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TMJ is the quick way of referring to your Temporomandibular Joint. Pardon the pun, but that’s quite a mouthful! What is this joint, what does it do, and, if your Dr. Vincent Cardinale and Dr. Chris Moody and our team have told you that you have a TMJ disorder, what can we do to help?

The Temporomandibular Joint

Your two temporomandibular joints are amazing works of anatomical design. These are the joints where the temporal bone in the skull meets the mandible bone of the jaw, and allow our mouths to open and close, move back and forth, and slide from side to side. Muscle, bone, and cartilage work together to provide easy movement and to cushion the joint. But sometimes, the joint doesn’t work as smoothly as it should, and this can lead to Temporomandibular Joint Disorder, or TMD.

When Should You Suspect You Have TMD?

You might have TMD if you experience any of these symptoms:

• Painful chewing
• Pain around your TMJ, or in your face or neck
• Earaches
• Changes in your bite
• Jaws that are limited in movement or lock open or shut
• Clicking, popping or grating noises when you open and shut your jaw

There are many conditions linked to TMD. If you grind your teeth at night, have arthritis in the jaw, have suffered an injury or infection in the area, or have problems with your bite, for example, you might be more likely to have TMJ problems. If you suspect you have TMD, or suffer from any of the symptoms listed above for an extended period, give us a call.

Treating TMD

During your visit to our Naples, FL office, we will check your medical history, and examine your head and neck. We can take an X-ray or scan if needed for further examination of the joint. Because there is no real scientific agreement yet about the best way to treat TMJ disorders, a conservative treatment plan is often best. If you do show signs of TMD, we might first suggest relaxation techniques, over-the-counter pain relievers, or the use of ice packs or moist heat compresses. A change to a softer diet can help, and you should stop chewing gum and making any exaggerated jaw movements.

If these self-care practices aren’t effective, we might suggest a nightguard. This appliance is a comfortable and flexible mouthguard custom fitted for you, and will bring relief from teeth grinding when worn at night. If this treatment is not effective, talk to us about other options.

Luckily, most cases of TMD are temporary and don’t become worse over time. But any persistent discomfort is a good reason to visit us. Whether you have TMD, or any other problem causing you pain in the head or jaw, we want to help.

We know that the foods we eat and drink can have a definite impact on our smiles. Staining is an unhappy side effect of many of our menu favorites. That’s why we sip red wine through a straw, rinse with water after a slice of blueberry pie, and cut back on the coffee and tea after a single cup (or two—we’re not perfect!). And sugar is the fuel for cavity-causing bacteria, so we try to substitute water for soda, or replace the hot fudge sundae with grilled fruit. And we always brush carefully after indulging.

So far, so good. But while we’re saving our brilliant smiles from stains and decay, let’s not forget one other source of diet-related damage—acids. Acidic foods and beverages can actually erode the surface of our enamel, leaving our teeth more vulnerable to sensitivity and discoloration.

What Is Dental Erosion?

Enamel is the strongest substance in our bodies—stronger than bone—but it is not indestructible. And acids are one of the major causes of enamel damage. (In fact, it’s the acids produced by bacteria that lead to cavities.) Luckily, our bodies are designed to protect our enamel. Saliva helps clean the teeth by washing away food particles and it neutralizes acidity as well. But a diet that’s too heavy in acidic foods can undo all this good work and upset the healthy pH balance in our mouths.

Why is this a problem? Because acidic environments actually cause the minerals in our enamel to break down, a process known as “demineralization.” This weakening of the enamel leaves teeth more sensitive to heat and cold. It can even lead to discolored teeth, as thinner enamel allows the brownish-yellow dentin underneath the enamel surface to become visible.

Are You Aware of Acids?

We can immediately guess at some of the most acidic foods. Citrus fruits and juices, tomatoes in their many culinary forms, anything pickled in vinegar, coffee, tea, wine—these foods are certainly acidic, but also a regular part of many a healthy diet. You don’t need to avoid these foods altogether, but it’s best to enjoy them as part of a meal or enjoy them sparingly. And balance out some of these high-acidity foods at mealtime with low-acidity choices like bananas, bread, and dairy products.

Other sources of damaging acids might surprise you. Studies have linked sodas, energy drinks, and sports drinks to higher levels of tooth erosion. The combination of citric acid, phosphoric acid and/or carbonation raises acidity levels in the mouth. And because we tend to sip them all day long, it’s like a continuing acid bath for our enamel. Water is always a healthy alternative for hydration, but if you do indulge in a soda or sports drink, rinse with water after drinking. And don’t swish—just swallow.

Won’t Brushing Help?

Yes, but watch your timing. Because the acids in foods weaken enamel, brushing right after a big glass of orange juice or a soda can actually be even more abrasive for tooth surfaces. We recommend waiting anywhere from 20-60 minutes to brush. This gives your saliva the chance to not only wash away acids, but to “remineralize” your teeth, bathing them in the phosphate and calcium ions that strengthen enamel.

If you notice any of the symptoms of dental erosion, including pain, sensitivity when you eat or drink something hot, cold or sweet, or yellow discoloration, talk to Dr. Vincent Cardinale and Dr. Chris Moody during your visit to our Naples, FL office about what you can do to help protect and strengthen your teeth. Unfortunately, our bodies can’t produce new enamel. By avoiding foods that stain, by reducing sugars that lead to decay, and by limiting the acidic foods that erode our enamel, we give ourselves the best opportunity for a lifetime of beautiful, healthy smiles.

