Taming TMJ

TMJ (temporomandibular joint) Syndrome [also known as TMJ Joint Disorder] is a disorder that comes with a great deal of discomfort before an individual reaches out to their doctor or dentist for assistance. Located on each side of the head, the temporomandibular joints are the joints and jaw muscles that enable us to open and close our mouths. These joints, which connect the skull to the jaw, work together when we chew, speak or swallow. They include the jaw bone, along with muscles and ligaments that must work in harmony to be effective. They control the mandible – or lower jaw – in moving forward, backward and side-to-side.


Any problems that prohibit the jaw moving the muscle can cause pain that is experienced in a number of places about the head. Pain associated with TMJ Syndrome may involve the face, ears, forehead, neck or eyes. Some signs to look for include:


►Popping/clicking of the jaw


►Locking or dislocation of the jaw (usually after widely yawning), referred to as lockjaw


►Tightness, stiffness, or soreness in the jaw or neck muscles


►Pain in the jaw, particularly around of the joint area


►Pain in or around the ears or sounds of cracking in the ears


►Ringing or popping sounds (tinnitus) or a sense of fullness in the ears


►Headaches


►Blurred vision


►Facial pain, cheek pain, or chin tingling or numbness


►Pain in the shoulders

There are several things that are believed to contribute to TMJ Syndrome. Some of the most common causes are:

►Dislocation of the joint

►Stress

►Grinding teeth while sleeping

►Arthritis

►Injuring the jaw or jaw joint

►Misalignment of the teeth or jaw

What should you do if you are experiencing one or more of these symptoms? In addition to a conversation with your dental professional about the symptoms you are experiencing, there are several home remedies that may provide some relief. Some home remedies to try include:

►Stress Reduction

►Avoid chewing gum

►Avoid biting one’s nails

►Over the counter anti-inflammatories, such as ibuprofen or naproxen

►Ice packs to the affected area

►Gentle stretching of the neck and jaw muscles

►Relaxation techniques

What can be done when home remedies fail to stop your pain? If you have tried home remedies and are still experiencing pain, your dentist can suggest several options that can help. Your dentist will diagnose TMJ Syndrome by taking a medical history and doing a physical exam. The dentist will examine the joints and muscles for tenderness, difficulty in moving, range of motion and popping or clicking. Sometimes an MRI of the temporomandibular joint is ordered to determine damage to the joint, as well as to rule out other medical problems in the area.

Following a diagnosis of TMJ Syndrome, your dentist may recommend a dental splint, which is a dental appliance placed in the mouth. The splint keeps teeth aligned and prevents tooth grinding. Relief using this method is often swift as no further damage can take place while you are asleep.

Your dentist may also recommend physical therapy to strengthen muscles, increase range of motion and improve flexibility. Physical therapy involves an array of exercises for the jaw. Where necessary, your dentist may recommend fixing an uneven bite by adjusting or reshaping a number of the teeth. Orthodontic treatment may also be recommended.  Some dentists prescribe medications to aid in treatment. Muscle relaxants, anti-anxiety drugs, steroids and anti-inflammatories are among the possible medications that may be prescribed. Finally, in severe cases of TMJ Syndrome, dental surgery or surgery on the jaw may be necessary. Your dentist will suggest a course of treatment based on the severity of your condition and the cause identified.

TMJ Syndrome causes discomfort and pain, but it is treatable. There is no need to remain in pain. If you are experiencing any of the symptoms listed above and need help, do not wait. Call your dentist for an appointment. Get answers and get relief.

Remember to keep checking back for new posts offering you more information about dental care issues and concerns. Your good oral health is our concern!

Wishing you bright smiles!

Your Dental Checklist – Part II

Our last post discussed the importance of having a check list for your daily dental care routine. A list for daily use will help you avoid missing steps needed to keep your teeth healthy and white. Check lists are also wonderful for preparing [in advance] for your dental appointments. They provide a practical way to make sure your questions and concerns are discussed with your dental care provider during your next visit.

With this in mind, as part two of our dental check list discussion, let’s look at items you may want to include on your check list for your visit to the dentist. During your dental check-up, ask your dentist what the visit will consist of (cleaning, X-rays, etc.). You may want to consider these additional questions to ensure you are getting answers that make you feel comfortable with your provider and set you on a course for good oral health:

My Dental Visit Check List:

□ What should I do to keep my gums and teeth healthy?

