If you were recently in an accident or received a hard hit while playing sports and you have been feeling jaw pain ever since, you may be suffering from a serious injury. It is important that you make an appointment with us immediately, so that we can conduct a proper examination, make a diagnosis and prescribe a suitable treatment. Even if the pain is lessening, you should still make an appointment.

Without seeing you, we have no way of definitively diagnosing the cause of your pain. However, here are a few possibilities:

1. You displaced a tooth or teeth.
2. You indirectly traumatized or injured the jaw joint (TMJ — temporomandibular joint). This trauma will cause swelling in the joint space, and the ball of the jaw joint will not fully seat into the joint space. If this is the issue, it is likely that your back teeth on the affected side will not be able to touch. Over time, the swelling should subside, allowing the teeth to fit together normally.
3. You may have a minor fracture of your lower jaw. The most common is a “sub-condylar” fracture (just below the head of the joint), which will persist in symptoms that are more severe than simply bruising and swelling.
4. You may have dislocated the joint, which means the condyle or joint head has been moved out of the joint space.

All of the above injuries can also cause muscle spasms, meaning that the inflammation from the injury results in the muscles on both sides of the jaw locking it in position to stop further movement and damage.

The most critical step is for you to make an appointment with our office, so we can conduct a physical examination, using x-rays to reveal the extent of your injury. We'll also be able to see whether the injury is to the soft tissue or bone.

Treatment may involve a variety of things, including anti-inflammatory and muscle relaxant medications. If your teeth have been damaged, we'll recommend a way to fix this issue. If you have dislocated your jaw, we may be able to place it back through gentle manipulation. If you have fractured your jaw, we'll need to reposition the broken parts and splint them to keep them still, so that they can heal.

If you would like more information about jaw pain, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Jaw Pain.”

Are the following statements true or false?

Thumb sucking in children may cause problems with their teeth later on.

A: TRUE

Prolonged thumb sucking may be responsible for many problems with the bite. The constant pressure of the thumb itself can create a gap between the top and bottom teeth in front, a condition called an “open bite.” It also reinforces the habit of using the “tongue thrust” motion in swallowing, where the tongue is positioned between top and bottom teeth. This habit may also block full eruption of the front teeth.

Infants and young children swallow exactly the same way that adults do.

A: FALSE

When they swallow, young children use what is called the “infantile swallowing pattern.” In this method, which begins before their teeth have erupted, the tongue is thrust forward in the mouth, sealing and supporting the lips. In adult swallowing, the tongue touches the roof of the mouth, behind the front teeth. The transition from the infantile method usually happens naturally, by around age 4.

Most open bites result from the habit of positioning the tongue too far forward.

A: TRUE

Failure to transition between the infantile and adult swallowing pattern is believed to be the cause of most open bites. The tongue's position alone may prevent the front teeth from fully developing. Allowing the thumb to rest between the teeth has the same effect — and it can also push the front teeth forward. Other causes of an open bite are skeletal or jaw-related problems.

It is harder to cure open bites caused by thumb sucking or bad tongue position than those from other causes.

A: FALSE

Open bites that are caused by skeletal factors (patterns of bone growth, etc) are often difficult to resolve. Those caused by dental factors (tongue position, tooth eruption, etc) are generally easier to fix. However, the pressure exerted by the thumb over a long period of time can influence bone growth in the jaw.

There is a dental appliance that can help discourage thumb sucking.

A: TRUE

A thin metal “tongue crib” placed behind upper and lower incisors discourages the thumb-sucking habit. It also helps to “re-train” the tongue, keeping it from going between upper and lower teeth. To successfully treat an open bite caused by dental factors, and to prevent its reoccurrence, it is essential to eliminate the unhelpful habits of both the thumb and the tongue.

If you would like more information about thumb sucking or open-bite problems in children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How Thumb Sucking Affects The Bite.”

Oral cancer is not as uncommon as people think. In 2008 an estimated 34,000 cancers of the mouth and throat were diagnosed. In order to minimize your risk of developing oral cancer, be aware of habits that increase your risk.

Risk Factors for Oral Cancer include:

• Use of smoking or chewing tobacco: Tobacco smokers have 5-9 times greater risk of developing this cancer than non-users; snuff and chewing tobacco users have a four times greater risk than non-users.
• Excessive use of alcohol: Moderate to heavy drinkers at are 3-9 times greater risk than non-drinkers.
• Exposure to sun: Chronic sun exposure is associated with development of lip cancers.
• Certain viral infections such as the human papilloma virus that can cause cervical cancer in women can also cause oral cancer.
• Compromised immune (resistance) systems that are not functioning properly can be associated with cancers.
• Poor nutrition including diets low in fruits and vegetables can increase risk for all cancers including oral cancer.
• Family history: People carry a predisposition in their DNA (the genetic material they inherited from their parents) for developing cancer.

