Thursday, December 23, 2010

The Pain of TMD

The nerves and muscles of the jaw control opening and closing and cause separation as pressure is applied between the teeth.  Pressure sensitive receptors in the tiny ligaments suspending the teeth in the jaw bone and the receptors in the chewing muscles cause a reflex to occur during biting to minimize the duration and magnitude of the forces on teeth.

Dysfunction  in the jaw joint occurs when this reflex control of the jaw movement is over-ridden by higher brain centers during clenching and grinding (bruxism).  During bruxism, tooth contact occurs for extended periods of time and with much greater magnitude.  These pressures measure ten times greater than the force commonly exerted on teeth.  These excessive pressures can result in severe tooth wear, cracking and fracturing of teeth and fillings and pain during chewing due to incomplete fracture of the tooth (Cracked Tooth Syndrome).  A crown is necesary to splint a cracked tooth to prevent further separation of the crack.

The excessive forces of bruxism can also cause jaw pain from fatigue of the jaw muscles and inflammation from damage to the cartilage and ligaments of the jaw joint.  These sign and symptoms are referred to as Temporal Mandibular Dysfunction, or TMD.  If you believe that you are experiencing any of these changes, then visit http://www.dulski.com/jawbite.html to learn how Dr. Dulski at Adult Dentistry of Rochester can help.

Tags: TMJ ProblemsTMD

Wednesday, December 15, 2010

Pain Control In Dentistry

Pain is a protective response to tissue injury and has two components.  The first is the propagation of the sensory impulse along the nerve to the brain where the impulse is recognized and described in terms of location, nature and intensity.  The second is the emotional response to pain which involves the interpretation of pain and the fear triggered by this interpretation.  The experience of pain is therefore the product of the magnitude of the sensory input and its psychological processing.

In dentistry, pain control often requires analgesic drugs.  Adjunctive measures can augment the effectiveness of these drugs in the dental office.  Studies show that the sensation of pain is increased as anxiety increases.  This relationship suggests that efforts to reduce anxiety can lessen pain both in the dental office and at home after the procedure.

At Adult Dentistry of Rochester, Dr. Dulski uses the following simple measures with each patient to optimize patient comfort:

     1)  Present a calm, well-organized staff and treatment environment.

     2)  Provide information both about the procedure and what sensations to expect.

     3)  Assure the patient that no treatment will be initiated unless the patient is 100% completely numb.

     4)  Discuss the patient's previous experiences of pain management in other dental offices.

     5)  Assure the patient that effective pain control will be provided with medication after the procedure.

And, for patients with a heightened sense of fear, Dr. Dulski provides a range of sedation to meet every need.  To learn more about effective control of the pain and anxiety of dental procedures, visit http://www.dulski.com/oral.html.

Tags: Dental InjectionsPain ControlDental AnesthesiaSedation Dentistry

Tuesday, December 7, 2010

Oral Health and the Geriatric Patient

Several factors influence the planning of treatment for the older adult.  More than any other age group, some patients may benefit from complex and invasive treatment such as implant restorations while limited supportive care may be the optimal choice for others.  The factors which influence this decision include:

      1)  Patient desires and expectations

      2)  Type and severity of the patient's dental need

      3)  The problem's impact on the patient's quality of life

      4)  The probability of positive treatment outcomes

      5)  The availability of reasonable and less extensive treatment alternatives

      6)  Ability of the patient to tolerate the physical, mental and emotional stress of treatment

      7)  The patient's capacity to maintain oral health

      8)  The patient's financial resources

      9)  The dentist's skills and facility access

     10) Other issues such as life expectancy, family desires and bio-ethical issues

Treatment outcomes are optimized by incrementally prioritizing treatment.  Initially, care should center on emergency care such as control of pain and infection; extraction of hopelessly decayed teeth; removal of deposits of plaque, stain and tartar; fillings to prevent further decay ; and repair of broken dentures.  Then treatment of periodontal disease and simple restorations such as root canals, crowns and temporary dentures should be pursued.  Finally, complex restorations such as implant crowns and bridges, and partial or complete removable dentures can be provided.