The dentist or dental hygienist should be able to demonstrate proper brushing and flossing techniques to you, as well as identify any areas of the mouth you seem to be missing in your regular routine.

□ Should I use a fluoride rinse?

Your dental care provider should discuss with you the choices available in fluoride rinses and which he/she recommends. If you are partial to one brand, ask your dentists’ opinion of its efficacy. The same holds true for recommendations on toothpaste and brand of toothbrush. Your dentist can provide suggestions on which will give you greater results for your daily brushing efforts.

□ How can I improve my dental health?

Your dentist can offer tips on how to improve your dental health or provide educational materials that you can peruse following your visit. Websites may also be recommended that can give you a good deal of information about improving long-term dental health.

□ What do you need to know about my health history and medications to evaluate my oral health?

Your dentist may ask about your general health and for a list of your current medications which could explain findings during your check-up or have effects on your oral health. 

□ Have you seen any warning signs of a possible medical condition that I should relay to my doctor?

The dentist may be the first to see signs of a wide array of systemic diseases, such as osteoporosis. Dental X-rays and exams often show early warning signs of issues that may be present in the body. Your dentist may recommend seeing your physician for a full evaluation if signs are present. Remember, better safe than sorry.

□ Can you help me quit smoking?

Smoking has a wide array of negative effects on overall health as well as dental health. From yellowed teeth to oral cancer, smoking is one of the greatest enemies to your mouth as well as the rest of your body. Your dentist will be delighted to hear you want to quit smoking and can direct you to a number of sources to help you successfully kick the smoking habit. If you are a smoker, please consider quitting today. Ask your dentist for assistance today...don't wait until your visit. Call today. The dentist or office staff will gladly guide you on getting started right away.

If your visit to the dentist is a first time visit, you will also want to confirm that you are at a practice at which you feel comfortable. After all, you want to develop a long-term relationship with your dental care provider. These are additional questions to ask at the front desk:

□ Is the dental office close to your home or office?

Is the location convenient for you and/or your family? We lead such busy lives these days. As in all things related to real estate, remember…location, location, location. It is helpful if the office is near your home, office or other location that you frequent.

□ Are the office hours convenient for your schedule?

Make sure that your dentist is open at times when you will be able to get in for a check-up without needing to take time off from work or having to take your child out of school.

□ Does the office appear to be clean and well organized?

This is one to ask yourself…if the location appears unclean, will you want the dentist working in your mouth? If the office seems disorganized, will you worry that they did not schedule you correctly or process your insurance accurately? There is a lot to be said for comfort and trust. These things come from a practice that is clean and well run.

□ Is the office staff friendly and helpful?

This is, again, yours to answer. You should feel welcomed when you enter the office and treated with respect throughout your visit. If the office staff is rude or unwilling to be of assistance, this may not be the practice for you.

□ What is the office policy for cancelling or rescheduling appointments?

Be sure to ask about this policy, particularly if you are prone to getting to places late or are often in need of rescheduling. Most practices have a 24 hour cancellation policy in place. Be sure to know it ahead of time.

□ How are dental emergencies handled?

Dental emergencies can happen at hours when a practice is typically closed. How will the dentist handle your emergency? Be sure to know his or her plan for patients during off hours. Learning what the process is in the middle of an emergency is never a good plan!

□ What is the policy on fees and payment plans?

Office staff should be able to explain which insurances are accepted and what types of payment arrangements may be made. Before agreeing to begin any course of treatment, you should know the costs and what options you have available to manage your bill.

Finding a practice that meets your dental care needs and making of the most of each visit will set you on a course for good dental health.

Remember to stop back for our next post where we will offer more information about dental care issues and concerns to help you best care for your oral health.

Wishing you bright smiles!

Your Dental Checklist – Part I

If you are like me, check lists help you get to the end of each day, week, and month having accomplished all that needs to be done on the list. Checking off items on a check list has actually been shown to be psychologically beneficial in goal setting; it is cathartic to see what is done and what still remains. Check lists can be a good tool when it comes to keeping your teeth healthy as well.