Oral Cancers Can Mimic Harmless Sores

Early signs of oral cancer can mimic harmless sores that occur in the mouth such as canker sores, minor infections, or irritations that occur from biting or eating certain foods. Cancers in the lip area can easily be mistaken for harmless sores.

Early Detection is Key

It is important to have regular oral examinations to detect signs of oral cancer. Although 90 percent of oral cancers occur in people who are over 40, it is becoming more prevalent in younger people, particularly those who adopt risky behaviors: smoking, drinking and oral sex.

• If you notice any unusual lesions (sores or ulcers), or color changes (white or red patches), anywhere in your mouth that do not heal within two to three weeks, come and see us and have it examined immediately.
• Definitive diagnosis may require a small biopsy, the microscopic examination of a piece of tissue from the affected area.

It is important not to let a suspicious sore go unchecked. If detected and treated early, while a lesion or growth is small, survival rates can exceed 80 percent. Contact us today to schedule an appointment to discuss your questions about oral cancer. You can also learn more by reading the Dear Doctor magazine article “Oral Cancer.”

No one wants to hear the word “cancer.” But thanks to advances in detection and treatment, the disease increasingly can be stopped in its earliest stages when it's most treatable and outcomes are most favorable. Oral cancer accounts for a relatively small 3% of cancers in men and 2% in women, but early detection rates are lagging. Our office screens for oral cancer as part of your regular checkups. Knowing some of the signs and symptoms can help you monitor as well.

The main areas where oral carcinomas (cancers) occur are:

• the tongue (most common location, particularly the sides and on the floor of the mouth),
• the lip (especially the lower one),
• the oral cavity (the mouth), and
• the pharynx (back of mouth and throat).

Early Signs

Most oral cancers are preceded by surface changes (lesions) of the oral membranes. In the “precancerous” stage, white or red patches start forming and a non-healing ulcer may appear. The most common locations on the tongue for this to occur are on the sides and underneath on the floor of the mouth. Lip cancers typically develop on the lower lip, usually in people with a history of sun exposure. There has often been prior damage at the site such as scaling and crusting.

Be aware that oral cancers can be mistaken for cold and canker sores, ulcers, minor infections, and even irritations caused by biting or certain types of food. If lesions don't heal within two or three weeks, there's a higher likelihood that they are cancerous.

An in-office examination includes the following:

• visual inspection of face, lips, neck and mouth;
• inspection of sides and underneath of tongue and floor of mouth using gauze to gently manipulate the tongue;
• palpation of the floor of the mouth, sides of neck and glands to detect unusual lumps; and
• an “open wide and say ‘Aah’” examination of the back of your throat.

There are some risk factors for oral cancer that can't be controlled, such as a family history, age and race. But awareness, monitoring for potential signs and seeking prompt attention are always key ingredients in protecting your oral health!

If you would like more information about oral cancer detection, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Oral Cancer.”

Congratulations! In a few months, you're expecting a new baby... but, in the mean time, your body is adjusting to nausea, weight gain, food cravings, and a hundred other changes. Is this really the time to worry about your teeth and gums?

Yes and no — don't worry, but do be aware of a few basic facts about your oral health and your pregnancy, and how they affect each other.

Being pregnant may make your teeth and gums more sensitive. It also puts you at greater risk for some periodontal diseases, like pregnancy gingivitis (“gingival” – gum tissue; “itis” – inflammation of) and benign growths on the gum called “pregnancy tumors.” You may think these problems are just uncomfortable, but you should really have them evaluated as soon as they develop. Why?

Once upon a time, it was believed that periodontal (gum) diseases just affected the mouth. Today, we think these diseases and their associated bacteria may be involved with the whole body, playing a role in cardiovascular ailments, heart attacks, strokes, diabetes, and other illnesses.

What's more, recent studies suggest that these oral bacteria may be able to cross the placenta, stimulating an inflammatory response that may lead to preterm delivery. Babies who are born pre-term often have low birth weight, and are at greater risk for a number of health complications. That's one reason why maintaining good oral health is so important to expectant moms.

So, what should you do? First of all, keep in mind that maintaining your own general and dental health is the best thing you can do for your developing baby. Eat a balanced diet, keep up healthy habits — like limiting sugary between-meal snacks and brushing regularly — and don't put off visiting your dentist to get your dental cleanings. Those cleanings and a thorough evaluation can set your mind at ease and give your baby the best chance at a healthy start.

If you would like more information about pregnancy and oral health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Pregnancy and Oral Health,” and “Expectant Mothers.”