The Anatomy of Temporomandibular Joint Disorder (TMJ)?

The temporomandibular joint (TMJ) is one of the most frequently used joints of the entire body. We use the temporomandibular joint for many purposes all related to the movement of the jaw. We use the TMJ for speaking, facial expressions, yawning and especially for biting and chewing. The TMJ is located directly in front of your ears on both sides of your head. It’s the point where the upper jaw (maxilla) and the low jaw (mandible) come together. It is the pivot point of the jaws open and close movements. This type of joint is usually referred to as a “ball and socket” that has a disc sandwiched between it. So you can see the TMJ is a very important joint in the human body.

When the temporomandibular joints are healthy, relaxed and aligned we are able to talk, sing, chew, or yawn without any pain. Each complex component allows for smooth operation. The TMJ is complex and is composed of muscles, tendons, and bones. Here is a diagram of the TMJ.

What are the symptoms of TMJ?

People who suffer from TMJ/TMD can experience many different symptoms. The symptoms of TMJ/TMD are directly related to the stress or overuse of the jaw muscles. Unfortunately patients who suffer from TMJ/TMD symptoms tend to be chronic. Treatment is commonly aimed and eliminates the behavior or alignment that causes the TMJ. Here Dr. Michael Roessler lists common symptoms. Dr. Roessler notes that some symptoms may not appear to be related to the TMJ, but in fact are.

- Headaches and facial pain. Approximately 80% of patients with a TMJ disorder complain of headache, and 40% report facial pain. The pain is often exaggerated when opening and closing the jaw. The muscle tissue becomes inflamed affecting the surrounding muscles and it can feel as though the pain penetrates into other areas of the head.

- Ear pain. This is a difficult symptom of TMJ because ear pain occurs so commonly with other problems such as ear infections. This makes it more difficult to diagnose and may be initially made by an ear specialist. Approximately 50% of patients with a TMJ disorder notice ear pain and do not have signs of ear infection.

- Abnormal Sounds. Grinding and clenching the jaw may result in a clicking, popping or crunching medically referred to as crepitus, common for patients suffering from TMJ disorder. These sounds may or may not be accompanied by increased pain. Ringing in the ear (tinnitus): For unknown reasons, 33% of patients with a TMJ disorder experience noise or ringing in the ears (tinnitus).

- Vertigo. The body’s equilibrium fluids are held in the anatomy of the ear. TMJ disorder can affect ones equilibrium creating dizziness or imbalance. Of patients with a TMJ disorder, 40% report a vague sense of dizziness or imbalance.

- Fullness of the ear: About 33% of patients with a TMJ disorder describe muffled, clogged, or full ears. They may notice ear fullness and pain during airplane takeoffs and landings. These symptoms are usually caused by eustachian-tube dysfunction, the structure responsible for the regulation of pressure in the middle ear. It is thought that patients with TMJ disorders have hyperactivity (spasms) of the muscles responsible for regulating the opening and closing of the eustachian tube.

About Michael Roessler, DDS Cosmetic Dentistry.

Dr. Michael Roessler has many years of experience with diagnosing and treating patients suffering from moderate to severe TMJ. Dr. Roessler knows first hand that TMJ can cause serious chronic pain. Dr. Roessler recommends consulting your dentist and discussing TMJ with during your regular dental checkups. If you’ve experience TMJ share your story in the comments section below. If you would like to learn more about TMJ contact Dr. Michael Roessler. Our practice is located in Mundelein, IL. We serve all the surrounding areas. In our upcoming blog post we will continue to discuss TMJ. Contact us at www.michaelroesslerdds.com or (866) 360-8643.

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In our first blog post Dr. Michael Roessler discusses the link between oral health and overall health. There have been many studies analyzing the connection between periodontal disease, also known as gum disease, and heart disease. The Journal of Periodontology conducted a study that found individuals with periodontal disease have an increased risk of heart attack, stroke and cardiovascular disease. The study results help to educate the public about research findings which support what dentists have long suspected: oral hygiene and infections in the mouth can cause damage elsewhere in the body. All the systems in the body are connected. These findings cement the tangible link between your oral health and overall health. They also further reinforce the importance of good oral hygiene. Dr. Michael Roessler and the dental team at Michael Roessler, DDS Cosmetic Dentistry is dedicated to educating their patients about gum disease prevention and treatment options.

The study by the Journal of Periodontology found that diseased gums have higher levels of bacteria and harmful endotoxins than healthy gums. Endotoxins, which are produced by bacterium, can enter the bloodstream through the gums and travel throughout the body to organs such as the heart. The research goes on to show, and experts agree, that there is an association between gum diseases and chronic inflammatory conditions, such as diabetes and even Alzheimer’s disease. Therefore, treating gum disease and inflammation may not only help manage oral health but may also help with the prevention of other chronic inflammatory health issues.

What is Gum Disease?

