How that nightly glass of wine can wreck your teeth Thursday, August 7, 2014 @ 09:44:17

 

We all know that sugary snacks and acidic fruit juice don’t do our teeth any favours.  But now dentists are warning of another hidden source of damage to our teeth: alcohol.

Dentists say even just a nightly glass of wine can dry out your mouth, suck the calcium from your teeth, and leave you with bad breath. Alcohol is also increasingly associated with mouth cancer.

Here, we reveal how too much booze could wipe the smile off your face...

THE ACID TEST

When we put acidic food or drink — such as citrus fruits, fruit juice, coffee and even chocolate — in our mouths, enamel, the white, protective, calcium coating on the surface of the teeth, starts to dissolve.  This is because the acid softens enamel, allowing some of its calcium content to leach out, weakening its structure. When enamel is eventually worn away, nerves underneath can be exposed, leading to sensitivity and pain.

Most alcoholic drinks are extremely acidic, with sparkling beverages at least as acidic as orange juice. As a rule, dry, sparkling wines are the worst of all alcoholic drinks, as the bubbles in them are caused by carbon dioxide, which is acidic. You’d be better picking a less acidic, flat wine over prosecco or champagne.

Artificial carbonated drinks of any kind also pose a threat because manufacturers pump them full of carbonic acid to produce bubbles, which helps soften teeth further. Fruit ciders are often artificially carbonated, so steer clear. Even fizzy water, harmless though it may seem, is very acidic!

For this reason, it is always better to choose any kind of flat drink over bubbles. As a rule, white wine is more acidic than red, though neither is great for teeth.

But there is hope, here are some ways you can spare teeth from an acid attack:

  • If you add plenty of ice to a drink, you’ll dilute the harmful effects
  • Surprisingly, beer isn’t too bad for teeth, as it has quite a lot of calcium, which encourages hardening of the teeth.
  • 'Detergent' foods, such as celery and cheese, scrub teeth clean while you eat them
  • Straight whisky or vodka with lots of ice is fairly low on the acid scale. Best of all, mix your spirit with still water.
  • Try to regularly rinse with water when enjoying several drinks. Or, better still, secrete a travel-size bottle of mouthwash in your bag to rinse with, as this will neutralise acid.

Wearing away enamel with acidic and sugary drinks will discolour teeth by exposing the dentine underneath, which is a darker, yellower shade.  So, whatever you do, don’t add to this by staining them as well.  Clear drinks aren’t a problem, but those darker in colour are.

Most obviously, red wine and port are drinks to avoid, but you should also steer clear of cranberry juice or blackcurrant cordial. Coffee-based cocktails are also a problem. These drinks can also stain expensive white fillings and dentures.  If teeth are stained, this may be removed by thorough brushing, but don’t over-brush as, counter-intuitively, you’ll brush away more enamel and make them look even worse.

If heavy staining can’t be shifted, visit your dentist or hygienist for professional whitening. If you’re really worried, you could ask the dentist for a custom-made rubber mouth guard.

If you can survive the embarrassment, this will cover teeth while you drink and protect against staining...not the best option I wouldn't think!

SUGAR ATTACK

Pina coladas, sticky liqueurs and sweet sherry are tempting, but are also full of sugar.  This is harmful to teeth, as the bacteria in our mouths feed off this sugar and release acid as a by-product, fuelling the process of tooth decay.

If you combine already-acidic alcohol with a mixer, such as cola, lemonade, tonic water, or juice (all of which are very acidic and sugary), the result is even more harmful to your teeth than either of the separate parts.

It may seem odd, but a creamy drink, such as Bailey’s, is a better option: while the sugar content is high, it is not acidic, so you’re not facing a double-whammy.

The best drink is probably something like a non-sparkling vodka cocktail — for example, one containing coconut water, which is very low in acid.

The worst are pre-mixed drinks, such as Bacardi Breezers, which have a high level of added sugar, or something like rum and full-sugar cola, which is highly acidic, carbonated and has a very high sugar content.

Go for diet cola or diet tonic, which are sugar-free, but bear in mind they are still highly acidic. For cocktails, pick a ‘short’ drink, as this means you expose your teeth to a smaller portion of harmful acids and sugars.

If you do have an acidic or sugary drink, wait at least half-an-hour before brushing your teeth.  This will allow the surface of the enamel to harden up and stop you eroding it by brushing.

