Bite Adjustment and Jaw Pain
In many cases, the aches and pains that people experience in their jaws (and related areas) are the result of a bad bite. Often, correcting the bite may be all that is necessary to alleviate the problem.
Dr. Patenaude will examine your bite and see if there is a deflecting surface where your teeth are meeting incorrectly. He may adjust teeth surfaces with high-speed burs or diamond stones. This is called equilibration or bite adjustment. A very fine knowledge of occlusion (how the teeth meet) is needed to recognize any discrepancies in the bite, as they may be very subtle.
Sometimes the bite cannot be corrected by equilibrating because the biting surfaces of the teeth need to be rebuilt. If this is your situation, Dr. Patenaude may recommend onlays or crowns as he restores your bite to a healthy occlusion. Occasionally, orthodontic treatment may be necessary to realign the teeth, and this alone may correct the faulty bite.
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Biting Your Cheek at Night
If you've noticed that you sometimes bite your cheek at night when you're sleeping, this may indicate a combination of problems, such as tension, irregularities in teeth surfaces, or improperly aligned teeth, Some people express tension by clenching or grinding their teeth, either while awake or unconsciously when they're asleep. When the lower teeth are rubbed against the upper teeth this is called bruxism. If you grind your teeth from side to side this may result in a bite or damage to your cheek or lips.
You may be able to relieve the emotional aspects of the problem by trying to eliminate what ever is causing the tension. Dr. Patenaude can help the dental aspects. For instance, he can check the relationship of your bite to see if there are any irregularities in your teeth that are causing problems. He may suggest that your wear a hawley-type appliance or a night guard to help break the bruxing habit. This will also give him another way of checking your bite to find out what dental problems should be corrected,
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Checking for TMJ Syndrome
Aside from checking the teeth and gums during a routine examination, Dr. Patenaude also examines the joints on each side near the ears. This is to determine whether or not you have temporomandibular joint dysfunction (TMJ Syndrome for short) and whether it requires treatment.
Dr. Patenaude will check for popping or clicking when you open and close your mouth. He will also try to correlate that with any history of pain or limited ability in mouth opening. He will feel the chewing muscles to see if there is any tenderness and ask whether you have many headaches, stiff neck, or problems with the chewing muscled or joints, that you have noticed
Such questions are important, many cases of TMJ pain are related to disharmonies in the bite (the way the teeth meet and chew), but there are a number of other possible causes. Dr. Patenaude will have to put all this information together to know how to treat you if it's needed.
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Crooked Teeth Problems
Years ago it was thought that orthodontic treatment only made for a prettier face and smile. Although beauty may be the main motivating force, in reality the straightening of crooked or misaligned teeth results in lower general dental bills. Teeth that are crooked or out of line not only make it difficult for the person to clean his teeth, but also destroy the natural cleansing process. Teeth need to have the biting pressure equal with a force directed straight down the vertical line of the root. If the biting force deviates from this (as with crooked teeth), your teeth can rock themselves from side to side or forward and backward, not unlike what the dentist does when wants to remove the tooth. Orthodonture equalizes the biting forces by aligning the teeth. If your teeth are rocked continually by chewing forces, the gums tend to get soft and bleed, leading to periodontal disease of the gums and bone.
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Discrepancies in your Bite
If there are any discrepancies in your bite or in how your upper and lower teeth meet, don't leave this condition untreated. It may lead to the chronic pain of temperomandibular joint syndrome. Your temperomandibular joints are located on each side of your head, just internal and near the openings of your ears. You use them whenever you move your mouth and lower jaw. Discrepancies in bite or malocclusion, however, can cause painful stress and muscle spasms in this area.
Sometimes your bite can be corrected by adjusting the surfaces of your teeth with high-speed burs so they will fit together better. But in other cases some of the tooth surfaces may need to be rebuilt by using onlays and crowns. It is also possible that more extensive orthodontic treatment may be needed so your teeth can be properly aligned. The inclined planes of the cusps of your teeth must be in good relationship, jaw to jaw, to relieve the muscle spasms caused by temperomandibular joint syndrome.