Gum disease, also know as periodontal diseases or pyorrhea, is an inflammatory condition caused by bacteria, plaque and tartar build up affecting the tissue supporting the roots of the teeth. It is believed that 75% of Americans adults have some degree of gum disease. Gum disease is the principle cause of tooth loss in adults throughout the world and is preventable with proper care of your teeth. In addition to tooth loss it can lead to receding gum lines, bone loss in the upper and lower jaw. Fortunately, gum disease is completely preventable. In our next blog post Dr. Michael Roessler will discuss “How-To Prevent Gum Disease”. Here is a diagram of the area surrounding the teeth that gum disease affects.

Gum disease occurs in two different stages of infection called gingivitis and periodontitis. Gingivitis is more mild that periodontitis and affects only the gums surrounding the teeth. Periodontitis is a more aggressive stage of gum disease that has spread below the gums deep into the ligaments and bone that support the teeth.

Here Dr. Michael Roessler lists some of the most common symptoms of periodontal disease according to the National Institute of Health:

Symptoms of gum disease include:

Red or swollen gums

Tender or bleeding gums

Painful chewing

Bad breath that won’t go away

Sensitive teeth

Loose teeth

Receding gums

Longer appearing teeth

The American Heart Association estimates that almost one million people die every year from heart disease and almost eighty million people suffer from heart disease. The pharmaceutical industry has responded to this huge demand by creating blockbuster drugs that are commonly used for heart disease – statins, ACE inhibitors, beta-blockers, amiodarone, digoxin, and more. A person can easily spend thousands of dollars each year trying to prevent or manage heart disease with expensive prescription medications and increased costs for health insurance. Dr. Michael Roessler suggests investing in a good toothbrush, flossing and biannual teeth cleanings. There is no substitute for regular dental checkups.

Brushing your teeth and flossing just got a whole lot more important. Check out this fun video about How to Floss Your Teeth.

Here are a some resources to read more about the the link between gum disease and your heart:

- Small Bacteria–Big Impact

- A Healthy Smile May Promote a Healthy Heart

- Periodontal Diseases May Aggravate Prediabetic Characteristics

Dr. Michael Roessler serves the Mundelein, Arlington Heights, Libertyville and the surrounding areas. He’s been practicing dentistry in the northern suburbs of Chicago for many years and has treated patients suffering with every degree of gum disease. Let us know if you have any other questions about your oral health. And share this information with someone you know by clicking on one of the links below. Staying informed helps us all stay healthier. Stay tuned for the next blog post, “How-To Prevent Gum Disease”.

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Every month Dr. Michael Roessler posts a featured Before & After Case. In this month’s before & after case we have a 25 yr. old young man who did not like the appearance of his teeth. His smile is important to him and most importantly he wanted his smile to match his great personality. This dental patient presented with multiple gaps/spaces, discolorations, an unlevel plane of bite and shortened teeth. Dr. Michael Roessler met with the patient and explained his options. Dr. Roessler and the staff were 100% confident they could restore his smile. All of these problems were corrected in the final result.

Here are our patient’s before photographs.

Now check out the amazing results in this dental patient’s after photographs. Dr. Michael Roessler is very proud of the results and the patient is excited about his new improved beautiful smile.

Thank you for visiting our Before & After case of the month. If you would like to see more before and after cases check out our smile gallery.

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Cosmetic Dentistry in Your Life
How much longer are you going to allow yourself to be unhappy with your smile? Another week? Another year? Another decade?

Do you look in the mirror every day and wish something was different about your smile? Your teeth could be whiter. The chips could be filled in. Maybe teeth could even be replaced. You can think of countless negatives about each and every tooth, and zero positives about your overall smile.

If you feel that your smile isn’t exactly how you want it, you might want to consider cosmetic dentistry with Dr. Roessler. At our office, we offer a wide array of services that are tailored and individualized to each client. The result is that you walk away every time with a smile that you can be proud of. If you haven’t felt that pride about your teeth for any amount of time, continue reading to find out why this dentistry might be right for you.

What Types of Procedures are offered?
If you are just starting to explore cosmetic dentistry options, then you might not know all of the procedures that are now available to you. These three treatments listed are some of our most popular, and usually give patients the smiles that they have been waiting for throughout their lives.

1. Tooth Bonding- while the name ‘tooth bonding’ might sound scary, it is only a fast, inexpensive way to repair cracks and chips in teeth. Just think of Dr. Roessler as a sculptor, who can use the tooth bonding resin to fill in the chips and cracks of your teeth. He can match the natural color of your teeth perfectly with the tooth bonding process, so that only your teeth shine. If your teeth feel sensitive, Dr. Roessler can examine to see if the tooth roots are exposed. With tooth bonding materials, those roots can be covered, and your tooth sensitivity can decrease.

2. Porcelain Veneers- these veneers are made out of porcelain and are thin shells affixed to the front of your teeth. They can be shaped into different shapes, so that your mouth features are taken into account. Porcelain looks natural, and is more stain resistant than resin dental veneers. The veneers can be used to alter severely stained teeth, cracked or chipped teeth, or to even fill gaps.

3. Teeth Whitening- at Dr. Roessler’s Chicago office, we provide only the best to our patients, including tools for teeth whitening. With the Zoom! Teeth Whitening system, a dramatically whiter smile can be achieved in one appointment. No extensive dental procedures or surgical appointments. You can have a brilliant smile in an hour! And once you leave our office, you have your own touch-up kit for home use, which can keep your smile whiter, for longer.