How can check lists help with dental care? There are two key check lists that come to mind for dental care. The first is a list for your dental care routine. As an adult, your routine is probably well established. However, it is always a good idea to review the list to ensure that everything that needs to be included in your routine is actually there. Additionally, if you are a parent or a child caring for an aging parent, using a list for establishing or ensuring the continuation of a good dental routine can be an important tool. The second list is a check list of topics or questions for your dental visit. Being prepared [with a list made in advance] to discuss questions or concerns with your dentist is a great way to make sure you do not forget anything that needs clarification or some explanation.

For today’s topic, we will go through a check list for your dental care routine. But, be sure to stop back in to our blog for our next post, which will cover the check list for your visit to the dentist.

My Daily Dental Good Health Check List:

□ Did I brush at least twice today?

Be sure to brush twice daily, particularly after meals or eating foods that may stick to teeth. Be sure to brush two to three teeth thoroughly, and then move on to the next cluster of two to three. Don’t forget to brush your tongue, too. Brush for at least two minutes, though five is better. For small children, use a two minute timer to be sure they are spending enough time brushing away food and debris before they turn to plaque.

□ Did I store my toothbrush uncovered and standing upright?

Storing your toothbrush this way will allow bristles dry fully so they are effective for the next time you brush. Without moisture from being covered, microorganisms are less likely to grow.

□ Did I floss before brushing?

Someone once asked me if I need to floss all of their teeth. The response, Only the ones you want to keep." Flossing removes stubborn food stuck between teeth so it cannot develop into plaque that will erode your teeth It is an essential part of your routine as it may help prevent gum disease, which is associated with heart disease, stroke, lung issues and Alzheimer's disease.

□ Did I check to make sure my toothbrush is still in good shape? Have I chosen a good toothbrush?

Check your toothbrush daily to make sure bristles are still standing up straight, not pushed off to the side and unable to do their job. We recommend changing your toothbrush every six weeks to avoid bacteria build up and ensure bristles are strong. Be sure to select a toothbrush with a small head and soft bristles. The small head will help you access hard to reach places in your mouth, while soft bristles will keep you from hurting yourself by brushing too hard.

□ Did I rinse with an anti-bacterial mouthwash after brushing?

We all miss places in our mouth when brushing. Mouthwash helps rinse loosened plaque and wash away bacteria. As a bonus, your breath will be minty fresh! For children, there are kids’ flavors to get them used to using mouthwash and enjoying a favorite character on the bottle.

□ Did I make sure to eat right today?

Busy lives often result in quick food choices rather than healthy ones. There are some quick things to remember when choosing what to eat, drink and snack. Remember to drink water. It washes away food bits in your mouth and is vital to every organ of the body. Choose cheese to snack on. The calcium is important for your teeth and stimulates saliva. Fruits and vegetables really are your friends! They are fiber rich, helping stimulate saliva that keeps food moving toward the stomach and neutralizing acids that attack the teeth. Plus the sweet taste can satisfy your need for a treat with artificial sugar. Sugars contribute to tooth decay. Don't feel as though you have to give up sweet foods entirely.  Try to enjoy sweet treats in moderation and, of course, be sure to brush.

□ Did I schedule my regular dental check-up?

Seeing the dentist twice per year will enable you to catch any dental issues that may be starting, as well as get a professional teeth cleaning.  Visiting your dentist now may save you time, money and pain later. Be sure to schedule your visit.

Checking off each item daily and making sure to go for regular check-ups will help you ensure a healthy mouth, and are good for your overall health.

Remember to check back in next week for Part II for a check list to bring with you to the dentist.

Wishing you bright smiles!

Healthy Smile, Healthy Heart

February is, for many, the month of the heart.  As Valentine’s Day approaches, we turn our thoughts to those we love and prepare for the day with flowers, chocolates and reservations for dinner.  While the heart may grow fonder from these lovely gestures, the heart may be healthier if your oral health is healthy too.

Many reports have been published on the oral-systemic link. This is the relationship between your oral health and your overall health. In no part of the human body is that more evident than the relationship between good oral health and good heart health.  Study after study has shown that those with moderate to severe gum disease (gingivitis early on and periodontal disease in its later stages) are at an increased risk of developing heart disease.