Better yet, use a straw. This means you’ll direct harmful liquids into your throat, bypassing most of your teeth.

Finally, as you recover from your hangover, you may crave sugary foods, but try your best not to add to the dental onslaught with a high-sugar fry-up for breakfast.

BAD BREATH

Alcohol dehydrates the body, including the mouth, as it is a diuretic (it makes the body pass out more water), resulting in reduced saliva flow.  Saliva helps fight bacteria in the mouth so, when it is dry, the micro-organisms flourish, leading to plaque build-up and, inevitably, bad breath.

Plaque, in turn, leads to higher risk of tooth decay, as well as gum disease, where bacteria irritate the gums, leaving them swollen, sore, or infected, resulting in bleeding during brushing.

Get that furry-mouth feeling after drinking? When the amount of saliva is reduced, the mouth feels uncomfortable rather than healthy and well-lubricated.

In fact alcohol will dehydrate your mouth and leave it a bit like those of post- menopausal women and the elderly — these two groups see saliva flow naturally reduce as part of the ageing process.

Medicines taken by older people can further contribute to dry mouth, for example, anti-inflammatories, and drugs for high blood pressure or pain relief.  These people’s problems with dry mouth would only be made worse if they drink a significant amount of alcohol without being very careful to keep their water intake up.

In other words, if you’re a post-menopausal woman, you’re doubly-blighted.  So, always drink lots of water in between alcoholic drinks and when you get home and sugar-free chewing gum and mints can help keep your mouth moist, as they stimulate saliva production.

CANCER RISK

Drinking to excess, particularly in combination with smoking, is a risk factor for mouth cancer.  Anyone drinking within the recommended daily limits shouldn’t worry, but binge drinking is a risk factor on its own and, when it is combined with smoking, it increases the risk to 30 times.

This is because alcohol can have a direct effect on the cells lining the inside of the mouth, including gums and cheeks — and spirits are the worst culprit.

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Botox to fix a "gummy smile" Sunday, August 3, 2014 @ 18:09:57

Images of study subjects before, at left, and after receiving Botox treatments to correct their “gummy smile,” which was defined by the study as two or more millimeters of “gingival exposure upon smiling.”Credit Aesthetic Surgery Journal

Images of study subjects before, at left, and after receiving Botox treatments to correct their “gummy smile,” which was defined by the study as two or more millimeters of “gingival exposure upon smiling.”Credit Aesthetic Surgery Journal

 

Susanna Miller-Pence’s teeth weren’t the problem; her gums were. When she smiled, her upper lip stretched up so high that a ribbon of pinkish gum was exposed, giving her a so-called “gummy smile.” She hated it.

“The doctor explained that my gums were longer than my teeth, so the dimensions weren’t right,” said Ms. Miller-Pence, 52, a psychoanalyst living in San Luis Obispo, Calif.

Fifteen years ago, she had a gingivectomy, an operation to remove some of the extra gum tissue. A month later, she was grinning broadly. “Now everyone comments on my smile,” she said.

Gummy smiles occur for a variety of reasons, most commonly a short upper lip, excessive gum tissue or small teeth, all of which are genetic. According to Dr. Stan Heifetz, a cosmetic dentist in New York and White Plains whose office treated Ms. Miller-Pence, ideal smiles show up only to about two millimeters of gum. “Anything over three to four millimeters of gum showing starts to look ‘gummy,’ ” he said.

Studies have been done with dentists, plastic surgeons, dermatologists and regular folk to assess smiles. Most everyone agreed that two millimeters or less of gum tissue showing was the level where most participants thought the smile looked normal. Participants started noticing the gum tissue at three to four millimeters, and thinking that too much gum tissue was showing at more than four millimeters, Dr. Heifetz said.

Doctors who specialize in cosmetic procedures estimate that about 14 percent of women and 7 percent of men have excessive gingival exposure when smiling.

“I believe the incidence is probably higher than we think, but we specialists just see and count the ones we treat, which are on the low side since not many people come to the doctor and ask about treatments for this,” said Dr. Jessica Suber, an attending physician in plastic and reconstructive surgery at Southern Ohio Medical Center in Portsmouth. “It’s something a lot of patients aren’t aware of.”

It’s hard to know how many operations are done annually to correct a gummy smile; many patients combine it with other medical and aesthetic treatments. According to data from the American Dental Association Health Policy Institute, 569,160 gingivectomies were performed in 2005-6, the most recent years available.