Sawing wood. That’s what your wife calls it when you wake her up with your snoring. This type of scenario plays out in homes around the world, and couples have to find a way to make light of the nocturnal annoyance. Snoring can become more than just an irritating nighttime disturbance, however. It can be the first sign of a potentially serious sleep disorder.

Sleep apnea is a disorder in which breathing repeatedly pauses throughout the night. Possible symptoms of sleep apnea include snoring loudly and feeling tired after a full night’s sleep.

Three health problems linked to sleep apnea

Sleep apnea often goes undiagnosed and untreated, which puts you at a greater risk of developing health problems. While being robbed of quality sleep can take its toll on you, sleep apnea can also result in the following.

1. High blood pressure. When you wake frequently throughout the night, it causes your body's hormonal systems to become unbalanced and go into overdrive. This results in high blood pressure.
2. Heart disease. The disrupted oxygen flow caused by sleep apnea increases your chances of having a heart attack or stroke. The cutoff of oxygen makes it difficult for the brain to regulate the flow of blood in the arteries.
3. Excessive daytime sleepiness. Daytime fatigue often results in impaired judgment and slow reaction times, and this may increase your risk of being involved in a motor vehicle accident.

Lifestyle changes like losing weight, avoiding alcohol, and quitting smoking are often enough to cure sleep apnea. Medical treatment is also a potential solution. Surgery, oral appliances, and continuous positive airway pressure (CPAP), which is a treatment involving a specialized breathing mask, are all possible ways to resolve the problem of sleep apnea.

If you think you may be suffering from sleep apnea, or to schedule a visit with Dr. Vincent Cardinale and Dr. Chris Moody at our convenient Naples, FL office, please give us a call! Our entire team at Cardinale Dentistry look forward to giving you back a full night’s rest!

Let’s see…

Toothbrush? Check.

Fluoride toothpaste? Check.

Floss? Check.

Two minutes of thorough brushing? Check.

Careful cleaning around your brackets and wires? Check.

Wait… there’s something else… it’s right on the tip of your…

Ah! Your tongue! Whenever you brush, morning, evening, or any time in between, if you want the freshest breath and cleanest teeth, don’t forget your tongue.

Why your tongue? Because the tongue is one of the most common sources of bad breath. Let’s examine just why this occurs.

The tongue is made up of a group of muscles that help us speak and chew and swallow. But there’s more to this remarkable organ than mere muscle. The surface of the tongue is covered with mucous membrane, like the smooth tissue which lines our mouths. But the tongue isn’t completely smooth—it’s textured with thousands of tiny bumps called papillae.

These little elevated surfaces have several shapes and functions. Some make the tongue’s surface a bit rough, which helps move food through your mouth. Some are temperature sensitive, letting you know that your slice of pizza is much too hot. And some are covered with thousands of the taste buds, which make eating that pizza so enjoyable.

All of these papillae with their various functions combine to create a textured surface, filled with miniscule nooks and crannies. And if there’s a nook or a cranny where bacteria can collect, no matter how miniscule, it’s a good bet that they will, and the surface of the tongue is no exception. But bacteria aren’t alone—the tongue’s surface can also hide food particles and dead cells.

How does this unappealing accumulation affect you? These elements work together to cause bad breath, especially the bacteria that break down food particles and cell debris to produce volatile sulfur compounds—compounds which create a particularly unpleasant odor. Including your tongue in your brushing routine helps remove one of the main causes of bad breath.

And that’s not the only benefit! Cleaning the tongue helps eliminate the white coating caused by bacterial film, and might even improve the sense of taste. Most important, studies show that regular cleaning noticeably lowers the levels of decay-causing plaque throughout the mouth.

So, how to get rid of that unwanted, unpleasant, and unhealthy debris?

• When you’re done brushing your teeth, use your toothbrush to brush your tongue.

Clean your tongue by brushing gently front to back and then side to side. Rinse your mouth when you’re through. Simple as that! And just like a soft-bristled toothbrush helps protect tooth enamel and gum tissue, we also recommend soft bristles when you brush your tongue. Firm bristles can be too hard on tongue tissue.

• Use a tongue scraper.

Some people find tongue scrapers more effective than brushing. Available in different shapes and materials, these tools are used to gently scrape the surface of the tongue clean of bacteria and debris. Always apply this tool from back to front, and rinse the scraper clean after every stroke. Wash and dry it when you’re through.

• Add a mouthwash or rinse.

As part of your oral hygiene routine, antibacterial mouthwashes and rinses can assist in preventing bad breath. Ask Dr. Vincent Cardinale and Dr. Chris Moody for a recommendation.

• Don’t brush or scrape too vigorously.

Your tongue is a sturdy, hard-working organ, but tongue tissue is still delicate enough to be injured with over-vigorous cleaning.

Taking a few extra seconds to clean your tongue helps eliminate the bacteria and food particles which contribute to bad breath and plaque formation. Make this practice part of your daily brushing routine—it’s a healthy habit well worth remembering!