TMD Pain and What You Can Do

Like many of our other body parts, we don’t realize how important the temporomandibular joint (TMJ) is until it stops working properly.  This unique joint allows your jaw to open and close and to move back and forth and side to side.  When problems with the TMJ arise, called Temporomandibular  joint disorder - or TMD[i], symptoms can range from being a simple nuisance to incapacitating, affecting your ability to speak, eat, chew and sleep.  Here is some information that may help if you are experiencing TMD:

Symptoms of TMD

Pain, particularly in the jaw joint, is the most common symptom of TMD.  People with TMD may also experience one or more of the following symptoms:

• Unusual sounds — Clicking, grinding or popping sounds when you open your mouth are common in people with TMD. The sounds may or may not be accompanied by pain.
• Locking or limited movement —The jaw joint sometimes may lock in an open or closed position. You may have difficulty opening your mouth either because the joint is locked or because of pain.
• "Ear" pain — You may think you have an ear infection, but ear pain may be related to jaw joint inflammation or muscle tenderness. Pain from TMD is usually felt in front of or below the ear.
• Headaches — People with TMD often report headaches, especially headaches when they first wake up.
• Morning stiffness or soreness — If your jaw muscles are stiff and sore when you wake up, it may by a sign that you are clenching your jaw or grinding your teeth in your sleep.
• Difficulty chewing — You may have difficulty chewing as a result of a change in your bite, or the way your upper and lower teeth fit together. 

Who Gets TMD and Why?

If you have TMD you are not alone - this disorder occurs in 10-12% of the population, and twice as often in women as men.  The cause is not always clear.  One factor may be physical stress on your TMJ from teeth grinding or clenching.  A recent injury to the jaw joint, or one from many years past, can lead to TMD symptoms.   Other conditions that affect joints in the body, such as osteoarthritis or rheumatoid arthritis, can also cause TMD pain.   

What Can You Do if you Have TMD?

Most people with TMD have relatively mild or periodic symptoms which quickly improve with simple home therapies, such as avoiding hard, crunchy and chewy foods, applying heat or ice packs to the jaw, and avoiding extreme jaw movements.  You may want to invest in a headset for your phone or work on your posture, especially if you find yourself hunching over your computer.  We also suggest that you consider the level of stress in your life - and do what is needed to reduce it.  If these home remedies are not enough, some of the effective, conservative treatments we use include medication to help with the pain and reduce inflammation, mild muscle relaxants to alleviate jaw clenching and grinding, and fitting our patients with oral appliances. 

If these symptoms sound familiar, contact Raleigh dentist Jeff M. Morrison & Associates DDS at (919) 755 3450 for a consultation.  

 

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[i] TMD is an umbrella term covering pain and dysfunction of the muscles that move the jaw and the temporomandibular joints (TMJ).  Many people refer to the jaw pain or discomfort they are experiencing as "TMJ" which is a misnomer.  TMJ simply refers to the joint.  Any disorders involving this joint are considered TMD.  

Millenials Face Unexpected Dental Problems

Do you think it's just little children chomping on sticky candy or older people struggling with tooth loss that are filling up dental chairs?

Think again. More and more young adults, age 18-34 years, are being seen for dental problems. If some millennials aren’t smiling, there’s good reason. A recent study by the American Dental Association (ADA) found they’re in a world of hurt – from tooth pain, trouble biting and chewing, and anxiety about the poor condition of their teeth.

Decaying teeth and gum problems make one in three young adults aged 18 to 34 (33%) reluctant to smile, the ADA found. About one in five have cut back on socializing as a result of dental problems. And one in three say the appearance of their teeth and mouth undermines their ability to interview for a job.  This study also found:

• More than 30% of young adults have untreated tooth decay (the highest of any age group)
• 35% have trouble biting and chewing
• They are three times more likely than children to lack dental care due to financial reasons, with only 30% of millennials visiting the dentist each year.
• Tooth pain was the most common dental complaint.

If tooth pain and anxiety surrounding poor dental conditions aren’t bad enough, attaining affordable dental insurance is viewed as difficult for much of this generation, who are often struggling to find jobs and pay off student loans. A large segment of millennials work part-time or as freelancers, which means they do not have access to employer-sponsored dental plans.

