The temporomandibular joint (TMJ) is the hinge joint that connects the lower jaw to the temporal bone of the skull, which is immediately in front of the ear on each side of your head. 

TMJ disorders (TMD)

The cause of TMD is not always clear, we know that the symptoms arise from problems with the muscles of the jaw or with the parts of the joint itself. Common symptoms include…

• Pain or tenderness in jaw joint area and in or around the ear when you chew, speak, or open your mouth wide. May occur on one or both sides.
• Jaws that lock in the open or closed-mouth position
• Clicking, popping, or grating sounds in the jaw joint when opening or closing the mouth
• Difficulty chewing or a sudden uncomfortable bite
• Limited ability to open wide

Because many other conditions can cause similar symptoms to TMD – including a toothache, sinus problems, arthritis, or gum disease – your dentist will conduct a careful patient history and physical examination to determine the cause of your symptoms.

Common Causes

• Grinding or clenching the teeth, which puts a lot of pressure on the joint
• Dislocation of the soft cushion or disc between the ball and socket
• Presence of osteoarthritis or rheumatoid arthritis in the TMJ
• Stress, which can cause a person to tighten facial and jaw muscles or clench the teeth
• Trauma to the jaw, TMJ or muscles of the head and neck – such as from a heavy blow or whiplash – can cause TMD.
• Habitual gum chewing or fingernail biting

Treatments

Jaw rest: It can be beneficial to keep the teeth apart as much as possible. Avoid eating hard, chewy, or crunchy foods such as harder raw vegetables, nuts or foods that require opening the mouth widely. Pre-chopping or blending these foods can allow for their consumption

Heat and ice therapy: These assist in reducing muscle tension and spasm. However, immediately after an injury to the TMJ, treatment with cold pack applications is best.

Medications: Anti-inflammatory medications such as ibuprofen, naproxen , or steroids can help control inflammation. Muscle relaxants, such as diazepam aids in decreasing muscle spasm.

The treatment of chronic TMD can involve Physical therapy, Stress management, Occlusal therapy (a custom-made acrylic appliance such as a mouth guard) or Corrective Dental Therapy. Surgery is used only in extreme cases as a last resort.

Our mouths are full of bacteria. These bacteria, along with mucus and other particles, constantly form a sticky “plaque” on teeth. Plaque that has not been removed can harden and form “tartar”.

The longer plaque and tartar are on teeth, the more harmful they become. The bacteria will eventually cause inflammation of the gums that is called “gingivitis.” Gingivitis is a mild form of gum disease.

If gingivitis is not treated the infection breaks down the gum tissue that attaches to the teeth. Gingivitis has then advanced to periodontitis where bacterial toxins from the plaque and the body’s natural response to infection start to break down the bone and connective tissue that hold teeth in place. If periodontitis is not treated, the bones, gums, and tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed.

The following are some of the warning signs of periodontal disease:

• Bad breath or bad taste that won't go away
• Red or swollen gums
• Tender or bleeding gums
• Loose teeth
• Gums that have pulled away from your teeth
• Any change in the way your teeth fit together when you bite

There are few factors that increase the risk for periodontal disease such as poor oral hygiene, smoking and diabetes.

Prevention and treatment Gingivitis can be controlled and treated with good oral hygiene and regular professional cleaning. More severe forms of periodontal disease can also be treated successfully but may require more extensive treatment. Such treatment might include deep cleaning of the tooth root surfaces below the gums and sometimes corrective surgery.

To help prevent or control periodontal diseases, it is important to:

1. Brush and floss every day to remove the bacteria that cause gum disease.
2. See your dentist at least once a year for checkups, or more frequently if you have any of the warning signs or risk factors mentioned above.

It is important to know that once your child has teeth, he/she is susceptible to tooth decay and that early childhood caries (tooth decay) is avoidable. Decay is associated with food and liquids high in sugar, bathing the teeth for extended periods of time. Bacteria in our mouth consume the sugar to create an acid that damages the enamel of a tooth. The longer and more often food is left in the mouth, the greater chance of developing ECC. Mother's milk, formula, cow's milk and fruit juice all contain sugars in quantities which promote ECC.

Babies may get decay from going to bed with a bottle of milk, formula or juice. Unrestricted at-will breast-feeding at night may increase the risk of tooth decay as well.

Primary teeth are very important for a child's development. Some primary (or baby) teeth will be in your child's mouth until age 12.  If teeth are not cared for, your child's ability to chew food properly will be compromised which can limit his or her ability to meet their dietary requirements.

If primary teeth fall out prematurely due to lack of care or treatment, general growth and development are compromised. The presence of teeth helps to guide proper growth and development of a child's head and neck.  Primary teeth also guide the permanent teeth into a better position which may help to eliminate the need and expense of orthodontic intervention later in life.

If you give your child a bottle at bedtime, stopping all at once will not be easy. Here are some tips:

1. Put plain water in the bottle.

2. If your child gets upset, do not give up. Comfort the child and keep on trying

3. If this does not work, try watering down your child's bottle over a week or two, until there is only plain water left.

Once your child has teeth, lift his or her lips once a month and check the teeth. Look for chalky white spots or lines on the teeth specifically along gum line of the front teeth. Darkened areas on teeth can also be a sign of tooth decay. If you see any signs, go to the dentist right away. Early childhood tooth decay must be treated quickly.

Parents and caregivers should start oral hygiene practices as soon as a baby is born by using damp gauze to wipe the mouth and gums pads after feedings. Once teeth start to erupt, introduce tooth brushing with a very soft toothbrush made for children. 

The Canadian Dental Association recommends the assessment of infants, by a dentist, within 6 months of the eruption of the first tooth or by one year of age. The goal is to have your child visit the dentist before there is a problem with his or her teeth.