Posts for category: Oral Health

By Debra A. Chinonis, DDS
September 25, 2019
Category: Oral Health
Tags: tmj disorders   jaw pain  
TwoMouthandFacePainDisordersandWhatYouCanDoAboutThem

Chronic pain affects the quality of life for an estimated 50 million adults in the U.S. alone. The American Chronic Pain Association designates September as “Pain Awareness Month” to highlight the many conditions that cause chronic pain and strategies to manage them. Among these are conditions that can involve your oral or facial health. Here are two painful mouth and face disorders and what you can do about them.

Temporomandibular Joint Disorder (TMD). TMD is a common condition often seen in the dental office. The temporomandibular joints connect the lower jaw to the skull and facilitate activities like eating or speaking that require jaw movement. If they and their associated muscles become inflamed, this can trigger debilitating chronic pain. If you suffer from TMD symptoms, make sure we know about it so we can make your dental visits as comfortable as possible.

When possible, avoid irreversible and invasive treatments for TMD that may permanently change your bite, such as surgery or having teeth ground down. Instead, most healthcare professionals recommend a more conservative approach. Try the following tips to alleviate TMD pain:

  • Eat soft foods so you do not aggravate the jaw joint.
  • Avoid extreme jaw movements like suddenly opening your mouth very wide.
  • Use ice packs and moist heat to relieve discomfort.
  • Ask us about jaw exercises to stretch and relax the jaw.
  • Practice stress-reduction techniques, such as meditation, yoga, tai chi or taking short walks to clear your mind.

Burning Mouth Syndrome. The sensation that the mouth has been burned or scalded without an obvious cause is most common among women during menopause. While researchers can’t yet pinpoint clear causes for it, the list of suspects includes hormonal changes, neurological or rare autoimmune disorders or medication-induced dry mouth.

The first step to treatment is an oral exam along with a complete medical history to identify any possible contributing factors. Depending on the results, we can offer recommendations to manage your symptoms. The following tips often help:

  • Keep your mouth moist. We can recommend an artificial saliva product or medication to increase saliva flow if needed.
  • Change your toothpaste if it contains irritating ingredients.
  • Identify and avoid foods and beverages that seem to precede an episode. These may include spicy foods, coffee and alcoholic beverages.
  • Quit smoking, as this is often linked to burning mouth episodes.

The pain and discomfort caused by these and other oral conditions can put a dent in your life. A visit to your dentist, though, could be the first step to finding relief.

If you would like more information about oral conditions that produce chronic pain, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Seeking Relief From TMD” and “Burning Mouth Syndrome.”

By Debra A. Chinonis, DDS
September 15, 2019
Category: Oral Health
Tags: oral hygiene   oral health  
WatchOutforTheseDentalHealthIssuesasYouAge

One thing’s for sure: We’re all getting older. Here’s another sure thing: Aging doesn’t necessarily look the same on everyone. That one spry octogenarian lapping younger folks on the track is all the proof you need. That’s why September has been designated Healthy Aging® Month: to remind everyone that aging well is an investment you make throughout your life—and that includes taking care of your dental health.

Just like the rest of the body, your teeth and gums are susceptible to the effects of aging. For example, after 50,000-plus meals (about 45 years’ worth), you can expect some teeth wear. A tooth-grinding habit, though, could accelerate that wear. If you think you’re grinding your teeth (especially at night), we can fit you with mouthguard worn while you sleep that reduces the force on your teeth. Managing your stress could also help reduce this involuntary habit.

Aging also increases your risk for the two most common dental diseases, tooth decay and periodontal (gum) disease. Although different in the way they infect oral tissues, both can ultimately cause tooth and bone loss. Prevention is your best strategy—through daily oral hygiene and visiting the dentist regularly to keep the dental plaque that fuels both diseases from building up on your teeth.

You should also see your dentist at the first sign of a toothache, unusual spots on the teeth and swollen or bleeding gums. These are all indicative of infection—and the sooner you’re diagnosed and treated, the more quickly you can return to optimum oral health.

Aging can bring other health conditions, and some of the medications to manage them could reduce your mouth’s saliva flow. Because saliva fights dental infections and helps restore enamel after acid attacks, “dry mouth” can increase your disease risk. If you’re noticing this, speak with your doctor about your medications, ask us about saliva boosters, and drink more water.

Finally, have any existing restorations checked regularly, especially dentures, which can lose their fit. Loose dentures may also be a sign of continuing bone loss in the jaw, a consequence of losing teeth. If so, consider dental implants: The design of this premier tooth restoration can help curb bone loss by encouraging new growth.