In the past, surgery was the main treatment option, but that is often costly and painful. Doctors sever the muscles that elevate the upper lip so it can no longer rise as high, or they do a crown lengthening procedure that cuts away gum tissue so the crown appears longer.

In extreme cases, they might perform orthognathic surgery, which repositions the upper jaw if it sticks out too much. But this can be complicated and can take up to two years to complete, Dr. Heifetz said. Laser therapy is also sometimes used.

Now people are going another route: onabotulinumtoxinA, otherwise known as Botox.

For the last few years, dentists have been injecting Botox into the upper lip “elevator” muscles. It paralyzes the muscles, inhibiting contraction of the upper lip when smiling to prevent the gummy smile.

In contrast to surgery, Botox is quick and easy, doctors who do the procedure say.

A March 2014 study in Aesthetic Surgery Journal found that off-label use of Botox was a safe and effective procedure for gummy smile, albeit one that lasts only three to four months for the average patient, confirming the findings of an earlier report in the American Journal of Orthodontics and Dentofacial Orthopedics. The price is also more appealing than surgery: Botox costs around $350 (depending on the part of the country you are in and the doctor you see). Ms. Miller-Pence said she paid about $15,000 for surgery and crowns, which was not covered by insurance.

Botox goes directly into the lip tissue, so there’s almost no risk of digesting it, said Dr. Peter Taub, a plastic and reconstructive surgeon at Mount Sinai Hospital in New York.

Stephanie McCarrell, a nurse anesthetist in Tampa, Fla.,says she has received Botox three times for her gummy smile, which has always bothered her.

“When I was a girl, the other kids made fun of me,” said Ms. McCarrell, 36. “It really bothered me. I would smile without my teeth, just a closemouthed smile.”

A few days after her injection, her upper lip had dropped and her gums were less visible, she said.

But Botox works only if the problem is in the lips, not the bone. And doctors have to be careful not to overinject the muscles, or they could create an unnatural look.

As Dr. Ariel Ostad, a cosmetic dermatologist in New York, said, “A little bit too much, and you really inactivate those muscles and when you smile, you smile crooked.”

Author: Abbey Ellin - New York Times 

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When do I take my child for their first trip to the Dentist? Sunday, August 3, 2014 @ 17:20:39

"An ounce of prevention is worth a pound of cure".  How well this proverb applies to children’s oral
health!

The Australian Dental Association recommends that your child’s first oral health visit take place at 12
months of age, or shortly after the eruption of the first baby teeth.

Your dentist will evaluate your child’s oral and dental health and diagnose any problems, which may
exist. Do not wait until a problem occurs. Preventive dental visits from an early age lay the foundation
for a lifetime of good oral and dental health.

During your child’s visit, the dentist will:

  • Look at the child's face and jaws for signs of mal-alignment
  • Try to look at any teeth that are through to make sure they are healthy
  • Instruct the parent or guardian on fluoride, diet, brushing and general oral health tips


Identifying signs of early childhood decay is vital. It starts as white patches on the teeth that don't seem
to be able to be cleaned off. They are often close to the gum and they eventually break down further to
form holes

Some first visit DO'S:

  • Take time to play "dentist" with your child at home. Pretend that you’re counting teeth, then switch roles and let your child play "dentist
  • Read your child a story about going to the dentist
  • Make the dental appointment for a time when your child is well-rested
  • Inform your dentist about any medical or psychological problems that your child may have
  • Openly discuss your questions and concerns

Some first visit DONT’S:

  • Don’t convey anxiety about the dental visit to your child. For example, don't say "It's OK, the dentist won't HURT you" or "The dentist won't need to use the INJECTION". These are usually the parent's fears, not the child's
  • Don’t worry if your child cries a little during the visit. A very young child may react that way but will be won over eventually
  • Don't use negative words like: hurt, shot, needle, or drill around your child

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Medicine and oral health Friday, August 1, 2014 @ 14:23:51

 

If you take any sort of medication—over-the-counter or prescribed—you’ve probably noticed those long lists of potential side effects listed on the labels.

These can range from skin discoloration and headaches to blood clots or worse. But one symptom most people don’t think twice about is how some medications affect your teeth, gums and mouth. Below are just a few of the common oral-health-related side effects from different medications:

Abnormal bleeding 

Asprins, anticoagulants and other blood thinners are helpful in preventing strokes or heart disease, but they can cause your gums to bleed, especially during any oral surgery. Let your dentist know if you’re taking any medications so they can take precautions to minimize bleeding (and so they don’t assume the bleeding gums are due to poor flossing and brushing habits).

