Temporomandibular joint disorder also known as TMJ, is a term covering  chronic inflammation of the temporomandibular joint, which connects the jaw to the skull.  The disorder can result in severe pain and impairment.  Because the disorder goes beyond the boundaries of several health-care disciplines, in particular, dentistry, neurology, physical therapy, and psychology, there are lots of treatment approaches.

Many of the conditions that affect other joints in the body, including  arthritis, trauma, dislocations, developmental anomalies, and neoplasia can affect the temporomandibular joint.  If you are diagnosed with TMJ, you can first expect gentle therapies such as home-care treatments, including moist heat or cold packs on the face, vitamin supplements and exercise.  Dentists who treat TMJ disorders will administer X-rays and prescribe a mouth guard. Surgery is considered a last resort by most TMJ experts.

Mouth guards have been used since the 1930’s to treat teeth clenching and TMJ disorders. Problems arise because  mouth guards can lose their effectiveness over time. Some  patients claim that they feel more pain when they wear a mouth guard.  However, various types of support exist like splints.  Splints are inserted over the top of the teeth while others rest on the bottom. Splints and guards inhibit clenching and promote relaxation.

One new kind of support is called NTI-tss, a splint that fits over a couple of top, front teeth. This design ensures the back teeth remain separated as most clenching occurs at the back teeth.  Splints may only work for a short term period and may even change your bite. If a mouth guard fails to work, your dentist may recommend orthodontics for re-alignment of your teeth.

If gentle techniques fail, more aggressive treatment can be considered. Under local anesthesia, dentists insert two needles in the TMJ to wash it out. A syringe filled with a cleansing mixture connects to one of the needles, while the fluid exits through the other needle. Most patients report relaxation after this medical treatment.  The last option, surgery, involves removing the jaw joints and replacing them with implants. The National Institute of Dental and Craniofacial Research (NIDCR) urges that when surgery is recommended, patients should seek other medical opinions before continuing.

We all  have some fear of the dentist.   If you’ve had a traumatic dental experience in their past, or a full blown phobia that prohibits you from getting the health treatment you need, Sedation Dentistry might be your ticket to a healthier smile.

Sedation dentistry refers to the use of different anesthetic agents that help to calm and relax a patient before and during a dental appointment. The pharmacological agents usually belong to a class of drugs called sedatives, which work by depressing the central nervous system.  There are different types of central nervous system depression, each representing a level of relaxation which ranges from minimal, moderate, to deep sedation.

Generally, minimal sedation means a patient has reduced anxiety but is still aware and responds to verbal or physical stimulation.  Moderate sedation means the patient is even more relaxed, but will still respond to strong stimulation. In deep sedation, the patient is deeply sedated, as in anesthetized, and will not feel or respond to stimulus.

Sedation Dentistry is performed by either of two methods.  The Enteral  includes medications that are either swallowed, absorbed through the mucosa of the oral cavity, or inserted rectally. The Parenteral route  include intravenous, inhalation, intramuscular, and submucosal administration, among others.

Prosthodontics focuses on the restoration and replacement of teeth and associated structures. They specialize in implant dentistry, dentures, crowns and other supportive prosthesis of the oral cavity. Patients requiring rehabilitation after a traumatic injury or creating new smiles for those born with genetic facial deficits,  can benefit from  treatment by a qualified Prosthodontists.  With advanced training, Prosthodontists can improve your appearance by fixing broken, discolored, misshapen or missing teeth.

Prosthodontists are qualified to offer service in state-of-the-art procedures and techniques such as, Reconstructive/Rehabilitative Dentistry, Crowns  and Caps, Veneers, Fixed Bridges, Removable Bridges and Removable Partial Denture, Cosmetic Dentistry, Implants Placed and Restored, Complex Case Management Involving Multiple Specialists, Complete Dentures, Replacing Lost Teeth and Gum Tissue,Traumatic and Genetic Injuries for Adults, Maxillofacial Prosthetic Procedures, Such as Oral Cancer Reconstruction and Obturators.