There is an abundance of plausible data showing that the two are intertwined. The leading body of cardiologists and the leading body of periodontists in the U.S. recently came together to publish a report in each of their respective professional journals on the topic, following the review of more than 100 studies showing the link between oral health and heart health. They arrived at several conclusions linking the two including:

• Gum disease is a risk factor for coronary heart disease
• Gum disease is a risk factor for stroke
• There is a direct link between gum disease and clogged vessels in the legs

How to Tell if You are At Risk

Poor nutrition, diabetes and tobacco use, among the highest risk factors for heart disease, are also risk factors for gum disease. In fact, many risk factors for one will be found on a list of risk factors for the other. When plaque builds up below the gum line or along the gum line, gum disease begins to develop. A growing body of research shows that the bacteria contributing to this gum disease can actually detach and move along the bloodstream to attach to blood vessels. This begins the process of clot formation. These clots clog the arteries, making it difficult for blood to flow freely, and increasing the risk of a heart attack.

What Signs Should You Look for

Gum disease is often undiagnosed, yet affects the majority of people in the United States. Your best defense is to pay attention for any warning signs that gum disease may be beginning. If you are experiencing any of the following, it is time to act:

• Bleeding gums when flossing or brushing
• Red, tender or swollen gums
• Gums that appear to be separating from teeth
• Loose teeth
• Chronic bad breath

Any one of these symptoms on their own may not mean gum disease is developing, but the best course is to discuss it with your dentist. Make an appointment today for a check-up, cleaning and a discussion of whether you are showing signs of gum disease.

What Can You Do

It is vital that you take steps each and every day to ensure good dental health.  Thorough brushing and flossing is key, and be vigilant about seeing your dentist for regular check-ups and cleanings. Your dentist will provide a comprehensive exam that should include checking for any signs of gum disease and a vigorous cleaning to remove any plaque or tartar that has built up since your last visit.

If you have been diagnosed with gum disease, even in its early stages, you should schedule an appointment with your doctor. Having your doctor and your dentist work together on ways to help you reduce your ongoing risk of heart disease is important in your overall planning.

A cardiologist can be a great ally in your battle to combat heart disease – either to prevent an initial diagnosis or, if already diagnosed, to prevent progression of the disease process. Your cardiologist can work with you to reduce blood pressure, increase blood flow and make your heart a healthier organ once again. Many cardiologists do this by prescribing medications designed to improve blood pressure, cholesterol and overall health of the cardio vascular system. Some cardiologists, however, are expanding to a more integrative approach. At PM Dental Care, we live under the same roof as Integrative Cardiology Center of Long Island (ICCLI), a practice offering a combination of traditional medical therapies with yoga, weight loss, stress reduction, vitamins and supplements. Dr. Regina Druz, founder of the practice and an experienced cardiologist, brings her expertise along with that of each member of her team, to patients seeking a comprehensive approach to good heart health. Patients walk in for their preliminary visit apprehensive about what can be done to improve their heart health. Following the course of treatment laid out by Dr. Druz and her team has resulted in smiling patients, many of whom note they feel better now than they have in years. For more information on Integrative Cardiology Center of Long Island or Dr. Regina Druz, visit www.ICCLI.com or call (516) 746-1103.

The various systems and parts of our bodies do not operate in a vacuum. The intertwining of our systems means we need to take good care of ALL of our systems. And taking care of one part, may benefit another. So keep up the good daily dental care you may reap the benefits all over your body.

One last Valentine’s Day note…dark chocolate is rich in antioxidants that may benefit the heart. So, you can enjoy some holiday sweets while with your sweetie too.  Just be sure to brush before bedtime.

Wishing you bright smiles to fill your day and a healthy heart to keep you going.

When the Pain is too Much... Knowing What to Do in a Dental Emergency

Mouth pain might be slow to begin and get worse until the level of pain becomes unbearable, as can happen with an infection or worsening condition with a tooth or its root. It can also be sudden onset as is often the case with an injury. As is with most things in life, it is better to have a plan in place for what to do should you find yourself in need of relief from mouth pain.

