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Temporo-mandibular joint disorders, or TMJ for short, are a group of problems related to the jaw joint. Symptoms for TMJ could include a "clicking" sound, pain, grinding noises or a misaligned bite when opening the mouth, as well as difficulty in opening wide. There are numerous reasons a person may develop TMJ disorders, such as grinding or clenching their teeth. This type of unconscious behavior causes tightening of the jaw muscles which results in stress to the temporo-mandibular joint. Another cause may be that the jaw joint is damaged due to disease or injury.
TMJ is easily diagnosed and treated, however some types of TMJ problems lead to more serious conditions if the problem is left untreated. Treatment takes time to be effective, so early detection of these problems is crucial. During a consultation by an oral surgeon, you can discuss the proper course of treatment once the evaluation confirms that you have a TMJ disorder.
Extractions are only performed when absolutely necessary to prevent future complications for a patient. Some reasons why an extraction may be necessary include: when a tooth is blocked and unable to erupt, a tooth is severely damaged or decayed to the point where it is non-restorable (cannot be saved) or a tooth is impacted or partially erupted.
A tooth can be removed simply or surgically. A simple extraction can be performed when the tooth can be seen by the dentist and easily removed after applying numbing medication. A surgical extraction is more complex and is necessary when a tooth is not exposed, broken down or is imbedded in the bone. A patient is typically sedated for a surgical extraction.
An average eighteen year old has 32 teeth: 16 on top and 16 on bottom. However, the dilemma is the average mouth can only comfortably hold 28 of those 32 teeth. The extra four teeth are called third molars or more commonly referred to as "wisdom teeth." Being the last teeth to erupt in the mouth, it is often recommended that they be removed during teen years to prevent future problems from occurring.
Some of these associated problems include wisdom teeth that only partially erupt. Teeth that do not erupt fully can remain trapped beneath the bone and gum causing teeth to grow sideways. Impacted wisdom teeth may embed themselves in several different positions within bone as they unsuccessfully attempt to find a pathway to erupt.
Conditions resulting from poorly positioned wisdom teeth provide an area for bacteria to grow, which in turn results in an infection. The infection will cause a person to experience stiffness, swelling, pain and illness. Also, the erupting wisdom teeth may move the surrounding teeth and disrupt the natural alignment of the teeth. In some cases cysts or tumors can form around the impacted tooth, which can lead to the deterioration of healthy teeth and/or jaw bone.
Your dentist or orthodontist can determine if your wisdom teeth may pose any future problem. However, more than likely you will be referred to a trained an Oral Surgeon to perform the extraction.
The inside of the mouth is lined with a type of skin called mucosa that is smooth and pink in color. Your dentist should take note of changes in your oral condition during your routine examinations, however, you should also be aware of any changes that occur in your gums, skin on the inside of your cheek, around your teeth, your tongue, the floor or roof of your mouth and your face and/or neck. You should also be aware of any swelling in the bony areas of your mouth or face. In addition, the following may be signs of pathological changes in the oral cavity:
Pain does not always go hand-in-hand with oral diseases, and is not often associated with oral cancer. However, oral pain in the face or mouth without an obvious cause should be evaluated. In addition, most growths are benign (non-cancerous), but this must be determined with a laboratory test. Even if they are benign, the growths may require treatment, removal or monitoring.
It's recommended that everyone perform an oral self-examination monthly and remember that your mouth is one of your body's most important warning systems. Suspicious lumps and sores should not be ignored.
Most cysts are caused by tooth decay (periapical cysts) which result from infections spreading from the pulp of the tooth to the bone, or by impacted teeth (dentigerous cysts). As a cyst expands they can weaken or damage the surrounding tissue and/or bone or affect the positioning of the surrounding teeth.
When a patient has a missing tooth, over time the bone begins to deteriorate, which is called bone resorption. If this occurs there may not be enough bone present to place a suitable dental implant, which will restore natural alignment and function for the patient. However, we now have the ability to grow bone where needed, to place an implant which restores function and is more aesthetically to the patient.
For small bone defects, synthetic or replacement materials can be used in guided bone regeneration. This type of grafting can be used for ridge preservation after dental extraction, bone defects around teeth or implants, dental ridge defects and/or to fill in cysts in the jaw.
Large bone defects require major bone grafts and the use of the patient's own bone to regenerate the missing bone. These larger defects can be caused by injuries, congenital defects, early loss of teeth and/or tumor surgery.
Implants are tiny titanium posts which are placed into the bone where teeth are missing. The implant is the anchor which secures the artificial tooth in the mouth, like a root does for a natural tooth. Dental implants allow a person who has lost a tooth to regain prior functionality and to smile with confidence, knowing their teeth appear natural and their facial contours are preserved.
In some situations an implant can be placed at the time a tooth is removed, however, when a tooth has been missing for an extended amount of time, a bone graft may be necessary before implant placement is possible.
The ideal candidate for a dental implant is in good general and oral health. Adequate jaw bone needed to support the implant. The best candidates have healthy gum tissue that is free of periodontal disease. Smoking is detrimental to healing, but is not an absolute contraindication. Your dentist or an Oral Surgeon can determine if you are a good candidate for this procedure.
Sometimes an adult tooth has trouble erupting (pushing through the gums), and remains locked in position below the gumline. In a situation where an Orthodontist can not proceed with treatment due to the unerupted tooth, an Orthodontist will recommend for an Oral Surgeon to expose and bond the tooth to help with the eruption process.
If necessary, any of the baby teeth that are obstructing the adult tooth are removed first before the exposure of the adult tooth can take place. Then an Oral Surgeon will expose the tooth and attach a small chain to the tooth. The other end of the chain is attached to a bracket on the braces, which will be adjusted over time by the orthodontist to help guide the tooth into the correct position.