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Filling the Void
If you've lost a tooth and never had it replaced, there are changes going on in your mouth that you may not notice until a serious dental problem develops. For one thing, some of your teeth may be shifting and tilting. Changes may also be taking place in the roots and supporting bone of teeth on either side of the gap. Teeth on either side are now leaning toward the open space. The opposing tooth on which the missing tooth used to rest is also probably been adversely affected because of the missing tooth.
This usually happens gradually, but the problems begin to mount. As the teeth shift and tilt or lean into the open space, this will affect your chewing efficiency. Because your teeth are out of alignment, extra pressure is exerted on the bone and periodontal ligaments. This causes a weakening of supporting structures. If you have a missing tooth, see Dr. Patenaude to find out what he would recommend to replace it before serious problems develop.
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High Spots
High spots on fillings, crowns, fixed bridges, or partial dentures may produce hypersensitivity in teeth because of excessive pressure. The amount of pressure concentrated on these high spots can be enormous, since the muscles used in biting and grinding can produce a force of several hundred pounds!
The teeth may become sore and tender when the jaws are tightly closed or when a person eats, especially if the teeth are subject to temperature changes, even if only a few degrees. Fortunately, this type of pain usually subsides immediately after the excessive pressure is released.
Though Dr. Patenaude makes every effort to restore all parts of the teeth so that they closely match the patient's natural teeth in form and function, occasionally there is a high spot. A patient who has recently had restorative work should not be surprised to need adjustments. What is important is that he or she relate any experience of pain or hypersensitivity to Dr. Patenaude.
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How is your Bite?
If your teeth do not rest comfortably on each other when your mouth is closed, Dr. Patenaude may want to check your bite to see if your teeth hit evenly in the closed mouth position. Then, with the marking material placed in the upper and lower teeth, he may ask you to slide out your lower jaw in several directions. This is one way of checking to see if you have any high spots on the surface of some of your teeth when they come in contact. He will also check to lateral movements of your jaw as well as forward movements of the lower front teeth against your upper front teeth.
All of these movements help him to discover where certain teeth may need building up or reshaping so they will meet the opposing teeth properly. It also gives him other information he may need so your bite can be corrected before serious dental problems develop.
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How Your Sleep Affects Your Teeth
How important is your sleep posture to your dental health? More important than you may think. Researchers, dating back to the early 1930's have discovered that certain malocclusions (bad bites) develop because of long-standing sleeping habits. Dentally speaking, we are now aware that sleeping on your side can cause improper bites in the back teeth and jaw joints, possible headache problems and even the development of overbite and underbite. The solution is simple, but it must be started early in life because once you develop an individual posture, it is hard to change. At the earliest stage possible, try to teach your child to sleep on his or her back. This is the healthiest posture for the body in general, as well as the teeth. Certainly, if your child is undergoing orthodontic treatment, proper sleeping habits can only shorten the treatment time and make it more successful.
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Importance of Proper Bite
After Dr. Patenaude completes a filling involving the biting surface, he or she will check to make certain it doesn't interfere with the normal bite. It must duplicate the natural bite-exactly.
Articulating paper is commonly used to show whether the tooth is in proper contact. The patient bites on paper containing an ink which indicates high points to be removed. A filling that is too high can cause a tooth to meet its opposite before the others and eventually cause the tooth to ache. The filling could also break from the pressure of the premature bite and/or become sensitive to temperature change.
A filling that is only fractionally high (0.5mm) may feel mountainous. The bite relationship is the most sensitive in the human body. You could hold three pieces of paper between your thumb and forefinger and not notice the difference if a fourth were added. The same addition to a filling would feel enormous.
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Is it Really Sinus Trouble?
Perhaps you've been experiencing occasional or dull pain in your face or head area and wonder if it may be caused by sinus trouble. This is one of the symptoms of temporomandibular joint syndrome (TMJ); a condition checked by your dentist to see of the problem is caused by TMJ.
