"I have TMJ" ????

WHAT IS THE TMJ: Many people come into my office and tell me that they have "TMJ". This term needs some clarification. Most people don't know what TMJ stands for let alone what it means. TMJ stands for Temporo-Mandibular Joint. It is the name of the joints of the jaw. It is the spot just in front of the ears ... on both the right and left sides. Saying that "I have TMJ" is like saying "I have 'elbow' or 'knee'". Most people have these body parts. What we mean when we say that we have "TMJ" is that we have a problem there. One term that has been assigned to this condition is "TMD". This stands for Temporomandibular Disorder. What this means is that there are a host of symptoms related to the joints of the jaw and the structures that support them. WHAT STRUCTURES ARE RELATED TO THE TEMPOROMANDIBULAR JOINTS: Since we're talking about terms, ... what is TEMPOROMANDIBULAR? TEMPORO- relates to the skull, the temporal bone, and MANDIBULAR relates to the lower jaw, the mandible. The TMJ is the joint between the lower jaw and the base of the skull. The lower jaw is basically a bone that hangs from our skull, held by a sling of MUSCLES. These MUSCLES make up a very important component of the TMD picture. There are also NERVES, TEETH which support the jaws when we swallow and chew, and a DISC of fibrous tissue between the JAW BONES which prevents the BONES from rubbing against eachother. The DISC is held in place by LIGAMENTS and MUSCLES. Behind the joint there is very sensitive tissue which has many nerve endings that can lead to pain when all these structures don't work together harmoniously. To add one more layer of complexity to this picture, these body parts that I have listed do not work in isolation. They are attached to the rest of the body. As a result of this connection, the TMJ can be influenced by the rest of the body, and the body can be influenced by the TMJ. As a result of all this, treatment for these problems can be quite a tricky puzzle to solve. WHAT ARE SOME CLUES THAT YOU HAVE A TMJ PROBLEM? a) Do you hear clicking or popping or grating sounds when you open or close? b) Do you have pain in the joints of your jaws? c) Do you get headaches? d) Do suffer from dizziness or ringing in your ears? e) Do you have difficulty opening your mouth wide? f) Do you grind or clench your teeth? g) When you open or close your mouth does your jaw move in a smooth straight path? h) Does your jaw ever lock open or closed? i) Do you sleep well at night? Do you wake rested? Can you get to sleep? Can you stay asleep? k) Do you have pain on opening your mouth? l) Do you pain in your shoulders or back? m) Are your eyes sensitive to light? If you answered YES to one or more of these problems, seek some advice from your dentist. Not all of these need be treated, but TMJ problems can definitely worsen with time. Don't wait until it is too late. Yours for excellent health ... Dr. Marty Frankel, 5775 Yonge St., suite 1000, Toronto, 416-770-8526, drmartyfrankel@rogers.com

Modern tooth repair options

HISTORICALLY SPEAKING: Last week I talked a bit about tooth decay and the impact it can have on our teeth. Today I would like to mention some of the modern options for repairing and restoring teeth that have been broken down by tooth decay. In the past, we typically would fill back teeth with mercury amalgam fillings which are very durable, but offer no strength to the tooth. Mercury is also known to be a neuro-toxin and its safety has been debated for over a hundred years. Some claim that in the form of an "amalgam", the mercury is bound and safe. Some studies done in the past seem to show otherwise, that mercury vapor is released from the fillings in small quantities for years, and that traces of mercury can be found in various body tissues and organs. Other options which eliminated the mercury question included gold restorations ... these have been considered the standard against which to measure other options. Gold was usually costly compared to the amalgam fillings and therefore amalgam was often the restorative material of choice. In the '60's the ability to bond filling material to tooth structure was developed. At that time dentistry and medicine focused on amputation, or removing body tissue in order to repair a problem (surgery). Today the focus is on Augmentation. Our goal is to preserve as much healthy body tissue as possible and add back what is missing. This is true of both medicine and dentistry. Dental technology has advanced by leaps and bounds since then, but the discovery of bonding has changed the course and face of dentistry. PROPERTIES OF AN IDEAL RESTORATIVE MATERIAL: Research is always being conducted to improve dental materials and make them more ideal. Some desirable properties of restorative materials would be:1) Durable and functional 2) bond to tooth structure - thereby strengthens tooth 3) ability to seal the tooth with the filling 4) conservative preparation - ability to preserve tooth structure 5) esthetic i.e. looks like a tooth 6)Bio-compatible - does not harm us to have the material in our mouths. Bonded restorations are able to deliver these requirements. We can bonded resin based filling materials and porcelain restorations to tooth structure. These are such things as tooth coloured fillings, porcelain or resin-based onlays, porcelain veneers, and porcelain or resin-based inlays. All-ceramic crowns can also be bonded to tooth which seals the tooth and creates a durable bonded to tooth which in turn strengthens the crown. With modern dental materials and techniques it is possible to create beautiful, long lasting, health-supporting, smiles. This is by no means exhaustive but rather intended to let you know some of the possibilities that are available. Until next time I sign off sincerely, Dr. Marty Frankel 5775 Yonge Street, suite 1000 Toronto, Ont. 416-770-8526