A change in your tastebuds

Certain medications like cardiovascular drugs, nicotine skin patches and some respiratory inhalants can leave a metallic or bitter taste in your mouth and some could even change the way you taste food altogether. If you can’t tolerate this side effect, talk to your doctor about switching your medication.

Soft-tissue reactions

Prescriptions that have been linked to mouth sores, inflammation or discoloration of the soft tissues in your mouth are typically blood pressure medications, oral contraceptives and certain chemotherapy drugs. Your dentist can recommend a special dental care regimen to reduce your discomfort if you notice these symptoms.

Enlarged gums

Gingival overgrowth (a.k.a. enlarged gums) can be the symptom of anti-seizure medications, immunosuppressant drugs (commonly used after organ transplantations) and calcium channel blockers. If you are taking any of these drugs, you’ll want to be extra gentle when brushing and flossing (and, of course, talk to your dentist about specific care instructions).

Increased risk of cavities

It’s true that a teaspoon of sugar helps the medicine go down. That’s why sugar is a common ingredient in liquid medications, cough drops, vitamins, antacid tablets and antifungal agents. Even though it may make the medication easier to take, the sugar can also make your teeth that much more susceptible to cavities. To help reduce your risk:

  • Take the medication in tablet form, if possible.
  • Take the medication at meal time.
  • Avoid taking the medication at bedtime.
  • Visit the dentist regularly for preventative care.

Dry mouth

Numerous medications, both prescribed and over-the-counter, list dry mouth as a potential symptom. If saliva doesn’t flow normally, your soft tissue might get irritated, which can cause inflammation and make you more susceptible to infection. If your dry mouth is severe due to your medications, you can ask your doctor about switching or try one of these tips:

  • Sip water or a sugarless drink throughout the day.
  • Cut down (or skip) caffeinated beverages, alcohol and tobacco because they contribute to dry mouth.
  • Suck on sugarless candy or gum to increase saliva production.
  • Avoid salty and spicy foods which can cause extra pain to a dry mouth.
  • Use a humidifier at night.

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Tattoos move from the body to the teeth Wednesday, July 30, 2014 @ 14:47:48

Tattoos have conquered the final frontier, the only part of the body that was thus far thought best as spotless — the teeth.

Getting the teeth inked is fast gaining currency as a fashion trend in India of all places. And it's not just tattoos. Tooth jewellery, too, is becoming popular, adding bling to the smile.

Indian Dentist, Simita Madan, who has done everything from football impressions to cartoon characters and floral designs, and receives around 20 requests for dental tattoos and jewellery a month. "Both dental tattooing and jewellery have a very simple procedure. We fix a cap on the tooth. There is no drilling required. It can last for some four to five years, depending on the maintenance. Another advantage is that unlike body tattoos, you can get dental tattoos removed without hassles," she said.

On the safety of the procedure, a bonding agent, used for teeth filing, is used to fix a stone on the teeth. It is a superficial chemical, which is safe." She added that dental tattoos and jewellery are a good option for patients who require a crown due to decay or cavity.

While the most preferred teeth for tattoos and jewellery are the lateral upper incisors, canines, molars and premolars, most popular designs are floral designs and cartoon characters. 

Though dentists and cosmetologists claim that there are no side effects to the tattoos and jewellery, they stressed the need to maintain dental hygiene to avoid cavities. 

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The Link Between Periodontal Disease and Upper Respiratory Diseases Tuesday, July 29, 2014 @ 10:07:42

With Winter in full swing, it occured to me that many of the more acute infections associated with cold and flu might have a link to oral health (or lack of it)...low and behold I found a recent study published in the Journal of Periodontology suggesting a possible link between upper respiratory diseases—including pneumonia, acute bronchitis, and chronic obstructive pulmonary disease (COPD)—and periodontal disease. Typically occurring when bacteria are inhaled into the lungs, the bacteria that cause periodontal disease also can be inhaled into the respiratory tract and increase the risk of infection.

The study examined 200 people, 100 who had been hospitalised with a respiratory infection and 100 who were healthy. The study results demonstrated that those who were part of the healthy group had better periodontal health, while the periodontal health of those with respiratory illnesses was worse.