TMJ is not a new disease, but new methods of treatment have recently been developed to correct the condition and relieve the pain and discomfort. TMJ can have many causes, among them improperly aligned teeth or malocclusion. It can also be caused by bruxism, the habit of grinding or clenching the teeth. This can cause them to become misaligned and create other dental problems in addition to TMJ.
The pain and aching associated with TMJ will not go away by itself. Ask Dr. Patenaude for an examination to see if you have TMJ syndrome and how the condition should be treated.
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Lower Jaw Out of Balance
You use your lower jaw probably hundreds of times a day without even thinking about it. It's one of the most natural and easiest movements in the world when it's in proper balance and not causing any pain or discomfort due to temporomandibular joint problems. Your temporonmandibular joints are located on each side of your head, just internal and in front of your ear openings, and are connected to your lower jaw. You use your lower jaw, for example, whenever you chew, talk, yawn, swallow, sing, whistle, etc. It may surprise your to learn that your jaw does not move at all. It is fused to the skull. The muscles in the upper and lower jaws that you use for chewing all act together to help hold the lower jaw in proper relation to the upper jaw. But problems with the temporomandibular joints can throw your lower jawbone out of balance, bringing pain and discomfort when you open and close your mouth. When this happens, you should seek Dr. Patenaude's help as soon as possible.
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Noisy Jaw Joints
If you have noisy jaw joints that sometimes click when you open and close your mouth or have been experiencing occasional facial pain or a dull earache, you may have a dental problem. These are symptoms of myiofacial pain dysfuntion syndrome. This problem is associated with the muscles that control the lower jaw or tempermandibular joint.
Aside from chewing food. Consider how often you used your jaw muscles in everyday life. They are always involved when you experience deep emotion or stress, such as grimacing in pain or clenching your teeth. Sometimes this can lead to spasms of the jaw muscles. Another contributing factor is malocclusion or improper meeting of the teeth when your jaws are closed.
Missing teeth, fillings that are too high and teeth that are not properly aligned are some of the dental problems that should be corrected to prevent myofascial pain dysfuntion and other symptoms associated with your temperomandibular joint.
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Orthodontic Intervention
Actually, the bands and wires used in orthodontics haven't changed all that much over the years, but orthodontic treatment methods have. We now recognize and tend to treat malocclusion problems much earlier than in the past. We find that sometimes-lengthy orthodontic treatment in the teen years can be eliminated if a malocclusion problem can be diagnosed and treated at an early age.
A common example of early orthodontic intervention is the practice of inserting a space a maintainer when a child loses a primary tooth) usually a molar) due to some traumatic injury or decay. This keeps the space open until a permanent tooth erupts. And prevents neighboring teeth from drift. Sometimes orthodontic tongue and lip exercises (myofunctional therapy) are necessary to help overcome the problems associated with weak lip muscles (short upper lip) or bad habits such as tongue thrusting.
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Overbite
So, your child has an overbite ( sometimes known as 'buck teeth'). This malformation in the normal bite structure can alter the development of many things. For example, your child will have to learn to pronounce sounds, especially those of 's', 'f's, and 'th's, in a different way. The manner of swallowing and the placement of the tongue will have to be altered because the upper and lower teeth do not meet properly. Normal chewing will also have to be changed-not only because the front teeth don't mesh, but because the back (chewing) teeth do not mesh the way they should. The longer a person has an overbite, the more damage that can result. An overbite can be treated when it is first noted. If the condition is severe enough, very early treatment (age 3 or 4) might be instituted. However, the normal age to begin treatment of an overbite is in the range of 7 to 10. Any delay in treatment might mean that it may be too late to get the best results.