A visit to the dentist is not always a top priority, but here's why you shouldn't let this preventive measure slide:

• Most dental problems, such as decay or periodontal disease, will just get worse if left untreated.
• When a dental emergency occurs, being established with a dentist really helps you save money and often results in better care. 
• Dental procedures, even common ones, take time away from work, and sometimes require multiple visits, while a routine cleaning and exam takes about 30 minutes each six months.
• What you spend on a crown for a decayed tooth, or treatment for periodontal disease, probably could have paid for several years of preventive care (and you would have avoided the problem altogether).
• Research is clear about the connection between oral health and your overall health. Dental problems can lead to increased risk of cardiovascular disease and stroke, dementia, Alzheimer's diabetic complications and respiratory problems. Oral HPV is seen more and more in young adults and is a primary risk factor of cancer. It just makes sense to maintain your oral health.

At Jeff M. Morrison & Associates, DDS, we want you to have a confident, healthy smile. We offer flexible - and often same day - scheduling for preventive and urgent care and a convenient downtown location.  Do you have an urgent, or emergency dental concern?  We see our established patients on weekends and holidays.

If you have insurance, we are “in network” provider with Blue Cross Blue Shield North Carolina, CIGNA and Delta Dental Premier, and will conveniently file all other insurances for you. For our uninsured patients, we offer the St. Mary’s Street Dental Savings Plan, an in-office discounted plan to make regular preventive care and treatment more affordable.  We also participate in Care Credit dental financing, which offers a low monthly payment plan for dental treatments.

Don't neglect your dental health.  Call us today at 919 755 3450 to schedule an appointment.

A Beautiful Smile - in Two Weeks

Everyone wants an attractive smile. However, the reality is that chipped or crooked teeth, irregular tooth size, and discoloration of enamel are common. Do these imperfections cause you to hide your smile, or feel uncomfortable for any reason? If so, veneers are a great solution to consider.  One of the most asked-about treatments at our Raleigh dental office, veneers offer a beautiful, natural smile in just a couple office visits. Advances in dental technology mean that today's veneers are strong, attractive, and more affordable than you think.  


Veneers are customized restorations that mimic the natural look of teeth - minus the imperfections.  They are custom-made for each tooth and adhere to the front surface of existing teeth to improve their appearance.  We recommend veneers for teeth that are:

• Worn-down

• Fractured

• Discolored

• Chipped or broken

• Misaligned, uneven, or irregularly shaped

At our Raleigh dental practice, we offer different types of porcelain veneers to provide individualized treatment options for your smile. Depending on your specific needs, one veneer option might be better than the other.   

Interested in trying veneers?  Here's what you can expect: 

• Consultation and Exam: We’ll assess your overall tooth health and aesthetics to determine if you’re a good candidate for porcelain dental veneers.  If you are ready to move forward, all the teeth being fitted for porcelain veneers will be evaluated to ensure they’re good candidates for dental veneer fitting.
• Preparation: We’ll prepare your surfaces for a seamless fitting that will permanently bond the dental veneer to the front of your tooth.  
• Fitting: Your veneers will be individually applied by Dr. Morrison and double checked to make sure they’re fully bonded before letting the world see your new smile!
• After care:  Our staff will discuss with you way to maintain your veneers.

There are a lot of benefits to veneers - in additional to being aesthetically pleasing.   They are strong - often lasting 5-10 years.  These restorations do not require as much shaping of the natural tooth as crowns do allowing us to preserve as much of the tooth as possible.  They may also offer a more affordable option than other cosmetic procedures, such as crowns or braces.  

We invite you to take a moment and look through our Smile Gallery at some of the stunning results our team has achieved with veneers.   Our staff is happy to discuss payment options for your veneers, including Care Credit.   If you participate in the St. Marys Street Dental Savings Plan, our in-office financial plan for uninsured patients, you'll receive 15% off the cost of your veneers.   

To learn more or schedule a consultation,  contact our us today!

Add caption

This patient chose lower veneers rather than braces - a much faster, easier and less expensive way to have straighter lower teeth.

Oral Cancer Awareness Month

November is Mouth Cancer Action Month - giving me a good opportunity to again call attention to this growing problem. 