Several studies have suggested a link between periodontal disease and other inflammatory diseases, such as cardiovascular disease and diabetes. However, there is not a lot known about how periodontal disease can impact respiratory health. Considering that respiratory infections, including chronic obstructive pulmonary disease (COPD) and pneumonia, can be severely debilitating and are a major cause of death in Australia, particularly among the elderly, research into how periodontal health and respiratory health are potentially connected is imperative.

The significance of this research study is that it provides further evidence of the perio-systemic link by demonstrating that the incidence of pathogens in the periodontium may play a role in the progression of non-oral disease. These findings suggest that the presence of bacteria associated with periodontal disease, such as Porphyromonas gingivalis, may increase a patient’s risk of developing or exacerbating respiratory infections. The occurrence of these oral pathogens, and the resulting supragingival plaque accumulation, periodontal pockets, and most likely the inflammatory response diminishes the host defense, thereby increasing subjects’ risk for developing a respiratory infection.

Poor periodontal health, therefore, may be viewed as a risk factor for respiratory disease. But as the researchers note, other factors may come into play as well. Of course aditional research is needed in this area to better understand how periodontal disease and respiratory disease are related.

This study places a lot of emphasis on the role of bacterial pathogens in the progression of both periodontal disease and respiratory disease. While the presence of bacteria is a determinant of disease, it is often the inflammatory response to bacteria that is essential in the initiation and progression of disease states.

Individuals may be genetically predetermined to respond differently to a challenge, such as bacteria, and therefore their level of disease may be different. It seems that while an in-depth discussion of inflammation was missing in this study, there was speculation that periodontal pathogens not only are responsible for respiratory tract infection, but also that these pathogens may affect the local defense mechanisms of the region to increase these patients’ risk for respiratory disease.

Both periodontal disease and respiratory disease are often classified as inflammatory conditions, so it may be possible that inflammation may be a factor in the link between the two. Obviously, more research is required to illustrate this and better understand if and how the inflammatory response to periodontal bacteria leads to the development or aggravation of respiratory infections.

This really drives home the belief that the mouth, teeth and gums are the 'gateway' to holisitc health.

 

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How dental records will help identify victims of the MH17 disaster Monday, July 28, 2014 @ 10:23:55

 

The first of the bodies from Malaysian Airlines flight MH17 arrived in the Netherlands last week, ready for forensic investigation into the remains of the 298 passengers and crew.

Identifying the victims will pose many challenges given the potential state of the bodies and remains, both from the initial explosion and the delay in recovery, but dental records can definitely help.

It is not unusual for forensic science to investigate mass disasters and crimes, such as the 2001 World Trade Centre attacks in New York.

Neither is it unusual for forensic experts from different countries and organisations to participate into the one investigation, such as Nairobi’s Westgate mall attack in 2013.

But it is unusual when the incident occurs in a conflict region or area where there is no defined jurisdiction or hardly any legal structure to default to. Like in the case of thedowning of the MH17 in eastern Ukraine.

There are legitimate questions relating to the jurisdiction in place, the security of the evidence and the safety of the expected forensic team of experts.

This is especially so when the militant groups who are accused of downing the aircraft and therefore creating the crime site will themselves be guarding the crime scene and the forensic experts expected to work at the scene!

As a proper forensic investigation has been so far deliberately or unintentionally delayed, concerns relating to the accurate identification of victims' bodies has arisen.

As time passes, more crime site contamination is expected to occur along with the decomposition of victims’ bodies. The transfer of the first 40 bodies to the Netherlands is only took place after they were left in fields for several days of hot summer weather.

Research in forensic medicine and forensic odontology can offer some reassuring news for families and friends of the victims.

Dental identification has always played a key role in natural and human-made disaster situations especially in identifying victims of fires, and victims of mass disasters and aviation disasters.

In cases where a body is charred, conventional autopsies and DNA profiling become problematic and very limited in certain situations. Bodies in these instances can be disfigured to such an extent that identification by a family member is neither reliable nor desirable.

But the teeth often remain a good source of identification in those situations.

Ongoing forensic research in Egypt has been evaluating the changes in the root density and morphology of the teeth subjected to extremely high temperatures equivalent to that resulting from aircraft’s explosion.

Digital dental radiography was used to investigate the possibility of using these changes to identify bodies exposed to extreme heat.

 

A perfect match of all the examined points along the horizontal section copied from the pre-burning radiograph (right) and superimposed on the post-burning one (left). 