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Pain in the Jaw
If you've ever experienced a pain in the jaw, you know that it can be severe, almost unbearable, every time you open and close your mouth. Pain in the jaw is sometimes caused by a condition called TMJ syndrome or temperomandibular joint dysfunction. When the temperomandibular joints are thrown out of balance, this causes pressure on bone and muscle that can result in excruciating pain. These joints are located on each side of your head, just in front of your ear openings, and are connected to your lower jaw bone.
One of the unfortunate aspects of TMJ syndrome is that it may also cause referred pain to other parts of your body. Headaches, earaches, ringing, buzzing, clicking, popping, and scraping noises in the ears are sometimes symptoms of TMJ syndrome. So are stiff or aching neck or upper back muscles, shoulder pains, and other discomfort and pain in the upper part of your body.
At first sign of pain the jaw and any other symptoms that may be related to TMJ syndrome, see Dr. Patenaude immediately for treatment.
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Popping Noises
If you sometimes hear a popping when you move your jaw joints and have noticed a dull aching in your face or head, this may be caused by myofascial pain dysfunction. This is a common affliction of women under 40 years of age. It is characterized by pain in the temporomandibular or jaw joint and may also lead to headaches, toothaches, and painful limitation of the mouth opening.
The condition should be examined promptly by Dr. Patenaude so it can be corrected before the pain becomes more intense and affects other areas of your head. In extreme cases it may cause blurring of vision and hearing loss.
Pain in the jaw joints or temporomandibular joint syndrome (TMJ) can have many causes, such as improperly aligned teeth or the habit of teeth grinding or clenching. The goal of your treatment will be to correct any dental problems that are causing TMJ, returning the jaw to its normal function and eliminating spontaneous muscle spasms in the jaw joint area.
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Pressure and Periodontal Disease
There are other causes of periodontal disease (gum disease) besides poor oral hygiene and the build-up of calculus (tartar) around the necks of teeth.
How does this happen? For one thing, crooked teeth tend to cause such pressure. A tooth that is out of line in the dental arch is frequently subjected to abnormal pressures during chewing of food or grinding of teeth. This condition is called traumatic occlusion. Over a number of years the excessive burden may result in chronic inflammation, as well as loss of bone and supporting tissue.
Improperly placed fillings, crowns, or dentures may also exert abnormal pressures. Although Dr. Patenaude makes every effort to contour the restoration so that it will conform with the contour of adjacent and opposing teeth, only by using the restoration can the patient tell whether or not this goal has been achieved.
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Preventing Facial Change
If you have one or more teeth missing in your mouth, maybe you've put off doing something about it. This is a serious mistake if your want to avoid serious dental problems as well as protect the appearance of your face.
Just think for a moment what would happen if all your teeth were missing and you had no dentures or artificial teeth to fill the gaps. The entire lower half of your face would collapse.. Your mouth would pucker and sink in. The distance from the tip of your nose to the tip of your chin would decrease. Deep facial lines would form and the skin would sag, droop, and be deeply marked by wrinkles. Jowls would develop. All of these changes would add years to your true age. It is sometimes called the "Popeye" effect.
Millions of North Americans have lost all their teeth. The chief reason for this is neglect to get dental care. If you have any missing teeth. Make an appointment with Dr. Patenaude so he can fill the gaps and protect your dental health and your appearance.
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Preventive Orthodontics
There are some orthodontic problems that can, and should, be diagnosed and treated early. The result can be great savings in time, money, and discomfort.
If the child develops a narrower upper arch, for instance, the palate can easily, quickly, and painlessly be separated and expanded, placing the upper teeth in proper relation to the lower. Likewise, if the permanent teeth look very crowded as they come in, take your child to visit your dentist and ask for a referral to a good orthodontist. Sometimes with out bands or braces but with lots of orthodontic Know-how, serial extraction, or the judicious removal of certain teeth at the right time- - a big orthodontic problem in the future can be prevented,
It requires that the parent be alert to problems. The parent should also think of Dr. Patenaude as a resource, someone to periodically check the progress of their child's dental health.