The American Dental Association recognizes nine dental specialties, but does not include cosmetic dentistry as a specialty. Prosthodontists receive extensive training and experience in dental esthetics and cosmetics during their graduate programs which lasts three years.  Prosthodontist can be considered the architect of your dental project. Often other dental specialists may participate in your treatment to help establish a solid foundation for your restorations. Prosthodontist develops a treatment plan customized for each individual patient, and will determine if additional procedures by another doctor are necessary.

A Periodontist is a dental specialist who treats the supporting structures of your teeth,  including the gums, roots and bone. A periodontist can also specializes in the prevention, diagnosis, and treatment of periodontal diseases, and the surgical placement maintenance of dental implants.

Supporting tissues are known as the periodontium, which includes the gingiva, or the gums, alveolar bone, cementum, and the periodontal ligament. The word comes from the Greek words peri (around) and odons (tooth). Literally it means study of that which is “around the tooth”.

A Periodontist’s goal is to recognize disease, determine if it is advancing and then stop its progression. Treatment usually includes the following:

• Coaching patients to perform a higher level of Home Care
• Deep Cleaning to remove tartar from behind the gums
• Analyzing and adjusting the bite, sometimes splinting teeth to prevent trauma
• Appropriate use of antimicrobial may include antibiotic therapy or direct delivery of antimicrobial s into infected areas
• Surgical Treatment of more advanced periodontal disease may include reducing pockets or rebuilding the gum or bone with regeneration, often COSMETICS is the goal of reconstructive surgery

Periodontists  spend 3 years in postgraduate training after graduating from dental school. With this specialized training, periodontists are trained to:

• Diagnose and treat infections of the gum tissue and bone
• Perform bone regenerative procedures
• Perform periodontal cosmetic surgery
• Perform Esthetic Tissue Recontouring for improved restorative outcome
• Surgically placing dental implants and performing bone augmentation procedures
• Place Multiple Implants
• Manage oral medicine and pathology issues such as diabetes, drug induced overgrowth
• Providing supportive periodontal treatment

Pediatric Dentistry, including Pedodontics or Paedodontics,  is a branch of dentistry focusing on children from birth through adolescence.  This discipline focuses specifically on pediatric and adolescent growth and development, disease causes and prevention, child psychology and management, and all parts of the highly-specialized Pediatric dental care.  Pediatric Dentistry emphasizes  trust and confidence in children with their dentists. In fact, one of the main components of pedoontics training is child psychology. Special office designs, communication styles and an emphasis on teaching preventative dental habits to children is all an in an effort to make dental visits enjoyable and acceptable to children

Pediatric Dentistry focuses on preventing tooth decay. Studies show that poor oral health in children leads to poor school performance and  social relationships. Pediatric Dentists emphasize on giving advice taking care of your child’s teeth and the importance of developing healthy eating habits.

The role of the Pediatric Dentist changes as children age. Recognizing the growing importance of appearance in their patients, Pediatric Dentists work to make sure that a teens dental needs are met. Preventative dental health care and important information is provided to teens about subjects such as wisdom teeth, tobacco use, sealants and oral piercing.

It is recommended by the American Academy of Pediatric Dentistry (AAPD) and the American Academy of Pediatrics (AAP) that a dental visit should happen within six months after the presence of the first tooth,  or at least before a child’s first birthday. Early detection is essential to maintain health teeth, change bad habits, and treat as needed and as simply as possible.

Orthodontists are dentists that focus on the practice of orthodontics. An orthodontist is required to complete an additional two to three years of post-dental school education before becoming a certified practitioner.  Your general dentist can refer you to an orthodontist for evaluation of your bite. During your first orthodontic visit, your orthodontist may use several methods to develop an individualized treatment plan, including, oral, facial and functional evaluation, intraoral and facial photographs, panoramic and cephalometric X-rays and impressions for models of the teeth and bite.

Age is not a factor.   Orthodontics can protect and correct your bite (occlusion), maximize your teeth effectiveness, and create a well-aligned smile. Today’s orthodontics involves repositioning of your teeth and underlying roots, which provides better support for crowns. Orthodontic treatment associated with the benefits of esthetic appeal, increased comfort and reduced treatment time.