Research results confirmed that measuring the root density on direct digital radiographs and comparing the antemortem and postmortem values is a reliable tool for identification of bodies exposed at temperatures up to 1,100°C for durations up to 30 minutes.

Digital radiography is a preferred choice in any mass casualty situations where the number of victims overwhelms the ability of forensic examiners to quickly and accurately identify a person. It’s also useful where other tools of identification may be restricted, problematic or time-consuming.

In the MH17 case, digital dental radiography can be employed for identification purposes as the teeth of the victims are not as vulnerable to contamination and immediate decomposition as other evidence and parts of the body are.

In addition, the creation of electronic teeth-radiographs can be easily networked and transferred between forensic scientists on site (eastern Ukraine and the Netherlands in this case) and their colleagues at laboratories wherever they are, including Australia, Malaysia and the UK.

These advancements in forensic science mean investigators may be able to contain much of the mess already done on the disaster scene.

Identifying the victims’ bodies and remains is not only a legal and moral requirement towards human dignity but also an impartial step for the families, friends and colleagues to help grieve their loss.

Forensics will play a critical role in crime reconstruction, providing scientific explanations to understand the sequence of events relating to the downing of the Malaysian aeroplane.

By doing so, forensic experts will assist in bringing offenders to trials.

Among all the political and military battles, this forensic battle seems very hard to win in a contested area with hardly any jurisdiction or legal framework in place.

In the MH17 case we have to wonder to which law will forensic science relate to? Will it be to the Russian law, Ukrainian law, the rebels’ rules and orders, international law or that at the Netherlands from where the MH17 departed but never landed or Malaysian law its intended destination?

This is a difficult question in a difficult region where political interest seems to override any other interest.

 

 

 

This article was co-authored by Ahmad Samarji, Forensic Scientist (VIC University) & Dina Shokry, professor of forensic medicine and clinical toxicology at Cairo University and president of the New Mediterranian Academy of Forensic Science.

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Chewing gum might be the cause of your headaches Friday, July 25, 2014 @ 12:33:43

Its called temporomandibular joint dysfunction or TMJD.  A physical problem carrying symptoms including dizziness and headaches, your ears may feel permanently clogged, even exaustion and mood swings can occur in extreme cases.

However, GPs and Dentists don't always recognise the condition, leading to the assumption that it is psychological and often misdiagnosed as depression. And some dental treatments used to treat jaw pain - such as tooth extraction - can make it worse.

Although with a string of sypmtoms like the ones mentioned above may well lead to depressive feelings I'd imagine.

The temporomandibular - the technical name for the jaw joint - works like a complex hinge, which can also slide back and forth. The jawbone is held in place by muscle attached to the joint next to the ear. A cartilage disc acts as shock absorber between the jaw and skull.

Temporomandibular joint dysfunction - also called temporomandibular joint disorder - is a broad term for any problem with the joint, the muscles around it or the cartilage disc. It can cause jaw pain, difficulty opening the mouth and sometimes a clicking noise.

The clicking itself isn't neccessarily a problem but it can be a sign that the different components in the jaw joint aren't working in harmony.

The condition affects one in five people at some point. A common cause is over-worked, inflamed muscles and ligaments around the jaw from chewing gum, or grinding teeth - often at night.

When you clench your teeth to grind them, the jaw joint can't slide around and this puts stress on the muscles, teeth, and joint.  A mouthguard worn at night to keep the top and bottom teeth separated can help the joint and allow the muscles to relax.

As well as tooth grinding, the jaw joint can be pushed out of alignment by a blow to the head, poorly fitting dentures, dental treatment, biting your nails, or even by yawning or opening your mouth widely to eat.

While the problem often clears up on its own, in severe cases the cartilage can slip too far out of place, leaving bone to rub against bone, causing wear and tear.

Other conditions, such as osteo-arthritis, rheumatoid arthritis and gout flare-ups, can also cause stiffness, swelling and pain in the joint. Very rarely, TMJD may be caused by a tumour in the jawbone. The condition can cause headaches, as pain from the joint radiates to the side of the head, or because the muscles around it are in spasm. Pain can also radiate into the neck or back. Because the joint is so close to the ear, it can cause a blocked-up feeling, dizziness and tinnitus, too.

Patients with chronic TMJD need orthodontic treatment or surgery, but getting the right diagnosis can be difficult, a good Neuromuscular Tecnician along with a Dentist is who you should see.

