TMJ is the quick way of referring to your Temporomandibular Joint. Pardon the pun, but that’s quite a mouthful! What is this joint, what does it do, and, if your Dr. Sardzinski, Dr. Wilken, Dr. Stanley, Dr. Hanson and Dr. Heying and our team have told you that you have a TMJ disorder, what can we do to help?

The Temporomandibular Joint

Your two temporomandibular joints are amazing works of anatomical design. These are the joints where the temporal bone in the skull meets the mandible bone of the jaw, and allow our mouths to open and close, move back and forth, and slide from side to side. Muscle, bone, and cartilage work together to provide easy movement and to cushion the joint. But sometimes, the joint doesn’t work as smoothly as it should, and this can lead to Temporomandibular Joint Disorder, or TMD.

When Should You Suspect You Have TMD?

You might have TMD if you experience any of these symptoms:

• Painful chewing
• Pain around your TMJ, or in your face or neck
• Earaches
• Changes in your bite
• Jaws that are limited in movement or lock open or shut
• Clicking, popping or grating noises when you open and shut your jaw

There are many conditions linked to TMD. If you grind your teeth at night, have arthritis in the jaw, have suffered an injury or infection in the area, or have problems with your bite, for example, you might be more likely to have TMJ problems. If you suspect you have TMD, or suffer from any of the symptoms listed above for an extended period, give us a call.

Treating TMD

During your visit to our Hiawatha, IA office, we will check your medical history, and examine your head and neck. We can take an X-ray or scan if needed for further examination of the joint. Because there is no real scientific agreement yet about the best way to treat TMJ disorders, a conservative treatment plan is often best. If you do show signs of TMD, we might first suggest relaxation techniques, over-the-counter pain relievers, or the use of ice packs or moist heat compresses. A change to a softer diet can help, and you should stop chewing gum and making any exaggerated jaw movements.

If these self-care practices aren’t effective, we might suggest a nightguard. This appliance is a comfortable and flexible mouthguard custom fitted for you, and will bring relief from teeth grinding when worn at night. If this treatment is not effective, talk to us about other options.

Luckily, most cases of TMD are temporary and don’t become worse over time. But any persistent discomfort is a good reason to visit us. Whether you have TMD, or any other problem causing you pain in the head or jaw, we want to help.

Hearing that you need a root canal can be highly intimidating. What is a root canal? It is the removal of the nerve supply from the tooth. Here, Dr. Sardzinski, Dr. Wilken, Dr. Stanley, Dr. Hanson and Dr. Heying will describe the parts of a tooth and explain the reasons for a root canal and how it is done when you visit us in our Hiawatha, IA office.

Your tooth is made up of many layers. The outside layer is called enamel and is made of minerals. The middle layer is dentin, which is also a calcified tissue, but less dense. The center of the tooth is called the pulp, and that hosts the nerves and blood vessels. A root canal is the removal and replacement of this center with a sterile filling.

A root canal is needed when an infection spreads to the center of the tooth. This can be from trauma (recent or previous), a cavity, a severe crack, or other compromise that causes nerve damage. An X-ray and examination are required to see if a root canal is needed. Symptoms may include but are not limited to pain, swelling, change in tooth color, and over-reaction to temperature change or pressure.

When it is time to begin, you’ll receive local anesthesia (via injection) to make you most comfortable. A rubber dam is used to isolate the tooth, while other equipment determines the nerve location and maintains a sterile working environment. All of the infected area is removed including the nerve tissue and blood vessels. Then, medicines are used to sterilize and alleviate any pain. Next is the placement of a filling material in the spot where the nerve used to be.

When your nerve and blood supply are taken away, the tooth is non-vital, or dead, and can become weak and fragile. If your tooth is badly decayed, a large portion of it will have to be removed. It is recommended to place a crown on the tooth to keep the enamel from breaking or falling apart. If you do not get a crown, you could eventually lose the tooth to more decay or infection. The tooth could also break off completely and you would have to have an extraction. The crown fits over the top of the tooth and secures it from breaking down.

A root canal saves the life of a tooth that would otherwise succumb to further infection and eventually extraction. Infection is the cause of most-needed root canals. If you are ever unsure what is happening at your appointment, don’t be afraid to ask questions so you understand the procedure completely.

You’re constantly playing defense. Your child spends two minutes in the morning and two minutes at night carefully brushing and flossing with a fluoride toothpaste. You make sure sugary and acidic foods are not a major part of your diets. Your child visits our Hiawatha, IA office for regular exams and cleanings. Really, how can a cavity get past all that?

But even with the best defensive practices, you don’t have a level playing field—literally. The tops of our molars and premolars don’t have the smooth, easy-to-clean surfaces that our other teeth have. If you look at the chewing surfaces, you will notice deep grooves which toothbrush bristles have a much harder time reaching.  

