Posts for: June, 2018
If you’ve suffered from problems with your jaw joints, known collectively as temporomandibular disorders (TMDs), then you know how uncomfortable and painful they can be. You may also have heard about the use of Botox injections to ease TMD discomfort.
Before you seek out Botox treatment for TMD, though, you should consider the current research on the matter. Far from a “miracle” treatment, the dental profession is still undecided on the effects of Botox to relieve TMD pain symptoms — and there are other risks to weigh as well.
Botox is an injectable drug with a poisonous substance called botulinum toxin type A derived from clostridium botulinum, a bacterium that causes muscle paralysis. The Food and Drug Administration (FDA) has approved small dose use for some medical and cosmetic procedures, like wrinkle augmentation. The idea behind its use for TMD is to relax the muscles connected to the joint by paralyzing them and thus relieve pain.
The FDA hasn’t yet approved Botox for TMD treatment, although there’s been some use for this purpose. There remain concerns about its effectiveness and possible complications. In the first place, Botox only relieves symptoms — it doesn’t address the underlying cause of the discomfort. Even in this regard, a number of research studies seem to indicate Botox has no appreciable effect on pain relief.
As to side effects or other complications, Botox injections have been known to cause pain in some cases rather than relieve it, as with some patients developing chronic headaches after treatment. A few may build up resistance to the toxin, so that increasingly higher dosages are needed to achieve the same effect from lower dosages. And, yes, Botox is a temporary measure that must be repeated to continue its effect, which could lead to permanent paralyzing effects on the facial muscles and cause muscle atrophy (wasting away) and even deformity.
It may be more prudent to stick with conventional approaches that have well-documented benefits: a diet of easier to chew foods; cold and heat applications; physical therapy and exercises; pain-relief medications and muscle relaxers; and appliances to help control grinding habits. Although these can take time to produce significant relief, the relief may be longer lasting without undesirable side effects.
Even with picture perfect teeth, you may still be unhappy with your appearance. The problem: too much of your upper gums show when you smile.
There’s no precise standard for a “gummy smile”—it’s often a matter of perception. As a rule of thumb, though, we consider a smile “gummy” if four or more millimeters of upper gum tissue show while smiling. In any event if you perceive you have a gummy smile, it can greatly affect your self-confidence and overall well-being.
The good news is we can often correct or at least minimize a gummy smile. The first step, though, is to find out why the gums are so prominent.
There are a few possible causes: the most obvious, of course, is that there’s more than normal gum tissue present. But the cause could be the front teeth didn’t fully erupt in childhood and so the gums appear more prominent. Other causes include the upper lip moving too far upward when smiling (hypermobile) or an elongated upper jaw that’s out of proportion with the face.
Finding the exact cause or combination of causes will determine what approach we take to minimize your gummy smile. If too much gum tissue or not enough of the teeth show, we can use a surgical procedure called crown lengthening to expose more of the crown (the visible part of a tooth), as well as remove excess gum tissues and reshape them and the underlying bone for a more proportional appearance.
A hypermobile upper lip can be treated with Botox, a cosmetic injection that temporarily paralyzes the lip muscles and restricts their movement. But for a permanent solution, we could consider a surgical procedure to limit upper lip movement.
Surgery may also be necessary for an abnormal jaw structure to reposition it in relation to the skull. If, on the other hand it’s the teeth’s position and not the jaw causing gum prominence, we may be able to correct it with orthodontics.
As you can see, there are several ways varying in complexity to correct a gummy smile. To know what will work best for you, you’ll need to undergo an orofacial examination to determine the underlying cause. It’s quite possible there’s a way to improve your smile and regain your self-confidence.
If you would like more information on improving a gummy smile, 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 “Gummy Smiles.”
Each June, as we celebrate Father’s Day, we get a chance to pay tribute to the important men in our lives. One of the best ways to do that is by encouraging them to stay healthy—and June is a great time for that, since it’s also Men’s Health Month. So let’s take this opportunity to focus on one important aspect of maintaining good health: preventive dental care.
Preventive care includes all the measures we can take to stop disease before it gets started. One facet of prevention is encouraging people to make healthier lifestyle choices: for example, quitting tobacco, getting more exercise, and improving their diets. You can start by eliminating foods that have added sugar (like many soft drinks and processed foods) or acids (like some fruit juices and sodas, both regular and diet)—and by limiting snacks to around mealtimes, so your saliva has time to neutralize the acids in your mouth that can cause cavities.
There’s increasing evidence that having good oral health promotes better overall health—and coming in for routine checkups is essential. While some men avoid the dental office until they have a problem, that isn’t a wise decision. In fact, a routine dental visit is not only one of the greatest values in preventive health care—it’s also one of the best ways to maintain good oral health. Here’s why:
Tooth decay is among the most common chronic diseases—yet it’s almost 100% preventable! A routine office visit includes an oral exam and a professional cleaning that can help stop tooth decay before it gets started. But when decay is discovered, it’s best to treat it right away, before treatment gets more complex—and costly!
The major cause of tooth loss in adults is gum disease. If your gums bleed or show other signs of disease, we can help you get it under control with instruction for more effective oral hygiene, and/or appropriate treatment.
Routine exams include not only a check for tooth decay and gum disease—they also include screening for oral cancer. This isn’t just for older folks: Recently, the fastest growing group of oral cancer patients has been young non-smokers. The sooner it’s treated, the better the chances of a successful cure.
Good at-home oral hygiene is necessary to keep your teeth in top-notch condition. If you have questions about proper brushing, flossing, or everyday care of your mouth—this is a great time to ask. Our staff is happy to show and tell you the best practices for maintaining excellent oral health.
If you would like more information about oral health and hygiene, please call our office to schedule a consultation.