The entire team at Jeff M. Morrison & Associates DDS - from the front desk staff to the Dental Hygienists - as well as the American Dental Association, recommends that you schedule regular cleanings and exams twice a year.  During the "exam", in addition to looking at your teeth,  I  check everything from your lips all the way to the back of your throat.  That's a lot of surface area.  I'm looking for any changes - such as redness, lumps, lesions, pain, or changes in how your teeth fit together - anything that may indicate a problem.  Mouth cancer can often be spotted in its early stages and during my exam I can see parts of your mouth that you may not easily see yourself.  If I find something unusual - and I have a number of times - I'll refer you to a specialist for further follow-up. 

Most cases of oral cancer are linked to tobacco and alcohol use, and if tobacco and alcohol are consumed together the risk is even greater.  Recent reports have linked oral cancer to a virus (HPV) that affects the skin that lines the moist areas of the body.  HPV, the primary cause of cervical cancer, can be spread through oral sex, and research now suggests that it could soon rival smoking and drinking as one of the main causes of oral cancer.  Once a disease of old men, oral cancer is now seen more and more in younger men and women - many of whom have never used tobacco.

The death rate associated with oral cancer is particularly high not because it's hard to discover or diagnose, but due to the cancer being routinely discovered late in its development.  Another obstacle to early discovery (and better outcomes) is that HPV is contributing more to the incidence rate of oral cancers, particularly in the back part of the mouth (such as the tonsils or the base of the tongue) which are difficult to see and many times does not produce visible lesions or discolorations that have been the early warning signs of the disease.

If you notice any changes between your regular dental checkups don't hesitate to give us a call.  What "changes" should you be looking for?  According to The American Dental Association, the symptoms of oral cancer can include:

• ·        A sore or irritation that doesn't go away
• ·        Red or white patches 
• ·        Pain, tenderness or numbness in mouth or lips
• ·        A lump, thickening, rough spot, crust or small eroded area
• ·        Difficulty chewing, swallowing, speaking or moving your tongue or jaw
• ·        A change in the way your teeth fit together when you close your mouth

Keeping our patients healthy is our priority.  If you suspect a problem give us a call at 919 755 3450.  We will fit you in right away for an exam.  If you have  a friend or family member you are concerned about - due to their risk for oral cancer or symptoms they may be having - I encourage you to share this information with them.

For more information about oral cancer please visit: http://www.oralcancerfoundation.org/facts/

Why Do Dentists Want You To Come In Every Six Months?

           I hear this all the time when I tell a patient who just had a great check-up that I'll see them in six month - "Really? Six months. But my teeth are healthy." I understand - everyone is busy. If you don't have dental insurance, a routine cleaning and exam is an added expense. Instead of a waste of time and money - I suggest you to look at that exam as 30 minutes that can have a real impact on your teeth, your overall health, and your wallet.

The American Dental Association recommends semi-yearly exam and cleanings. That being said, everyone is different. Some adults with no risk factors and a great oral hygiene routine can get away with pushing it out to every nine months, while others really should stick to the twice yearly recommendation.  People with periodontal disease definitely need to get in every 3 or 4 months.  Children, because their teeth and jaws are still developing and they're still learning good oral hygiene habits, really need to come in every six months. 

Your oral health can change pretty quickly. A lesion can appear. A filling can fall out or a tooth fracture.  Decay or periodontal disease can start. You may not even be aware that anything is wrong. The time you spend here can mean much less time in our office down the road, much less expense, and if you have oral cancer - much earlier intervention and care.

In general, our "hygiene" appointments - which include a cleaning and exam - are about 30 minutes[1]. We cover a lot in that time.  I'll evaluate the health of your and gums, checking for redness, inflammation or signs of gingivitis or periodontal disease. I'll do an oral cancer screening, perform a head and neck examination, and check the health of your teeth, jaw and bite. I'll look for evidence of tooth decay, damaged fillings, contact between your teeth, and any broke or loose teeth. Your Dental Hygienist will also do a thorough cleaning of your mouth. This will include removing any plaque and tartar, polishing and flossing your teeth. She'll point out any areas that you may need to focus on, and talk with you about maintaining good oral hygiene at home between visits. Once your examination and cleaning are complete, I'll tell you about the health of your teeth and gums and we'll discuss any recommendations to improve your dental health.