Plaque and food particles can become trapped in these grooves (known as pits and fissures), providing perfect conditions for a cavity to develop. That is why cavities are so common in newly erupted molars. Dental sealants protect these teeth from cavities by providing a barrier which smooths out the surface of the tooth and prevents food and bacteria from reaching the molar’s crevices.

Most sealants are invisible plastic resin coatings which we apply in our Hiawatha, IA office. Usually the procedure is so quick and easy that no dental anesthetic is required. Each tooth will be examined first. If we find any signs of early decay, we will gently treat that area before beginning.

When the tooth is ready, it will be cleaned and dried. An etching solution will be brushed on to the dry surface to roughen the area a bit so that the sealant will hold to the tooth more effectively. A thin coat of the sealant is then painted on and hardened under a curing light. And that’s it!

Once teeth are sealed, they should be cleaned and flossed just as carefully as before. Regular exams and cleanings are still very important, and we can monitor the condition of the sealant and the sealed teeth. Properly applied, sealants can last from three to five years, or even longer.

Who should consider sealants? Sealants are typically recommended when the permanent molars first erupt. Children’s enamel takes a while to become its strongest, and so these just-erupted teeth are more at risk for cavities. Sometimes Dr. Sardzinski, Dr. Wilken, Dr. Stanley, Dr. Hanson and Dr. Heying will recommend sealants for primary (baby) teeth if needed. But even adults can benefit—talk to us if you are interested and we will let you know if sealants might be right for you.

Sealants are a simple, safe, and minimally invasive way to prevent cavities. Studies of sealed molars and premolars show a dramatic reduction in cavities compared to untreated teeth. Sealants are one of the most effective ways to defend your teeth or your children’s teeth from tooth decay. And as we’ve all heard—defense wins championships!

The Good News

Carbohydrates are one of the body’s essential macronutrients (along with protein and fat). We use carbs to convert the food we eat into energy. How does this work? It’s a sophisticated process:

• Carbs break down into sugars as we digest them
• Sugars are absorbed into our bloodstream
• The pancreas releases insulin when blood sugar levels rise
• Insulin enables sugars to move from our blood to our cells
• Cells throughout the body use this sugar for energy.

Without the necessary amount of carbohydrates, our bodies lose a vital source of energy. So, why are carbs a dental concern?

The Bad News

Some foods immediately begin breaking down into sugars in the mouth. Sugars are a favorite food source for the oral bacteria that form plaque. They use this sugar to produce the acids that weaken our enamel and lead to cavities. And the more often we eat these foods, and the longer they remain in the mouth, the more damage our enamel suffers.

But there’s a silver lining! We can be healthier physically and get a jump on preventing damage from sugary treats by becoming more discriminating in our choice of carbs and timing our indulgences wisely.

Good Carb/Bad Carb

Unprocessed, complex carbohydrates are found in foods like whole-grain breads and cereals, legumes, and vegetables. They contain the vitamins, minerals, and fibers which are lost when foods are refined. They are composed of larger, more complex molecules, and so they break down gradually for sustained energy.

Some simple carbohydrates break down into sugars more quickly, but also offer important vitamins, minerals, and fiber. Fruits and dairy products, for example, are an important part of a balanced diet.

But some carbs are not pulling their nutritional weight. Refined sugars (think candies, desserts, and sodas) and refined starches (white bread and rice, potato chips, pastries) break down quickly into sugar in the mouth. Worse, many of these foods tend to stick around. Sticky sugars and sticky starches cling to our enamel and hide between the teeth and in the crevices of our molars. Not only do these treats provide a sugary feast for acid-producing bacteria, they take their time doing it!

So, What to Do?

If you have a diet filled with healthy carbs (whole grains, fruit and vegetables, legumes, dairy products), you’re already on the right track. Kudos! But does this mean no desserts? Ever?

No! We all need a cookie sometimes. But you can decrease the chance of enamel damage by interrupting the carbs to cavities cycle.

First, if you are indulging in a rich dessert or some salty chips, better to do it as part of a meal. When you eat a full meal, your body produces more saliva. Saliva not only helps wash away food particles, it also helps neutralize the acids that damage enamel.

Secondly, if you eat simple carbs and sugars all day, your mouth and teeth are being treated to acids all day. If you are going for a snack, there are many great options that don’t use refined sugars and starches. Think fruit smoothies (with a big dollop of vegetables) or whole-grain crackers with hard cheese instead of a can of soda and a bag of pretzels.

Carbs aren’t really bad, they’re just misunderstood. Talk to Dr. Sardzinski, Dr. Wilken, Dr. Stanley, Dr. Hanson and Dr. Heying at your next checkup at our Hiawatha, IA office for ideas for the best carbohydrate choices for healthy metabolisms and healthy smiles!