Q. I’ve had a cracking sound in my jaw for the last month. What causes this and will it go away on it’s own?
A. Temporomandibular joints (TMJ) are involved in many functions such as eating, talking and swallowing. Like any other joint in the body, one or both can be injured, sometimes just by biting awkwardly or by sleeping with an unnatural head position. Obvious trauma such as falls, auto accidents, etc., can also severely injure these joints. Arthritis, loss of bite, poor dentures
and loss of teeth are still other factors to consider as possible causes of TMJ dysfunction. Non-
trauma related, sudden onset TMJ pain, whether cracking upon opening/closing or not, usually
resolves by itself if the joint is rested for a period of time (no bagels, etc.). If the pain, cracking
sound continues, a dentist should be seen. Often a guard/splint will be made to help aid in the
healing process. Sometimes, an oral surgeon will be consulted for further evaluation should
conservative measures fail.
Q.I am 90 years old. I wonder if it is possible to have a molar taken out? I have been using Oragel for quite some time now to relieve the pain.
A. A dental visit is in order. An x-ray and an oral examination will be done to determine the status of the molar in question. Once the problem is determined, various choices will be presented to you. An extraction is usually the last choice unless the tooth is grossly infected/loose, severely fractured or causing you intense discomfort. The treating dentist will make the appropriate diagnosis. Your age is really not a factor. If an extraction or root canal is necessary, there are many ways to mitigate any medications you may be taking or physical diseases you may have. Today’s dentistry is not limited by age and extractions are no longer the only options available for sore teeth.
Q.What causes receding gums?
A.Receding gums have a host of causes, including gum disease, brushing too hard, genetics, crowns/bridgework, and malocclusions. Sometimes it is difficult to pinpoint the exact cause; a variety of forces could be working together. Bleeding, receding gums should be checked by the dentist to rule out gum disease. A gradual lifetime slow recession may be normal for some people, however. Sometimes pain in the underlying teeth may occur due to the recession, but not always. This root sensitivity should be checked by the dentist. Treatments for exposed root sensitivity includes: desensitizing agents, desensitizing toothpastes, and the placement of white fillings. Ill-fitting crowns/bridgework should be replaced. An occlusal problem (grinding, clenching) can also cause premature gum recession. Your dentist can address this. Your hygienist can give you valuable tips on proper brushing techniques and also answer gum questions.
Q.Is there an established amount of time caps adhesive lasts? Many of my caps are being re-glued. They are 12 years old.
A.Today’s dental cements are stronger and more water-proof than those made years ago and are getting better all the time. However, even with these improvements, crowns can still come off unexpectedly. A variety of factors may be involved: The type of cement used, diet, the shape and amount of underlying tooth, oral hygiene, marginal fit of the crown and biting habits. Temporary cement is weaker than permanent cement. Permanent cements made 12 years ago are weaker than today’s cements. A diet of sticky, tugging foods places great strain on crowns, often dislodging them. Ill-prepared or short teeth, tend to have crowns come off faster regardless of the cement used. Grinding your teeth, malocclusions and other severe bite problems can also cause crowns to fail prematurely. If the crown does not fit well, it will come off sooner than later, even if a permanent modern cement is used. There is no magic number as to how long a crown should stay on. I have seen crowns that have been on for 50 plus years and other are lost within a few short years.
Q.What would you recommend for treating gingivitis?
A.Gingivitis is an inflammatory condition of the gums caused by bacteria. It is usually a result of poor oral hygiene. Bleeding of the gums can occur and is often the first sign that you have a gum problem. However, it can escalate to periodontitis, which is gingivitis compounded by a loss of bone around the teeth, bleeding gums, loosening of the teeth, pain, and ultimate tooth loss. Why some people stay at the gingivitis level and some progress to periodontitis is unclear. The patient’s immune system, oral bacteria, saliva quality, genetics may all play a part. Smoking, diabetes, and other medical conditions can exacerbate periodontitis. Gingivitis is treatable by twice yearly dental hygiene visits, daily flossing and brushing. Certain toothpastes containing Triclosan (a soap) may be beneficial. Also, there are some prescription mouth rinses that can be used as well. A thorough dental check-up is suggested to determine if you indeed have gingivitis or something more serious.
Q.I recently cracked a back molar, not sure if it will be able to be repaired. Should I consider an implant?
A.Often times a tooth fracture, cavity, or lost filling is over-magnified by the tongue and may not be as serious as first felt. Obviously, any pain or swelling should be dealty with immediately. A dentist will ascertain whether the fracture is repairable with conservative means, whether a root canal is needed, or an extraction is in order. If the tooth needs extraction, an implant/crown or bridge should be considered. Implants have great longevity and are now part of normal and customary dental treatment. There are usually two steps involved: One surgical and one restorative, usually performed by two separate dentists with two separate fees. It should also be noted that dental implants are not covered by most dental insurances.
This general Information is not intended to provide individual advice. Please make an appointment with a physician to discuss you particular situation and needs.