Believe me when I say it's worth it. In my 30+ years as a dentist, I've identified areas that turned out to be cancerous lesions in a number of patients, and have referred many patients follow-up care because of suspected diabetes, reflux, eating disorders and other problems. I've also helped countless patients sleep better with our custom-made sleep apnea devices (and there are a lot of health benefits to getting a good night of sleep), and have resolved chronic headaches in people with our oral appliances.

People think 'no pain, no problem', or have a false sense of security because cosmetically their teeth look good. The truth is, many dental issues can advance without pain until they're very serious and requires more invasive and expensive treatment. If you have insurance - we accept just about any plan and are in network with Blue Cross Blue Shield, Cigna and Delta Dental Premier - the cost of a 6 month cleaning and exam will probably be covered. Take advantage of it - even if you had a great visit in the past. If you don't have insurance - consider investing in the St. Marys Street Dental Health Plan - our in-office dental savings plan, which provides two cleanings and dental exams (including x-rays, periodontal and oral cancer screenings) per year at a significant cost savings, along with discounted care.

For more information on our financial options, or to schedule an appointment, please call us at 919 755 3450. You can also schedule online.  See you soon.

[1] If you're a new patient the initial cleaning and exam takes about an hour

Eight Ways to Help Your Anxious Child At the Dentist

As a dentist, and the father of a child who has dental anxiety, I know how helpless, embarrassed, and even frustrated parents feel when their child is experiencing a high level of anxiety at a dental appointment.  With the right amount of empathy, support, skills and coaching, nearly every child can overcome this fear.  

Here are my suggestions - as a dentist and a dad -  on how you can help your child deal with anxiety at the dental office:

Don't Share YOUR Dental Anxiety  

If a parent struggles with anxiety at the dentist - and I know a lot of adults do - there's a good chance their child will, too.  Why?  Because when you voice your fear, avoid going to the dentist, make jokes about how much you dislike dental appointments - your child picks up on it.  Addressing your own dental anxiety may help limit how much your child models these same behaviors.

The Benefits of the Dental Visit  

It's easy for a  frustrated parent to portray the dentist and a dental visit as a consequence or form of punishment for their child's poor oral hygiene.  Don't use threats like: "If you don't brush your teeth the dentist is going to use the drill to fix your cavities" - or something equally frightening.  Instead, emphasize how happy he is going to be when your child has a great check up, or how proud you'll be when the Dental Hygienist tells you that he has done a great job brushing.  Let them know the dentist is there to help keep their teeth healthy just as their pediatrician helps keep their body healthy. 

Visit Early  

Bring your child in at age three for their first visit.  We'll have a friendly chat, let them touch the instruments, see the inside of their mouth with the intraoral camera, listen to the noise of the suction machine, and sit in the chair.   We'll even take a quick peek in their mouth and let them get a toy out of the treasure box.   If your child shows signs of anxiety early on we can start to work on it.  Unaddressed dental anxiety usually just get worse.

Acceptance and Empathy 

Accept and empathize with - rather than invalidate - your child's anxiety.   Try to get at the specifics of their fear - are they worried about pain?  Fear of the unknown?   Getting a shot?  Loud or strange noises?  Taking a moment to understand and accept their feelings will allow you to support your child more effectively.  Share their fears with our staff so that we can assure their comfort when they're at the office. 

Don't Overreact 

It is hard to see your child upset, but as parents, we have to tolerate their distress, remain positive and calm, and move forward with the dental appointment because it's in the child's best interest.  Calling off the appointment or procedure,  providing excessive reassurance to a crying child, or appearing to be overly concerned about their anxiety may actually strengthen and reinforce it.  

We've found that often a child's anxiety will lessen when mom or dad remains in the waiting room during the appointment.  This lets the child know that their parent is confident  they're going to be fine, which alleviates some of the fear and allows the child to calm down. 