Signs its a jaw joint problem

  • Clicking or popping as you talk or chew
  • Muscle spasms around the jaw
  • Difficulty opening the mouth
  • Tension headaches on the side of the head
  • Earache and/or ringing or buzzing in the ears (tinnitus)

TMJD pain can be relieved by washing out the joint to get rid of debris that might be causing irritation, or by injecting a steroid if there's inflammation. But this is not always a solution as the disc may not be restored to its correct position.

So why is this treatment not commonplace? There continues to be controversy and debate among professionals, which causes confusion to patients.

A lot of clinicians don't accept the problem is due to disc displacement. In part, because too few patients with the condition undergo MRI scans, so clinicians are unaware of any disc displacement.  Many don't believe splints can be effective either, and too often they give patients an off-the-peg plastic mouthguard, which can make symptoms worse.

People with tinnitus or blocked ears may get sent to ear, nose and throat specialists and GPs are also more switched on to depression, which may be why they assume it's psychological.

So bottom line...if you're suffering any or all of these symptoms, it might be worth to perhaps mention TMJD to whoever is treating you, it might be lifechanging...Or, give us a call on 02 9415 6868...we have an amazing Neuromuscular Technician - he'll have a chat to you about it at no cost.

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Middle-class parents who've ruined their children's teeth Thursday, July 24, 2014 @ 11:14:32

When three-year-old Sophia Lister (pictured here) started complaining that the back of her jaw was hurting, her mother assumed the little girl's adult molars must have started to come through.

'I gave her some pain killers to help her sleep and waited for the pain to go,' says Solveig, 40, who works part-time as a financial director and is married to Chris, 43, an insurance underwriter. But the pain didn't ease, so two days later she took Sophia to the dentist.

'I nearly fainted when he told me that Sophia had serious decay in her baby teeth,' she recalls. 'I hadn't even noticed. I was mortified. She needed root canal work on one of her back teeth and fillings in three more. I kept thinking I must be a terrible mother to have let this happen.'

But Solveig isn't the only middle-class mum horrified to discover her young child has severe tooth decay - a condition more commonly associated with children living in poverty.

According to new figures, almost 26,000 children aged between five and nine have been hospitalised for multiple tooth extractions in 2013-14 - that's the equivalent of almost 500 a week.

Removal of rotten teeth is now the primary reason children in this age group are admitted to hospital. In some cases, dentists have no choice but to remove all 20 baby teeth from their young patients.

And those from comfortable lifestyles are at just as much risk as youngsters from disadvantaged backgrounds - with middle-class parents feeding their children so-called 'healthy' snacks that cause more damage than junk foods, and working mums often too busy to take their children for check-ups.

The legacy can be far more serious than just a phobia of going to the dentist.

'The best predictor of adult tooth decay is dental health at the age of five,' says Dr Mervyn Druian, a dentist who specialises in cosmetic dentistry and reconstruction. 'It's not something that disappears when your baby teeth fall out.'

Many so-called healthy snacks are packed with sugar...

Dentists have seen a steady increase in the number of children needing extensive dental work to save baby teeth, according to industry professionals, part of the problem is that parents think they are giving children 'healthy' foods and drinks, but it is these that can cause the most damage.

Parents don't realise that fruit juices contain more sugar than cola, and many so-called healthy snacks are packed with sugar, too.

It's a trap that Solveig admits she fell into with Sophia, who is now five. While she never let her little girl have sweets, she was happy to let her have apple juice in a sippy cup.

Cavities are caused by two factors:

  • decay, which occurs when bacteria in the mouth react with sugar, causing acids to form that soften and dissolve enamel
  • and acid erosion, which happens when acid in food or drink comes into direct contact with enamel.

Although enamel on baby teeth is as hard as enamel on adult teeth, the layer is thinner, making children's teeth more vulnerable.
Sippy cups containing juice are a short cut to dental decay. Sipping on apple juice all day bathes your teeth in acid soup and it's doubly damaging because it's both sugary and acidic.

Current advice is that a child should see a dentist at least once a year, but it seems most parents believe baby teeth don't really matter and regular check ups can wait until their adult teeth emerge...WRONG!

When I told the dentist I fed my son raisins, he told me I might as well be feeding him sugar cubes....

Then there are the dried fruit snacks - raisins, mango, apricots and the like - beloved by middle-class mums as a 'healthy' alternative to biscuits and crisps, but these foods are concentrated forms of fructose, or fruit sugar, which reacts with bacteria in the mouth to create acid.  They are sticky and cling to the space between the teeth, sometimes for an hour or more, all the time causing potential damage.

