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.”

Mike Tyson's gap-toothed smile is part of athlete-turned-celebrity's signature look. During his two-decade career as a professional boxer, the former heavyweight champion has been known for both giving — and occasionally receiving — knockout punches. But the story of how he lost one set of front teeth is a bit more unusual.

In a recent interview with the Las Vegas Review Journal, Tyson's wife Kiki stated that one of the champ's major dental dilemmas didn't come from blows inside the ring. In fact, she said, Tyson lost the teeth after being head-butted by his pet tiger, Kenya.

It's too bad Tyson wasn't wearing a mouthguard before he decided to play with kitty.

Fight fans know that boxers always put in a mouthguard before they enter the ring. But the pugilistic pursuit is just one among the two-dozen-odd sports for which the American Dental Association recommends the use of custom mouthguards. Others include baseball, skateboarding, surfing and bicycling. (Maybe horsing around with tigers should be added to the list!)

Why is it so important for participants in athletic activities to use this piece of protective gear? According to the U.S. Centers for Disease Control, sports-related dental injuries account for over 600,000 emergency-room visits each year. Many of these injuries require further dental treatment; some may lead to tooth loss and require costly replacement. Not wearing a mouthguard makes an athlete 60 times more likely to sustain harm to the teeth, according to the American Dental Association. So there's really no contest.

You can find basic, off-the-shelf mouthguards in limited sizes at many sporting goods stores. But for a reasonable cost, we can provide you with a properly fitted dental appliance that's custom-made just for you. Starting with a precise model of your teeth, individual mouthguards are crafted from impact-resistant materials which are designed to be strong, comfortable, resilient — and effective.

Research shows that custom-made mouthguards offer superior quality and protection. So if you or your loved ones like to get out on the playing field, don't neglect this important piece of sporting equipment. And watch out for the cat.

If you have questions about mouthguards, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “Athletic Mouthguards.”

There are some people, particularly women around the age of menopause, who experience an uncomfortable burning and dry sensation in their mouths most of the time. The exact cause of this condition, known as “burning mouth syndrome,” is often difficult to determine, though links to a variety of other health conditions have been established. These include diabetes, nutritional deficiencies (of iron and B vitamins, for example), acid reflux, cancer therapy, and psychological problems. Hormonal changes associated with menopause might also play a role.

If you are experiencing burning sensations and dryness, please come in and see us so we can try to figure out what's causing these symptoms in your particular case. We will start by taking a complete medical history and getting a list of all the medications you are taking as some drugs are known to cause mouth dryness. We will also give you a thorough examination.

In the meantime, here are some ways you might be able to get some relief:

Give up habits that can cause dry mouth such as chronic smoking, alcohol and/or coffee drinking, and frequent eating of hot and spicy foods.

Keep your mouth moist by drinking lots of water. We can also recommend products that replace or stimulate production of saliva.

Try different brands of toothpastes, opting for “plain” varieties that don't contain the foaming agent sodium lauryl sulfate, whiteners, or strong flavoring such as cinnamon.

Keep a food diary of everything that you put into and around your mouth (including food, makeup and personal care products). This might give us some clues as to what's causing your discomfort.

Check with us about any medications you are taking, either prescription or over-the-counter. We can tell you if any are known to dry out the mouth and maybe help you find substitutions.

Reduce stress in your life if you possibly can. This might be achieved through relaxing forms of exercise, joining a support group for people dealing with chronic pain, or seeking psychotherapy.

If you have concerns about burning mouth syndrome or any other type of oral discomfort, please contact us to schedule an appointment for a consultation.

You may think snoring is a minor problem, but it can be a lot more than that. Just ask hoops star Shaquille O'Neal, whose rambunctious snoring bothered his girlfriend enough for her to suspect a health problem. Her observations eventually led to Shaq's diagnosis of moderate Obstructive Sleep Apnea (OSA), which occurs when the soft tissue structures at the back of a person's throat, including the tongue, partially close off the upper airway and prevent air from moving into the lungs during sleep. Sometimes airflow can be blocked completely for 10 or more seconds.

When air flow is reduced, blood oxygen levels drop. This leads to brief waking episodes known as “micro-arousals,” which can happen sometimes more than 50 times an hour. The sleeper might not even be aware of this, even while gasping for air. Micro-arousals prevent the person from ever reaching deep, restful sleep.

Besides suffering from excessive daytime sleepiness, studies show sleep apnea patients are at higher risks of heart attacks, congestive heart failure, high blood pressure, brain damage and strokes. People with sleep apnea also have a higher incidence of work and driving-related accidents.

OSA can be treated in a few different ways. On the advice of his doctor, Shaq opted for a Continuous Positive Airway Pressure (CPAP) machine, which generates pressurized air delivered through a face mask worn while sleeping. The force of the pressurized air opens the airway (windpipe) in the same way as blowing into a balloon does.

For people with milder OSA, or who find they can't tolerate wearing a mask during sleep, an oral appliance supplied by a dental professional might be the answer. Oral appliances are worn in the mouth and are designed to gently reposition the jaw and move the tongue forward away from the back of the throat. Success rates of 80% or more have been reported using oral appliances, depending on the severity of the OSA.

If you would like more information on sleep apnea, please contact us or schedule an appointment for a consultation. You can learn more about sleep apnea by reading the Dear Doctor magazine article “Snoring & Sleep Apnea.” Dear Doctor also has more on “Sleep Disorders & Dentistry.”

Once an exclusive procedure reserved for movie stars and millionaires, teeth whitening has become increasingly popular among all sectors of the population — including teens. While long-standing research has proven the process to be safe and effective, there are a few things everyone should know in order to make the experience as pleasant and successful as possible.

Teens, perhaps even more than others, can benefit from the confidence that comes with a healthy smile. And, because sensitivity of the gums is rarely a problem in younger people, their whitening treatments are less likely to cause discomfort. However, it's important for teens (and everyone else) to get treatments under the watchful eye of a dentist. Why?

For one thing, immature adult teeth are relatively vulnerable to the whitening process. And for young and old alike, a discolored tooth may be a symptom of an underlying dental problem, like an abscess or a root canal infection. These problems must be treated before the whitening process is begun. Also, teeth can't always be lightened to the same degree, and existing or planned dental work may have an impact on the whitening procedure. So it's best to come in and see us before you begin any tooth whitening treatment.

There are generally three methods used in tooth-whitening: in-office treatments with concentrated bleach application, at-home treatments with custom-made trays and appropriate dentist-supplied bleach, and over-the-counter (OTC) products. All use a type of peroxide to lighten the teeth, and all are safe when used as directed, under a dentist's supervision.

So what's the difference? Time! One study showed as few as three in-office visits were needed to lighten tooth color by six shades — a change that required 16 days with OTC products. Many opt for the cost-effective middle ground of custom-tray bleaching, which can achieve the same whitening in one week.

But what's especially important for a teen is that a dentist becomes involved in his or her treatment. In some cases, over-enthusiastic young people have used OTC bleach excessively, causing severe damage to the enamel layer of their teeth.

If you would like more information about teeth whitening for teens, please contact us or schedule an appointment for a consultation. You can also learn more about these issues by reading the Dear Doctor magazine articles “Tooth Whitening Safety Tips” and “Important Teeth Whitening Questions Answered.”