Orthodontic treatments, years ago,  were only used for teens having problems with malocclusion, or bit. Today, orthodontic treatments like braces are for adults as well.  Close to 30 percent of all orthodontic patients in the United States are adults. Because of the growing trend towards adult orthodontics, it beneficial to start orthodontic treatment early for maximum effectiveness. The American Dental Association recommends children receive an orthodontic evaluation by seven years old.

The American Dental Association recognizes oral and maxillofacial surgery,  most commonly referred to as oral surgery, as one of dentistry’s specialty areas. Oral Dentistry focuses on the diagnosis, surgical treatment,  injuries and defects related to the the face, mouth, teeth and jaws (maxillofacial area).

An oral surgeon is an important part of your primary care provider network. When functional dental concerns arise, such as keeping your teeth, correcting congenital growth issues, controlling serious oral disease, and maxillofacial trauma, an oral surgeon is the right dental specialists to got to.

Conditions Treated With Oral Surgery:

• Removing diseased and impacted teeth and administering anesthesia.
• Placing dental implants.
• Treating facial trauma.
• Evaluating pathologic conditions.
• Alleviating facial pain.
• Performing reconstructive and cosmetic surgery.
• Performing corrective jaw (orthognathic) surgery.
• Providing surgical treatment for obstructive sleep apnea (OSA).

To be certified by the American Board of Oral and Maxillofacial Surgery, an oral surgeon, or an OMFS, must graduate from an accredited dental school and be licensed in the state in which he/she is practicing. Oral surgeons must also complete four or more additional years of training in an accredited, hospital-based maxillofacial surgery residency program.

Oral surgeons train alongside medical residents in general surgery, advanced anesthesia, plastic surgery, medicine and pathology. An OMFS may treat patients in hospitals, outpatient facilities, surgery centers,and in a dental practice setting.

Some of us will lose teeth due to disease, injury, or daily wear.  Not only bringing unwanted changes to a your facial appearance, missing teeth can have a negative effect on that your self-esteem. With the advent of implant dentistry, those of you that are missing  teeth don’t have to accept embarrassment. Dental implants, which are sturdy titanium posts that are anchored directly into your jawbone and finished with realistic replacement teeth, provide the perfect replacement for your teeth.  They are permanent, and in some cases, much better than your previous permanent teeth.

Dental implants are considered an improvement over traditional dentures. They’re  stable and human-friendly over other replacement options, and because the titanium posts that secure the implants in place are set directory into the jaw, they help prevent bone loss and gum recession.  There are some medical circumstances,  including radiation therapy in the oral area, and diseases such as diabetes, that can lower the success rate for implant dentistry.

Dental implants  allows you to replace missing teeth with ones that look, feel, and perform like their your originals. During the first step of the implant procedure, a doctor experience in implant dentistry will surgically place a titanium post in the patient’s jaw.  After the gums have healed around the embedded post, a replacement tooth is attached to the top of it.

Many denture and crown wearers might want to consider implant dentistry as an alternative to their partials or dentures.

General Dentistry can be defined as the evaluation, diagnosis, prevention and/or treatment of diseases, disorders and conditions of the mouth, teeth, maxillofacial (jaw and face) area or the near and associated structures and their impact on the human body.  General Dentistry is provided by a dentist, within the scope of  their  professional education, training and experience, in accordance with the ethics of the dental profession..

A General Dentist focus, ideally, is usually preventative. The American Dental Association (ADA) recommends that you visit your dentist regularly, at least once every six months, to make sure you are keeping up with proper dental hygiene and that your normal functionality is intact. Regular checkups help prevent the development of serious dental problems that result in costly treatment. It’s important to see your Dentist regularly.

Your general dentist can incorporate a variety of procedures in your treatment plan that will help prevent decay, disease of the teeth, mouth,  and gums . General dentists also use restorative dentistry techniques to repair the effects of tooth decay, trauma, defect or disease.

In addition to general dentistry, there are 9 recognized dental specialties in the US..  Becoming a specialist requires Dentists to train in a residency or advanced graduate training program. Once residency is completed, the doctor is granted a certificate of specialty training.