There’s a lot to keep up with health-wise if you want your senior years to be full of vim and vigor. Be sure your teeth and gums are part of that upkeep.

If you would like more information about protecting your dental health as you age, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Understanding Aging Makes Beauty Timeless” and “Dry Mouth: Causes and Treatment for This Common Problem.”

By Debra A. Chinonis, DDS
September 05, 2019
Category: Oral Health
Tags: gum disease  
PeriodontalMaintenanceCanHelpYouAvoidAnotherEpisodeofGumDisease

To keep a healthy smile, brushing and flossing your teeth every day should be at the top of your to-do list, along with regular dental visits. Dental visits are usually scheduled every six months when your dental professional will remove any built-up plaque and tartar (hardened plaque deposits) missed during everyday hygiene.

If you've experienced periodontal (gum) disease, however, these dental visits may become even more important toward preventing a re-infection. For one thing, your dentist may want to see you more frequently.

Gum disease is caused by bacteria living in dental plaque, which first infect the superficial layers of gum tissue. Even though the body initiates an inflammatory response to fight it, the infection continues to grow as long as there is plaque present to fuel it. The problem isn't just plaque on the visible tooth surface—hidden plaque beneath the gum line can create deep pockets of infection that can be difficult to treat.

To stop the infection, dentists must manually remove plaque through procedures known as scaling and root planing. Any and all plaque and tartar deposits must be removed, even those deep around the roots, to arrest the infection. This often requires several treatment sessions and sometimes gum surgery to access areas below the gum line.

These types of treatments, especially in the disease's early stages, have a good chance of restoring health to your gums. But because of the high possibility of reinfection, your dentist will need to step up your regular dental maintenance from now on. This could mean visits as frequent as every few weeks, depending on your particular case of gum disease and your dentist's recommendation.

Your dental visits after gum disease may also become more involved than before. Your dentist will now monitor you closely for any signs of reinfection and at the first sign initiate a new round of treatment. You may also need surgical procedures to make some areas around your teeth more accessible for future cleaning and maintenance.

Periodontal maintenance after gum disease helps ensure another infection doesn't rise up to undermine your progress. To paraphrase a well-known quote, eternal vigilance is the price of continuing good dental health.

If you would like more information on professional dental health maintenance, please contact us or schedule an appointment for a consultation.

DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”

By Debra A. Chinonis, DDS
August 16, 2019
Category: Oral Health
Tags: facial pain  
YoucanGetRelieffromFacialPain

Each year doctors treat about 150,000 new cases of severe facial pain. If you're one of those people, you don't have to suffer—there are ways to gain relief from these painful episodes.

Those recurring episodes are known as trigeminal neuralgia (TN). As the name implies, the source of the pain are the trigeminal nerves, which originate in the brain stem and extend on either side of the face. Each is divided into three branches (hence the "tri" in trigeminal) that serve the upper, middle and lower parts of the face and jaw.

TN can involve one or more of these branches, resulting in mild to severe pain that can last for several seconds. Jaw movements like chewing or speaking can trigger an episode, as well as a light touch to the face.

There are various proposed causes for TN, including links with inflammatory disorders like multiple sclerosis, which damages the insulating sheathing around nerve cells. The most common cause, though, appears to be a blood vessel pressing against the nerve. The compression causes hypersensitivity in that area of the nerve so that it transmits pain at the slightest sensation.

Other conditions like jaw joint pain disorders (TMD) or a dental abscess can cause similar pain symptoms, so it's important to get an accurate diagnosis. If your doctor does identify your condition as TN, you may then need a comprehensive approach to treatment involving a team of care providers, including your dentist.

For the most part, TN can be managed, beginning with the most conservative approach to gain relief, often with medications to block the nerve's pain signals to the brain or decrease abnormal nerve firings. If that proves insufficient, though, more intensive treatments are available.

One possible treatment for an impinging blood vessel is a microsurgical procedure to expose the affected nerve and relocate the vessel. While this can be effective, the surgery does carry some risk of facial numbness or decreased hearing. If the risks are too high for conventional surgery, an alternative procedure uses a precise beam of high-dose radiation to relieve the pressure from the vessel.

The most important thing to know about TN, though, is that it is possible to control it and relieve future pain episodes. If you're experiencing these symptoms, see your dentist or doctor for an exam and accurate diagnosis.

If you would like more information on trigeminal neuralgia, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Trigeminal Neuralgia: A Nerve Disorder that Causes Facial Pain.”



Debra A. Chinonis, DDS
Lindsay M. Lindemann, DDS


G-6111 S. Saginaw St.
Grand Blanc, MI 48439
(810) 695-5226

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