Help them Manage Their Anxiety  

If the sound of the suction machine is terrifying we can take a few minutes to let them see it and experiment with putting it in their mouth.  Prepare them for the appointment -  let them know the week before, the day before and the day of the appoint that they will be coming in to see the dentist.  Arrive early so they can sit calmly in the waiting area for a few minutes.  Help them come up with some calming strategies.  Do they have an item that keeps them calm?  We don't mind if their favorite toy or blanket is in the chair with them.   You can also download a kids or some special music for them to listen to on earphones while we work.  Finally, even very young children can practice simple breathing or relaxation techniques.  

Reward Brave Behavior 

Instead of paying attention to anxious behavior, or expressing disappointment about how they acted during the visit, praise their use of anxiety management skills - even if it was minimal.   Were they able to go into the exam room on their own?  Did they stay in the dental chair?  Did they get through the exam without crying?   Or maybe they cried for just for a minute?  These are all great steps.  

Prevention is Key 

The best way to help your anxious child?  Make sure they take great care of their teeth at home, and bring them in for regular exams and cleanings.  We can identify areas where they may need to improve their brushing, or intervene at a very early stage if there  is a problem.   With good oral hygiene, they may be able to avoid potentially anxiety-inducing procedures and simply have pleasant, comfortable visits for cleanings and exams.

We'll work together with you to make your child's dental experience as comfortable and pleasant as possible.  If you have questions or want to schedule an appointment, please contact us.   Do you have other calming strategies you've used with your anxious child a medical or dental visit?  Feel free to share in the space below.  

As always - we always welcome new patients (even anxious ones).  

Headaches? Call Your Dentist!

Are you suffering from unexplained or recurrent headaches? Have you been unable to figure out the culprit? It may sound strange, but headaches are often linked to your oral health.  Talking to Dr. Morrison, of Jeff M.Morrison & Associates, DDS, should be a starting point when dealing with chronic headaches.

"Many people suffer through headaches for years without getting to the root cause of their problem" notes Dr. Jeff M. Morrison, DDS.  "Letting your dentist know about your pain can be a great first step because chronic or recurrent headaches are frequently caused by dental issues."  In fact, the American Academy of Craniofacial Pain estimates that 80% of headaches are caused by muscle tension, which often originates in the jaws.  

What Do Tension Headaches Feel Like?

A tension headache may be on one side of your head, or it can pervade your entire skull. Typically, tension headaches feel like a dull, throbbing ache inside your head. Some patients report that they feel as though a metal band has been wrapped around their head and is causing significant pressure. Several common symptoms suggest that tension headaches may be caused by dental issues:

1.      Feeling as though your head or scalp is painful to the merest touch

2.      Experiencing a dull or throbbing pain behind the eyes

3.      Clicking or popping sounds in your jaw joints

4.      Grinding teeth or clenching the jaws, particularly in times of stress, anxiety or during the night

5.      Feeling as though your jaw muscles are sore when you wake up from sleep

Dental Origins of Headaches

Several dozen muscles control your facial expressions, jaw movements, and motions such as swallowing. When these muscles are contracted for long periods of time, tension builds up within the muscle and can lead to headaches. This may happen if you clench or grind your teeth at night, your bite is misaligned, or you have muscle imbalances in the jaw or neck.

Dental Treatments for Tension Headaches

Want to get to the bottom of your headaches?  Schedule anappointment with Dr. Morrison.  He will talk with you, review of your medical and dental history, and possibly take some x-rays.  If dental issues are contributing to you headaches, your care may include the following treatments:

1.      Bite adjustment. Every time you swallow the teeth come together to push the jaw against the skull.   If you have a poorly aligned bite, this can cause your muscles to work even harder. Those with TMJ (temporomandibular joint) disordersuffer from jaw joint and muscle problems that can cause pain and swelling and even headaches. In many cases, correcting your bite through orthodontics releases the stress on your jaw and muscles, and reduces the frequency of headaches.

2.      Nightguard.  A nightguard, which resembles a sports mouthguard, may also be helpful if you frequently grind your teeth or clench your jaws during sleep. Nightguards distribute the tension from your clenched jaws and reduce the possibility of dental damage.

3.      Physical therapy and relaxation. Correcting the posture of your shoulders, neck, and head may alleviate muscle tension associated with headaches. 

Have questions or want to talk with Dr. Morrison about your headaches?  Contact our office online or at (919) 755 3450 to schedule an appointment.