Scarily, many 'healthy' savoury snacks, such as breadsticks, wholemeal bread and bagels, also contain hidden sugar.  And if a type of bacteria that leads to cavities gets a foothold in childhood, it can ruin a child's smile for life....

But its not just the snacks themselves but the snacking habit that is dangerous.  As life gets busier, we seem to have gone from three square meals a day to six or seven snacks, which I am sure we can all relate to when we're on the go. This means that teeth are constantly bathed in acid - giving no time for saliva to neutralise it and let the enamel recover.

OH NO! - even milk is another culprit. While many parents assume cow's milk is a wholesome drink, it too contains a type of sugar: lactose. Formula milks for children aged from one year upwards also contain added sugar.  Decay is a particular problem if the milk is in contact with the teeth for extended periods.  There is even a condition called 'bottle cavities' which develops because a child is left to constantly suck on a bottle of milk (usually to stop them crying).

There is an overlap period between the ages of five and nine when baby teeth and adult teeth exist in the mouth together, so bacteria from decaying baby teeth will get to work on the adult teeth, too.

So what can parents do to stop their children developing cavities at such a young age?

  • Proper tooth brushing, twice daily with a toothpaste containing fluoride, is vital...and parents have to take responsibility for brushing their children's teeth until at least age eight 
  • Brushing should last at least two minutes twice a day
  • Flossing should start from around age four
  • Parents should give children water rather than fruit juice
  • Cut down on snacking

 

 

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Oral Piercing Thursday, July 17, 2014 @ 13:27:10

It’s important to know the facts about tongue and lip piercings so that you can make informed decisions.

In the best case scenario, soreness and swelling will be the only symptoms experienced following the piercing procedure, however in some cases, excessive bleeding and infection can occur.

Tongue piercing involves a needle being inserted through the midline of the tongue to place a stud, hoop or a barbell in the tongue, and is usually done without anaesthetic. After piercing, common symptoms include swelling and pain.

Possible Side Effects

  • Slight bleeding can be expected. There is a risk that blood vessels can be severed in the process of piercing the tongue, which can cause excessive bleeding.
  • While swelling of the tongue is expected after piercing, in severe cases, it can swell significantly enough to close off the airway altogether. The resulting difficulty in breathing can be life-threatening.
  • If an inexperienced practitioner pierces the tongue incorrectly, nerve damage can permanently inhibit feeling in the tongue and facial movement. There are nerves at the back of the tongue, which if severed, could lead to permanent numbness, speech impediments and the loss of taste.
  • There is also a risk of infection, especially if stringent hygiene practice is not followed. Bacteria can penetrate to the inner tissue of the tongue where it has the potential to cause infections.
  • In the long term, tongue piercings can lead to chipped or cracked teeth, because of the continuous rubbing of the metal/plastic against teeth. Tiny cracks can form and cause severe pain and a tooth can fracture and leave the nerve exposed. Sometimes, constructing an artificial crown over the damaged tooth is the only way to save it. Injuries to the gum and cheek tissue are not uncommon either.


Lip piercing is where a ring is placed through the lip. These heal relatively quickly, although extra care must be taken during the healing process as food, smoke and liquids that come into contact with the piercing might increase the risk of infection.
Retainers on lip rings can also damage gums, and possibly damage nearby teeth. In some cases, gum grafts are required to repair an affected area. Similar to tongue piercing, nerve damage is also a possibility, affecting facial movement and the ability to feel the affected area.


Contemplating an Oral Piercing?

If you’re thinking about getting your tongue or lip pierced here are a few suggestions to make sure you get the correct procedure and ensure your mouth stays healthy once it’s in place.

  • Ensure the practitioner performing the piercing is experienced, is aware of your oral anatomy and uses strict infection control practices, to guard against the risk of infection or long-term nerve damage.
  • Seek immediate medical advice if excessive bleeding, swelling or pain occurs following a piercing.
  • If infection occurs seek urgent medical advice.
  • Once the piercing is in place, it is recommended to visit your dentist every six months. Your dentist will be able to closely monitor the piercing and any potential damage to teeth and gums, and this will decrease the likelihood of any long-term damage.
  • Athletes undertaking sport should remove their jewellery prior to competing as piercings can be ripped from the skin accidentally.

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