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Replacing A Lost Tooth
You've recently had a tooth extracted. There are 'human nature' reasons to postpone having it replaced. For one thing, the space may not show. You may not like the idea of having work done on two adjacent teeth to replace the one lost. You may not want the sacrifice of time and money.
However, there are BETTER reasons for having the repair done promptly. Postponing it can make a good mouth start to break down. The teeth on either side of the space drift toward it and the tooth above the space starts to come down into it. Within a few weeks, the chain of contacts that maintained the integrity of the arch has been disturbed. Three other teeth are getting out of line and the groundwork for gum inflammation and the constant annoyance of food impaction and ultimately pyorrhea has been laid down. In the end it will wind up costing you more in time, money, and dental health than the original repair ever would.
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Saving an Aching Tooth
If your child should develop a toothache, your dentist will probably do whatever he can to save it if the decay is not too widespread. This will be true whether it's a baby tooth or one of the child's permanent teeth. It's important to the child's future dental health to try to keep all of his baby teeth in place until the permanent teeth erupt to replace them. If a tooth were extracted, the surrounding teeth might crowd together, filling the space, and blocking the eruption of the permanent tooth.
Dr. Patemaude will first anesthetize the decayed tooth so the child will not feel pain. He will then clean out the decayed area. Including the affected portion of the pulp where it enters the tooth's roots. The tooth will be medicated then filled to protect it from further decay. By remaining in place the tooth will help keep your entire child's other teeth in alignment. At the same time it will be reserving a place for the permanent tooth, so it will have a better chance to arrive in its proper position, unblocked by shifting or crowded teeth.
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Stress and Dental Problems
Stress can affect you in many ways, sometimes leading to dental problems when habits such as grinding the teeth develop. Bruxism, or grinding of the teeth, is usually an unconscious activity, occurring during the night when you're sleeping. The results are often felt in the morning when you feel pain or a dull aching in your jaw joints. This is one of the symptoms of temporomandibular joint syndrome (TMJ), and the problems can intensify until the condition is treated by your dentist.
Many forms of treatment are available, including the use of relaxation drugs as well as exercises. The goal in to help return the jaw to its normal function, eliminating the muscle spasms that cause pain and discomfort. Treatment will also include attention to other dental problems caused by grinding of the teeth.
One of the most common is malocclusion or improperly aligned teeth, which can intensify the pain associated with temporomandibular joint syndrome and cause it to spread to other areas of the head and neck.
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Teeth and General Health
If your were told that crooked teeth could lead to dry skin, brittle hair, poor circulation, headaches or emotional problems, I'm sure you would laugh. Bizarre as it may seem; the cause of many of these problems that do not respond to other forms of medical relief could possibly be found in your teeth and jaws. Recent research suggests that an improper bite puts a tremendous strain on the muscles of mastication (chewing muscles), leading to improper coordination in the brain and this secondarily leads to other medical problems.
The jaw joint and its proper function (or lack of it) can greatly influence general body health. If you wake up with a headache or have popping noises in your jaws when opening your mouth then could be suffering from a temporamandibular joint problem and should visit Dr. Patenaude. It certainly doesn't do any harm to have it checked. I could be the cause of other health problems.
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The Freeway Space
When you think of 'freeway' you probably think of the high speed motorways leading in and out of big cities. But you also have a freeway space in your mouth. When your jaws are in a normal and relaxed position, there's a space between your upper and lower jaws that we call 'the freeway space'. It has nothing to do with traffic, but it has a lot to do with mouth comfort.
Whenever full or partial dentures are place in a patient's mouth, Dr. Patenaude makes sure the freeway space is not eliminated. This may cause temperomandibular joint(TMJ) problems. Your temperomandibular joints are located on each side of your head, just internal and in front of your ear openings, and are connected to the lower jawbone.
If your chewing muscles or the ligaments that control them are over stretched, too slack, inflamed, or in spasm, this can cause the severe pain in the jaw joint area, If you are felling any discomfort or pain in your jaw area when your open or close your mouth, have this condition treated by Dr. Patenaude.