In our house, we keep a list with phone numbers for emergencies of all kinds. ‘Be prepared’ is the motto and the best way to do that is to know what your options are in the event of an emergency. We know the process for off-hours calls to our children’s pediatrician, where we can get care if our doctors’ practices are closed, even who to call if the dog is under the weather on the weekend. But most people have little or no idea where to turn if they are in dealing with mouth pain and their dentist’s office is closed.  Our best suggestion, don’t wait until an emergency happens; add a number onto that list today. Contact your dentist and ask what their policy is for emergency situations. They may have a plan in place for patients or another practice to which they refer when closed. “Go to the emergency room”, however, is the answer you do not want to hear. If that is the case, I would put another plan in place.

Be sure to have some dental emergency supplies on hand. You will need ibuprofen (please do not take aspirin), saline solution, gauze, ice pack, and either a small container or a zip tight bag (if your emergency is a knocked out tooth, braces, bridge, etc. place it in the container or bag for transporting to the dentist without further damage. If the tooth is completely knocked out, be sure to handle it only from the tooth, not the root. Any chance of saving the tooth may be lost by handling the root directly).

If your emergency involves the knocking out or loosening of a tooth, bridge, crown or veneer, be sure to call for an appointment right away. Rinse with warm water and take ibuprofen to reduce any pain. Injuries involving the inside of the mouth should also be tended to immediately, preferably by an oral surgeon. Again, warm water and ibuprofen are the first order of business, followed by a swift departure to the dentist’s office.

At EmergencyDentist.com, help is only a phone call away. With locations in New York City and on Long Island, our team will see you and work to get you out of pain as quickly as possible. Our professionals include dentists, oral surgeons, dental anesthesiologists, and dental technicians – all of whom prescribe to our motto of Dental Care When You Need Us Most.

As with any relationship, having trust in your dentist is critical. When you are in pain, having a professional with whom you have a relationship can help you relax so that the team can do their best to help get you out of pain. We take that trust very seriously, and do everything possible to help reduce your stress, lesson or eliminate your pain, and get you back to your busy life. 

Learn more about emergency dental needs and how EmergencyDentist.com can help you by visiting PMDentalCare.com/Emergency.html. If you have specific questions about emergency dental care, email us at info@emergencydentist.com – we are here to help.

Wishing you bright smiles to fill your day.

Start the Year Off Right - Proper Nutrition for Your Healthy Smile

With New Year’s right around the corner, you are probably considering your upcoming 2015 resolutions. While some resolutions are a big undertaking, it’s not hard to resolve to eat healthier to achieve a healthier smile. We care about your smile and your long-term oral health. And, with a growing body of evidence connecting oral health and overall health, you can feel confident that eating healthier will benefit your smile and your overall well-being.

What does proper nutrition mean? The answer is: several things. Resolving to improve your nutrition means taking stock of your overall eating habits. This will ensure your daily intake includes a healthy number of calories. For men, the number of calories per day should range between 2,000 and 3,000 depending on age, height, activity level, etc. For women, the range is 1,600 to 2,000 per day. And, for children, the range is 1,000 to 2,000 calories per day. But proper nutrition means a lot more than caloric intake. It also involves looking at what those calories are comprised of. Are you eating foods from all of the basic food groups? Are you getting enough protein? Is your fruit and vegetable intake high enough? Are you consuming too many empty calories…foods that taste good, but offer little nutritional value?

Most people are aware that eating healthy, balanced foods will go a long way in trying to stay healthy. What most people do not know, however, is that eating healthy can help prevent tooth decay and gum disease, important news when you are trying to make sure you have a beautiful and healthy smile. Generally, speaking, good nutrition is good for your total health, and that includes your oral health. Fresh fruits and vegetables, lean meats, whole grain foods and nuts will help your body sustain a more alkaline state. This will help protect you against inflammation and attacking bacteria, which can help protect your gums and teeth. These foods strengthen immunity with their many nutrients and natural antioxidants.

Foods that may make you more prone toward an acidic state, which increases bacteria and inflammation, are those with refined sugar, high fructose corn syrup, food coloring, artificial preservatives or sweeteners, and partially hydrogenated oils.  We know everyone enjoys an occasional indulgence, foods such as these are one to limit in your diet.

As you work toward a healthier diet, look for these foods or clues to foods to know you are making a good, healthy choice…

►Fresh, crisp fruits and raw vegetables help remove plaque from teeth and freshen breath while providing an array of vitamins and nutrients. They protect gums and other cells within the body from damage and bacterial infections.