An informed discussion with the patient includes the advantages, disadvantages, risks and alternatives to any proposed treatment along with the staging of care.  All treatment questions are answered before the treatment plan is finalized at the dental chair and a written plan with associated fees is presented at the reception desk for signature by the patient.  To learn more about the special care for older adults provided by Dr. Dulski at Adult Dentistry of Rochester, visit http://www.dulski.com/.

Tags: Oral HealthGeriatric DentistryGum Disease

Denture Care

Determination of a patient's capacity to chew adequately is an important part of the periodic denture exam.  Studies in the United Kingdom and Japan have found that maintaining 20 or more natural teeth represents an important cut-off for adequate nutrition.

In addition to tooth loss, chewing effectiveness may be impaired by pain; crooked , worn or loose teeth; dry mouth; loss of tooth or bone support for the bite; joint dysfunction; or ill-fitting dentures.  Complete denture wearers have about one-fifth the chewing ability of persons with natural teeth and take more laxatives and anti-reflux drugs for gastro-intestinal problems.

Existing dentures need to be carefully evaluated for fit, comfort and function.  Dr. Dulski evaluates dentures for stability, retention, support for the bite and esthetics of the face, bite contacts and alignment, tissue extension and pressure.  For a free comprehensive denture examination by Dr. Dulski to spot problems, visit Adult Dentistry of Rochester at http://www.dulski.com/banner.html.

Tags: Denture ExamDenturesDental Implants

Warning Signs of Periodontal Disease

The American Dental Association lists eight warning signs of periodontal diseasePeriodontal disease in its early stages is often painless.  It is the most common cause for tooth loss for adults age 35 years or older and it affects 75% of this age group.  Don't wait till it hurts.  The eight warning signs are:

      1)  Gums that bleed when you brush.

      2)  Gums that are red, tender or swollen.

      3)  Gums that have pulled away or receded from the teeth.

      4)  Pus between teeth and gums when the gums are pressed.

      5)  Permanent teeth that are loose or separating.

      6)  Change in the way your teeth fit when biting.

      7)  Any change in the fit of partial dentures.

      8)  Persistent bad breath.

If one or more of these warning signs apply to you, bring it to the attention of your dentist or hygienist.  Act now to save your teeth for a life-time.  For a free comprehensive dental examination by Dr. Dulski to screen for periodontal disease, visit Adult Dentistry of Rochester at http://www.dulski.com/banner.html.

Tags:  Periodontal DiseaseWarning Signs of Periodontal Disease

Monday, December 6, 2010

The Link Between Diabetes and Gum Disease

Did you know that gum disease is often linked to the control of diabetes?  If you are a person with diabetes, ask your dentist to show you how to keep your teeth and gums healthy because persons with diabetes get gum disease more often than people who do not have diabetes, and gum infections can make it harder to control blood sugar.  Conversely, good blood sugar control can prevent gum disease.

Because diabetes reduces the body's resistance to infection, the gums are among the tissues likely to be affected.  Gum or periodontal disease is an infection of the gum and bone that hold your teeth in place.  Keeping your own teeth is important for healthy eating.  Natural teeth help you chew foods better and easier than you can with dentures. Good nutrition is another way that healthy teeth and gums can make it easier to control blood sugar.

Persons with diabetes with inadequate blood sugar control appear to develop periodontal disease more often and more severely, and lose more teeth than persons who have good control of their diabetes.   It is possible to have periodontal disease and not be aware of it.  An early warning sign of periodontal disease is bleeding gums.  Healthy gums do not bleed.  A later warning sign is loose teeth.  Unfortunately, at this later stage of periodontal disease, so much supporting bone has been lost that there is no alternative than to remove the teeth.

Because of lowered resistance and a longer healing process, periodontal disease often appears more frequently and more severely among persons with diabetes.  That's why good maintenance of blood sugar levels, a well-balanced diet, good oral care at home, regular dental check-ups and periodontal examinations at each appointment are important.  For a free comprehensive dental examination by Dr. Dulski to spot problems which could affect the control of your diabetic condition, visit Adult Dentistry of Rochester at http://www.dulski.com/banner.html.

Tags: Gum DiseasePeriodontal DiseaseDiabetesDental Examination