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Tooth Grinding
Grinding your teeth (Bruxism) eventually can cause destruction to the supportive bone and gums around the teeth. Eventually this can lead to TMJ (Tempromandibular Joint Syndrome), headaches, jaw pain, worn teeth or other problems. Until told, many people do not even realize they grind while sleeping.
Bruxism is considered to be a stress related problem and effects upwards 30% of the adult population. It is a serious problem today. The noise developed by a sleeping grinder cannot duplicate when the grinder is awake. Although children brux (grind) as early as 3 years, they usually stop around 12. Adults often stop when stress leaves their lives. Even some people who have no teeth grind their gums, so obviously it isn't always a tooth problem.
Although the dentist is a good place to start. Much success has been realized by therapy such as splints. Don't be surprised if Dr. Patenaude recommends other help directed toward teaching you to relax.
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Treatment of TMJ syndrome
Many People suffer from problems related to the temporomandibular joint (TMJ)- the joint in front of each ear that controls the opening and closing of the jaw. The symptoms are varied and can include pain, swelling, limited movement of the jaw, muscle spasms, clicking and grinding of the joints, even headaches and stiff neck.
A dentist trained to treat these problems will take a history, conduct a thorough examination and special x-rays to rule out specific joint disease, Then Treatment will begin as indicated.
To break the spasm, muscle relaxants are often recommended. There may be a need for a bite adjustment, and possible treatment appliance may be fabricated to relax the jaw. Muscle injections directly into the joint may also be used. Such conservative treatments, along with efforts to reduce stress, should precede more aggressive forms of treatment.
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Why A Fixed Bridge?
Whenever there is a legitimate choice for replacing a missing tooth, opt for a fixed bridge. The result will be stronger and more permanent. Think of your teeth as fence posts. If you were to put lateral (shaking) forces upon those fence posts and exert that force about 3, 000 times a day every day of your life, what do you think would happen? You would make the holes in the ground larger and larger and the posts looser and looser.
You swallow about 2,000 times a day. Swallowing brings your teeth together. Chewing foods adds another thousand. This goes on every twenty-four-hour day. Gum chewing compounds the felony.
With a fixed bridge, much can be done to minimize the effect of these forces on the teeth. The top of the restored chewing surface can be narrowed from cheek to tongue. Also, it can be rounded to minimize the forces received. These forces go more into the long (or strong) axis of the teeth than laterally.
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Why Tooth Replacement?
Once you have a tooth extracted, there are all sort of false reasons to postpone having it replaced. It may be a molar toward the back which doesn't show, so who cares? You don't want to have the adjacent teeth prepared just to replace a missing one. You don't have time for the replacement work. There are better things to spend money on. None of these reasons are valid.
The number of reasons may seem to make an overwhelming argument, but the reasons on the other side of the issue are just as numerous and definitely more compelling. The simple, indisputable fact is that leaving a space where the tooth once stood will hasten the break-down of otherwise good teeth. Teeth next to and opposite the space can and will shift. The chain of contacts will break down. Food will pack into and cause inflammation and gum problems between the teeth on that side of the mouth. Radical bone changes also occur.
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Dental Spilints
By far, the most common cause for teeth to become loose and mobile is advanced periodontal disease which erodes the supporting bone. If the mobility is not too severe and the teeth are otherwise sound, they may be stabilized with a splint which binds them to healthy adjacent teeth and to each other. This distributes the chewing pressures among them. A very simple splint may connect a single tooth to a single firm tooth, or it may connect a group of mobile teeth to teeth on either side. One type of splint is created by cutting continuous channels into the involved teeth. Wire or nylon filaments are laid in these grooves. The dentist then fills the channels with a tooth-coloured material which holds the wire and binds the teeth together. These splints are inconspicuous and can be inserted easily.
Another more elaborate splinting device is the Maryland bridge. Although it is beautiful and strong, it must usually be redone if one of the splinted teeth becomes loose.
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