth is located, and how its roots are structured.

For instance, it is significantly easier to remove a front tooth with one, straight root, compared to extracting a back molar with several roots. One case that is particularly tricky is an impacted wisdom tooth, as they are not visible to the naked eye. Impacted teeth are below the surface and don’t have enough room to emerge due to other teeth in its way. Therefore, getting to the actual tooth itself while navigating multiple root systems can become difficult.

Teeth are not affixed to bone structure; they are actually connected to the bone by fibers that make up the periodontal ligament. With careful planning and execution, we can free the tooth from these fibers and remove it without too much discomfort or difficulty. At the end of the day, having a tooth removed should not be a scary or painful experience if the procedure is done by a seasoned professional, like Dr. Brumbach.

Why Would We Extract a Tooth?

There are a number of reasons for removing a tooth. We’ve outlined some of the reasons below and the advantages and disadvantages to each:

  • Trauma or Disease — While our main priority is to preserve your teeth, sometimes an extraction is necessary in order to maintain function and overall health. Otherwise, if we can place a crown or perform a root canal, we will definitely consider those options before proceeding. However, in some cases, we may decide it is best to extract the tooth and replace it with a durable, long-lasting dental implant.
  • Orthodontic Treatment — Crowding is a condition where there are too many teeth for the size of the jaws. In order to make more room for teeth to emerge and align, we consult with the orthodontist and may extract certain teeth for optimal alignment.
  • Impacted Wisdom Teeth — Identifying and removing impacted wisdom teeth can prevent future damage to nearby healthy teeth, bone structure and gum tissues. Additionally, it can prevent damage to nerves and blood vessels. It is best to remove impacted teeth as early as possible before the roots have time to fully develop.
  • Baby Teeth — In order for permanent teeth to emerge normally, baby teeth have to be in the right position and sequence. If for some reason baby teeth are not in the right place, removing the baby tooth could be necessary in order to prevent the necessity of orthodontic treatment in the future.

The Tooth Extraction Procedure

Before we can get started on extracting a troublesome tooth, we will need to take an x-ray in order to study the tooth’s position, its root structure and its bone structure. Our goal is to identify any issues that may cause complications during the procedure. We also complete a medical and drug history to make sure that you are in good enough health for this type of treatment. Finally, we will go over your anesthesia options.

Typically, we use local anesthesia to numb the teeth and nearby bone and gum tissue prior to removal. However, in addition to the anesthetic, we may also utilize an oral sedative (pill form), or nitrous oxide. In more complicated or difficult situations, we may use conscious sedation, administered intravenously. Most patients do not experience negative side effects from these types of sedatives, and often don’t even remember the surgery!

During the extraction, we are very cautious to not damage the bone structure surrounding the tooth. Like we mentioned above, our goal is to preserve as much of your tooth as possible, including the bone. In some instances, it may be necessary to put a certain amount of lab-processed bone-grafting material into the tooth socket in order to help keep the bone volume, especially if we plan to place a dental implant in its place. A dental implant needs to fuse to existing bone in order to function correctly.

What Happens After a Tooth Extraction

After we’ve completed the removal, we cover the empty socket with gauze and apply pressure in order to slow down and eventually stop the bleeding. Dr. Brumbach may opt to stop the bleeding with small stitches instead, depending on the case. Swelling, discomfort, and some pain is standard post-surgery. These symptoms can be treated with an over-the-counter anti-inflammatory (like ibuprofen) and an ice pack to help with the swelling. Antibiotics may also be prescribed in order to prevent infection while you are healing. You should feel back to normal after a couple of days! Until then, avoid hard, crunchy, spicy foods and focus on incorporating softer foods into your diet to manage pain.

Root Canals

Endodontics refers to the branch of dentistry that focuses on the diseases and injuries of the soft tissues inside of the tooth (the dental pulp). “Endo” means “inside” and “dont” means “tooth”. Endodontists specialize in diagnosing the cause of tooth pain and performing root canal treatments.

The Benefits of a Root Canal Treatment

Root canals have the reputation of being a painful procedure; however, for most patients the pain level is comparable to getting a filling. And, if you’re already experiencing pain in your tooth, a root canal is one of the best ways to alleviate that type of discomfort. Root canal treatments are designed to relieve the pain that patients are experiencing, which is actually infection or inflammation in the tooth’s pulp. Moreover, the longer treatment is put off, the more pain it can cause later on down the road.

Tooth preservation is an additional benefit of a root canal treatment. The sooner we identify and treat the infection, the more likely it is that we can save and, ultimately, restore the tooth. If we have to remove an infected tooth, it can lead to additional problems such as tooth migration, which may change the alignment of your bite, and eventually, may require bridgework or dental implants to correct. We want to avoid the extra costs, complications, and potential bone structure loss that come with tooth extraction, if at all possible.

What Causes Root Canal Problems?

A circumstance that warrants a root canal is when the pulp tissue develops an infection or inflammation. The dental pulp that is located inside of the tooth is made up of blood vessels, connective tissue, and nerves. The heightened sensitivity of the nerve cells could be why patients report severe pain and discomfort with an infected tooth. An infected tooth must be treated and will not go away over time. In fact, if left untreated, the infection could progress into a dental abscess, and may even manifest itself with symptoms that affect other parts of your body.

Infections can be caused by severe, untreated tooth decay that has penetrated into the tissue. Bacteria can also penetrate the dental pulp by means of a chipped or cracked tooth. If the protective enamel is broken at any place, this could allow the bacteria to enter into the inner tissue.

Any type of trauma to the tooth itself can lead to tissue damage and eventual problems down the road. If you feel any type of pain or discomfort after a sports injury or fall, it is crucial to see your dentist as soon as possible so he or she can identify any damage and create a treatment plan.