►Boost your bones with calcium-fortified juices, milk and other dairy products. They are high in calcium and vitamin D. They help reduce the risk for tooth loss.

►Fresh cranberries are now known to stop bacteria from sticking to teeth before it can form plaque, preventing damage before it starts.

►Folic acid is vital for pregnant women and their growing babies. It aids in cell growth throughout the entire body and supports a healthy mouth. Eating dark, leafy vegetables will give you a tasty supply. Avocados, asparagus and spinach are three top sources of folic acid.

Did you know that when you eat is also important to promoting good oral health? “How is this possible?” you might ask. Foods requiring a long time to chew or that you keep in your mouth (such as gum or sucking candies) hold sugar against teeth longer which may result in damage. These are ones to limit in your diet.

For those who want to have some foods known to be high in carbohydrates, acidic or sugary, try not to snack on these foods. Instead, eat them during meal times. During meal time, your body produces more saliva, which will wash away more harmful acids, thus, protecting your teeth from. Remember to avoid sweet, sticky foods that can stick to your teeth. These offer no benefit to your mouth or your body. Try dental smart snacks such as cheese, nuts, raw vegetables, fruits and yogurt.

Last, but certainly not least, remember to drink lots of water throughout the day. In addition to hydrating the cells in the body, water helps keeps your mouth moist, stimulating saliva. This protects both oral tissues and keeps your mouth fresher.

Small steps are all it takes to walk your body toward better oral health. With a healthier mouth and body, and a brighter smile, you will be happy you did!

Happy New Year!

Dr. Ari Druz

and the team at PM Dental Care

You Don’t Need to be Afraid of the Dentist!

Overcoming Anxiety Related to Dental Care

For millions of people, visiting the dentist can produce anxiety and stress that can keep them from routine dental care and even prevent them from seeing a dentist when experiencing mouth pain. Experts estimate that more than 20% of the population experiences enough emotional discomfort to avoid the dentist unless they are in significant pain. 5-10% experience a significant enough dental phobia to avoid the dentist completely.

Proper dental care is more than simply a check-up or having a bad tooth extracted. Dentists work with patients to avoid or treat gum disease, a condition that, if left untreated, can lead to serious medical problems. In other words, visiting your dentist regularly is more than a nicety…it is a necessity for good health.

So how do you get to the dentist when you fear the visit? Fortunately, many dentists have been trained in handling patients who are experiencing fear related to their dental care. There are many techniques and tools for reducing any discomfort and ensuring a successful visit for the patient.

At PM Dental Care, in Mineola, LI, we want your dental experience to be a positive one. That’s why we make every effort to ensure your comfort.  We explain every step of the process, to avoid any surprises. And, we check with you at every stage to make sure you are ready for the next steps.

If you are someone who suffers from dental phobia, do some research…ask friends or others who you trust for a recommendation. Go visit the office before your appointment. You can even ask to meet the dentist first to make sure you get a good feeling from him or her.  An eye to eye conversation can be very helpful before sitting in the dental chair. At your appointment, you may try several techniques to keep calm – from deep breathing exercises to listening to music to focusing on an image that calms you (bring a favorite photo with you) – there is an array of self-soothing techniques to help you through the experience.

And, for those, who need to ‘sleep’ through the procedure or check-up, we have a dental anesthesiologist on staff, who can offer sedation therapy. He can help determine the best choice for you and for the procedure you need. Whether you need anesthesia, nitrous oxide (laughing gas) or IV sedation, we can accommodate you. Once the procedure is over, you will awaken to find your procedure is over and you are better than alright!

Avoiding dental phobia is yet another reason to begin bringing small children to the dentist. Children who see their dentist twice annually from a very young age come to know the dentist as someone on their side in staying healthy, just like their pediatrician. In developing a relationship with the dentist early on, children can avoid the issue of dental phobia from ever beginning. If your child is over two years of age and has never gone for a check-up, or it has been more than six months since your child’s last visit, one should consider making an appointment.

Dental phobia is a serious issue. But there are many solutions and one will be right for you. So be sure to get your check-ups taken care of…the dentist is really there to help!

Have a great day and a bright smile!