Interest in Cosmetic Dentistry
If you, or someone you know, is looking for an updated smile, then you are on the right blog, checking out the right dentist. You deserve a beautiful smile—let us be the ones that help you achieve it!

For more information about the work that Dr. Roessler does, check out some our testimonials! These success stories will give you a taste of why patients choose Dr. Roessler to make their smiles beautiful! Call us today at 847-566-9330!

References
• About Cosmetic Dentistry. Tooth Bonding. http://www.aboutcosmeticdentistry.com/procedures/dental_bonding.html
• American Dental Association. Cosmetic Dentistry. http://www.ada.org/2990.aspx?currentTab=1
• Dr. Roessler. Cosmetic Dentistry. http://www.drmichaelroessler.com/pages/cosmetic-dentistry.html

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Tooth Decay

Tooth decay is one of the most common infectious diseases known to man. (Only the common cold is more prevalent.) Decay or caries occurs when the teeth are attacked by acid, which is introduced to the mouth in one of two ways: 1) Through the consumption of foods or acidic drinks like soda pop, fruit juice, etc. or 2) Through the breakdown of the sugars and starches in our diet by the naturally occurring bacteria in our mouths.

For most people, cavities develop due to excessive ingestion of sugary foods and candy, as well as soda pop. This causes the localized acid load in the mouth too increase to such a high level (pH < 5.5) that the acid literally rots a hole in the tooth. Excessive consumption of carbonated beverages like colas can be especially bad for the teeth, because they contain both acid and sugar.

To avoid cavities, and still enjoy a sweet or carbonated beverage, simply brush and floss immediately after eating or drinking these. This removes the sugars and acids and stops the decay process from progressing.

However, for some of us, the decay process has already occurred, necessitating a filling or perhaps a crown.

Fillings

If the cavity is small, fillings are an appropriate restorative option. By small, we mean that the old filling (if present) and decay must take up less than 50% of the tooth (above the gum line). If the cavity takes up more than 50% of the tooth, then a crown or cap is necessary. In other words, there must be enough teeth left to structurally support a filling. If there is not, then the top of the tooth needs to be replaced with a crown.

Fillings are commonly differentiated by their color, either silver (grayish) or white (tooth-colored). Silver fillings or amalgams are made up of an alloy comprised primarily of silver, tin, copper and mercury. Amalgams have been around for over 150 years are extremely durable and work extremely well. However, cosmetic concerns have resulted in these being phased out in favor of the more esthetically pleasing tooth-colored fillings.

Silver fillings also have a major disadvantage: They contain mercury, which is quite hazardous to the environment (because of this, some countries in Europe have banned silver fillings). However, for the vast majority of the population (>99%), silver fillings are considered to be safe in the mouth. The issue is more an environmental one: factories that process mercury generate waste that is extremely toxic to wildlife, especially birds.

Modern dental offices have therefore largely moved to tooth colored fillings and are doing fewer and fewer silver fillings. Tooth colored fillings are comprised of either composite resin or glass/resin ionomers. Composite resin fillings are more common since they can stand up to heavy chewing pressures and not break. Ionomers are better suited for non-load bearing situations—cavities between the teeth, for example.
Tooth colored fillings look great, but do have the disadvantage of costing slightly more. The white filling material usually costs more than amalgam and typically takes longer to place in the tooth (resulting in a higher fee from the dentist).

And be aware that some (not all) dental insurance companies view silver amalgam as “good enough” and only have one payment amount for a particular type of filling—regardless of whether it is silver or white. This results in the patient having to pay a slightly higher “out-of-pocket” for white fillings than for silver. If your dental insurance downgrades the fee for white fillings down to that for silver, be sure to voice your concerns to the person in human resources that buys your insurance.

Crowns and Caps

When the decay and old filling (if present) take up more than 50% of the upper portion of the tooth, a crown or cap is necessary— there is not enough tooth left to structurally support a filling.

A crown necessitates a two-visit procedure for the patient (unlike fillings which are a single visit procedure). Two visits are necessary with crowns, since the new tooth top (or crown) is fabricated by an outside dental laboratory (though a few dentists do have in an in-house lab). The outside dental laboratory takes about 1.5-2.0 weeks to fabricate the crown out of porcelain or gold, after which the patient needs to return to the dentist to have this placed.

In the crown procedure, the dentist removes the decay from the tooth and then places a temporary plastic crown. The patient wears this temporary for about 2 weeks—the time it takes for the lab to fabricate the permanent crown—and then returns to have the temporary popped out and the permanent crown cemented in.

The temporary crown should feel just fine during this two week period. And for the majority, this is the case. However, if the crowned tooth is sensitive, you need to contact your dentist. With deep decay, a bit of sensitivity can occur and the dull pain should be controlled with Ibuprofen (Advil). If the temporary is sensitive only after eating, you may need a quick adjustment of the bite. And if the crowned tooth if sensitive to hot/cold and percussion (or tapping), you may need to be evaluated for a root canal.

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