Many specialty programs have optional or required advanced degrees:

• Masters degree: MS, MSc, MDS, MSD, MDSc, MMSc, or MDent
• Doctoral degree: DClinDent, DMSc, or PhD
• Medical degree: MD/MBBS specific to Maxillofacial Surgery and sometimes Oral Medicine

Recognized Dental Specialties

• Dental public health – study of dental epidemiology and social health policies
• Endodontics – root canal therapy and study of diseases of the dental pulp
• Oral and Maxillofacial Pathology – study, diagnosis, and sometimes the treatment of oral and maxillofacial related diseases
• Oral and Maxillofacial Radiology – study and radiologic interpretation of oral and maxillofacial diseases
• Oral and Maxillofacial Surgery – extractions, implants, and facial surgery
• Orthodontics and Dentofacial Orthopaedics  – straightening of teeth and modification of midface and mandibular growth
• Periodontics – study and treatment of diseases of the periodontium (non-surgical and surgical), and placement and maintenance of dental implants
• Pediatric dentistry -  dentistry for children, also known as Pedodontics
• Prosthodontics -  dentures, bridges and the restoration of implants. Some prosthodontists further their training in “oral and maxillofacial prosthodontics”–a discipline concerned with the replacement of missing facial structures—such as ears, eyes, nose, etc.

Endodontics, derived from the Greek endo, meaning inside, and odons, meaning tooth, is one of the nine specialties of dentistry recognized by the American Dental Association.  It deals with the tooth pulp and the tissues surrounding the root of teeth. If the pulp in your root has become diseased, infected or injured, endodontic treatment is required to save the tooth and relieve the underlying pain.

Although the endondontic therapy is relatively painless when done by an experienced Endondostist, the root canal is still a “fearsome” dental operation that most people want to avoid.   In the United States, alot of people  respond to unpleasant situations with, “I’d rather have a root canal.”  This shouldn’t be the case.

Endodontic Therapy, also called root canal therapy,  removes infected pulp tissue within the root of the tooth. The remaining void is filled with an antibacterial solution, and the tooth is usually capped with a crown. Endodontists specialize in performing root canal therapy, though general dentists can also perform the procedure.

Although the procedure is most commonly referred to as root canals, this term is actually incorrect.  Root canals and their pulp chamber are the hollow area inside the  tooth which contain nerve tissue, and blood vessels, and endodontic therapy includes the complete removal of these structures, including the  cleaning, reshaping and disinfecting of these root by using tiny files and irrigating solutions and the filling of the decontaminated root canals with an dental filling, such as gutta percha and a usually eugenol-based cement.

After root canal surgery the tooth will be necrotized or  “dead”.  If the infection is spread deeper into the apex, root end surgery is would be the next step.  Endodontic Therapy tries to capture the infection before this type of surgery is needed.

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The root canal is the space within the root or center of your tooth.  It’s part of the natural space within your tooth that consists of the pulp chamber, which is within the coronal  or crown part of the tooth, the main canal, and the branches that connect the root canals to each other and/or the surface of the root.

The root branches are mostly found near the end , also known as the apex, but can also be found anywhere along the root length. There cam be one or two canals within each root. Some teeth have more variances than others.

This space is filled with a vascular, loose connective tissue, called the dental pulp.  Dental pulp is the tissue which forms the dentin of the tooth. The formation of adult teeth is completed usually after the second year of teeth appearing in your mouth. Once your teeth have reached their final size and shape, the dental pulp’s  function ceases  and it takes on a new role as a sensory organ.

There are many reasons why someone would consider dentures, chief among them are complete the complete dental structure failure that comes with prolonged infections, rotting, and tooth loss due to accidents or simply old age.  Replacing your teeth is not an easy decision when you are faced with the procedures that entails denture placement, particularly the removal of your remaining teeth, but in the long run, it might be the necessary step needed to help correct problems which can affect the quality of your life.  Eating, speaking and your general facial structure is dependent on your teeth and it surrounding areas.

Dentures are dental prosthesis  created to replace  your missing teeth.  They are supported by surrounding soft and hard tissues of the mouth and oral cavity.   Most conventional dentures  can be removable, but there are different denture designs that can be bonded or clasped onto teeth or  existing dental implants.  There are two main categories of dentures.  They are dependent on whether you need to replace missing teeth on the mandibular arch or the maxillary arch.