Finally, some people may inadvertently incur dental pulp damage during another dental procedure. Having an extensive amount of dental work done, such as multiple fillings or restorations on the same tooth, can sometimes cause tissue damage. Sometimes, common procedures like crown placements or orthodontics can cause tissue damage, as well, but this is not typical.

What Types of Symptoms Indicate Root Canal Problems?

Pain is an obvious indicator that something is wrong within the root canal. Pain, pressure, swelling or extreme gum sensitivity should be examined immediately by a professional. Another indicator of dental pulp damage could be pain when chewing, or pain after eating hot or cold foods. If you are experiencing any tooth pain in general that lasts more than a few days, we suggest scheduling an appointment with Dr. Brumbach.

The Process of a Root Canal Treatment

If Dr. Brumbach determines that you will benefit from root canal therapy, you can expect a safe, routine, and effective procedure that can be completed in a single office visit.

To begin, we numb the tooth with a local anesthetic administered via injection. Then, we make a small opening in the tooth to gain access to the pulp chamber and root canals. We remove dead and decaying tissue from inside the narrow canals using tiny tools and a microscope, if needed. Once the canals are emptied of dead tissue, we clean and disinfect the empty chambers. We fill those tiny chambers with biocompatible material, and seal the opening with a cement to prevent bacteria from getting back in.

Sensitivity and tooth tenderness for the next couple of days is normal. To alleviate some of your pain, pain relievers such as ibuprofen or aspirin are recommended. If you find that you’re experiencing severe pain, we may prescribe a stronger medication to relieve your discomfort. We also advise that during your temporary healing period, you avoid hard, crunchy foods and stick to softer foods.

As an additional means of protection, we generally recommend placing a crown, such as a traditional gold crown or a high-end tooth replica, on the treated tooth. If not a crown, then perhaps another means of restoration. Whichever option you decide to go with, the investment will pay off in knowing that you’ve protected your teeth for the long-term.

Headache and Migraine Prevention | TMJ/TMD

Headaches and Migrains from TMJ or TMD
Temporomandibular Disorder, or TMD, can manifest itself as recurring pain in the area near the ears, jaw, or the muscles on the side of your face. Some patients experience restricted jaw movement or hear a popping or clicking noise when moving parts of the mandible. TMD is often referred to as TMJ (temporomandibular joint), which refers to the jaw joint itself. Everyone has two TMJ’s, but that does not mean you have TMD.

TMD is a condition that affects the TMJ and/or the muscles nearby. Sometimes the cause of pain or dysfunction is hard to identify, but luckily, we can prescribe treatments you can do at home to alleviate discomfort. We recommend using all non-permanent treatments before progressing to more permanent solutions, like bridgework or surgery.

The lower jaw, mandible, and the temporal bone of the skull are connected by two TMJ’s on either side that allow three dimensional movement for talking, chewing, and opening your mouth. This is a complex system, held together by large muscles in the cheeks and temples located above the lower jaw. Because of this system’s complexity, it becomes difficult to identify the exact source of the pain or dysfunction causing the TMD. It’s best to see a professional as soon as possible if you experience pain or have difficulty opening or closing your mouth.

What Causes TMD?

Inflammation, soreness, strains of the tendons or ligaments, and disk problems can all affect the TMJ. Genetics and gender can also play a role in who develops TMD – women tend to be more prone to it. A person’s age and stress level can cause it as well. And, in some cases, a condition known as fibromyalgia, which affects connective tissues and muscles of the entire body, could also be the source of jaw pain.

Indicators of TMD

Clicking Sounds — Clicking, popping, or a grinding sound when opening or closing the mouth could be an indicator of TMD. The noise is usually attributed to the disk inside of the TMJ shifting and coming out of alignment. Clicking alone is not an indicator of TMD because thirty-three percent of all people have jaws that click. However, if the noise is partnered with pain or restriction of movement in the jaw, such as it getting stuck or not being able to open it all the way, this may be symptom of TMD.

Muscle Pain — Pain, stiffness or soreness, felt in the cheeks and/or temples can indicate TMD, especially if felt first thing in the morning. The reason behind this is because the two large pairs of the muscles that help the jaw close can suffer from clenching or grinding while you sleep. If you grind or clench while you sleep, we typically recommend having our office create a custom nightguard for you to wear while you sleep. This will help relieve the pressure on your jaw, and help your muscles to relax – saving your teeth and allowing you to get a better night’s sleep.

Joint Pain — Most people are familiar with arthritis, a condition of joint inflammation. Technically, TMJ is arthritis in one or both jaw joints, but in some cases it is difficult to identify. When we examine patients’ x-ray images, we discover that some patients have signs of arthritic TMJs, but don’t feel any pain or experience other TMD symptoms. In other cases, patients come to us with pain in the TMJs, but show no signs or arthritis in the x-ray image. Unfortunately, we have not found a cure for arthritis, but we can prescribe medication to help manage the symptoms.

Relieving the Pain

The first step in relieving pain is having an examination and working with Dr. Brumbach to come up with a treatment plan. Treatments can range anywhere from restructuring your diet to include softer foods for temporary relief, to icing or applying heat to help reduce soreness. We can even provide you with a stretching routine to help relax those tense muscles in the jaw. If those treatments aren’t providing you with results, we can prescribe an anti-inflammatory or muscle relaxer to reduce pain.

Other Treatment Options

If your case is more severe and the treatment options outlined above just aren’t enough, we may have to pursue a more permanent solution like surgery or orthodontics. Other minor procedures could include cortisone injections into the joint, or joint flushing (lavage). We always suggest employing reversible, or temporary treatments, before moving onto a major surgery or other permanent solutions. However, our main goal is to reduce your pain and make sure you are as comfortable as possible, so please make an appointment if you have any concerns.

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