Removable partial dentures are for those people who are missing or must remove some of their teeth or a dependent arch.   There is also fixed partial dentures, which are also called crowns or bridges, that are made from crowns that are fitted onto your remaining teeth, and are made from pontics made from materials to resemble the missing teeth.  Fixed bridges are more usually the more expensive option but are more stable than partial dentures.

Complete dentures are for people with no remaining teeth. An experienced dentist can take up to 15 hours and up to six appointments to complete dentures.   They are needed by patients who are missing all of the teeth in either single or both oral arches,  the maxillary (upper) or mandibular (lower) arch.

There are some problems associated with complete dentures.  Patients are not used to having something in their mouth that is not food.  The brain can  interpret a new denture appliance as food and starts to send signals to your salivary glands to produce more saliva and at a higher rate.   Usually this only happens in the first 24 hours,  The  salivary glands normally return it’s regular output. New dentures can also cause sore spots as they press the soft tissues that bear the dentures.  Denture adjustments following the implants of the dentures takes care of this issue. Getting used to new dentures is usually the most difficult problem.  Some people are prone to gagging, or experience a psychological rejection of the dentures.  This is out of the denture dentists control, but their experience and help will go a long way in helping you accept your new dentures.

Enamel shaping is an often unknown method to help correct the look of misshapen, rough, over sized or uneven teeth. Often overlooked because of it’s simplicity, enamel shaping really only involves restructuring or even removing a fraction of the outer  part  of your teeth to create a pleasant and  uniform appearance.   Usually, this process does not take a long time at all.  In fact, results can be seen in just a few minutes.

Enamel shaping is provides a quick and often perfect solution for many of the cosmetic flaws or irregularities you might feel in the shape, look or texture of your teeth. It’s  particularly great if you wish to correct minor problems such as, uneven front teeth, small chips or surface flaws, sharp canine teeth, teeth that appear too long, tooth overcrowding or unbalanced smile due to crooked teeth.

Enamel shaping, in most cases, can be completed in only one visit to the dental office.  Unlike many cosmetic procedures that require temporary teeth and a  many appointments, the results can be immediate. Further, because such a small amount of your enamel is removed, it’s usually pain free with no need for a  local anesthic or sedation dentistry needed.

Many cosmetic dentists will combine enamel shaping with various forms of dental bonding to allow for the teeth to be perfectly reshaped and help achieve a flawless surface appearance. Sometimes, if your teeth are extremely crowded and can’t be completely repaired with enamel shaping,  a cosmetic dentist can combine the treatment with  traditional dental procedures.

Bleaching your teeth is a procedure by which teeth are brightened, often called teeth whitening, using chemical agents, such as bleach in a gel state, that can dramatically affect the visible appearance of stained teeth.

Teeth whitening can be achieved by many methods, including bleaching strips, bleaching pens, bleaching gels, laser bleaching, and natural bleaching. One method, called at-home whitening, is done with a bleaching gel applied to the teeth with guard trays. At-home whitening is often done using commercially available whitening strips that are applied over the front teeth. For example, Crest Whitening Strips is one of the most popular at-home whitening products available.

Other chemicals, such as oxidizing agents like carbamide peroxide or hydrogen peroxide can be used to lighten the shade of the tooth. By penetrating the crystal structure of your teeth enamel, the agent used oxidizes stain deposits. Over a period of time, the layer lying below the enamel of your teeth, called the dentin layer, is also bleached.

There is also a method of bleaching called laser bleaching. Performed by an experienced Cosmetic Dentist, the method uses the laser light energy to speed up the process of bleaching in a dental office. The whitening affect achieved by bleaching can last for several months, but it also greatly depends on the patients lifestyle and habits. For instance, smoking and drinking of coffee, teas and red wine will lessen the effects of teeth whitening.

However, staining doesn’t just happen externally on your teeth, they can originate from the inside as well. At the dentin level, below the enamel, staining can discolor the teeth from inside out. This calls for internal bleaching, which can be a remedy. Extensive staining or damage caused by tetracycline often means that whitening has little or no effect, and an alternative method of whitening teeth is necessary, like  bonding.   Bonding is when a thin coating of composite material is applied to the front of a person’s teeth.  The material is cured with a blue light, and it maskes the staining.