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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. Joseph Brogan 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 Philadelphia, PA 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.

You might be surprised to learn that Dr. Joseph Brogan and our team recommend an orthodontic appointment even before your child has had that last visit from the Tooth Fairy. In fact, orthodontic assessments at our Philadelphia, PA office can be beneficial at many stages of your child’s life. Let’s look at some of the reasons why.

The Right Spaces

There’s a reason why we recommend that every child see an orthodontist by the age of seven. If there’s room enough in your child’s mouth to accommodate all the permanent teeth that will be arriving soon, you’re good to go. But if it looks like there won’t be enough space for those adult teeth, there are solutions we can offer to make the transition from baby teeth to adult teeth a smoother one.

• If your child’s mouth is small, the permanent teeth might have too little room to fit in when they arrive. We may recommend gently enlarging the upper dental arch with the use of a palatal expander. This device will provide room for the adult teeth, and could potentially shorten second phase treatment time.
• Too much space can also be a problem. If a child loses a baby tooth too soon, too much space between the remaining teeth can cause them to shift out of position, leaving the wrong spot open for the adult tooth to come in. We might recommend a space maintainer so that there is no shifting of the teeth, and there is room for the adult tooth to erupt in its proper spot.
• If there is a bite problem, early treatment can prevent more serious problems down the road.

If no treatment is necessary immediately, we can monitor the development of your child’s teeth and bite during periodic visits.

(Stay in) The Right Places

Once your child has achieved that perfect smile, it’s time to maintain it. Teeth actually move and shift throughout our lives, whether we have had orthodontic treatment or not. But with orthodontic treatment, the bone tissue and ligaments around the teeth remodel over time to hold the teeth in their new and improved positions. That’s why it’s often important to wear a retainer constantly for several months after the braces come off, as bone and ligament become a firm, strong anchor for the newly aligned teeth and bite.

But there’s no one expiration date on retainers! Worn nightly as needed, they help teeth stay securely in their new positions for a lifetime of beautiful smiles.

Healthy Smiles Mean Happy Faces

If you think your child is ready for any phase of orthodontic work, give us a call. We will be happy to make sure there is ample room for permanent teeth to erupt in their proper spots even during the baby teeth years. If braces are indicated at a later date, we will analyze any potential alignment and bite problems and present all of your treatment options. Finally, after the orthodontic work is completed, we want to make sure your child knows the best way to maintain that beautiful smile with conscientious retainer wear.

If you have any concerns about your child’s teeth or bite, even before the permanent teeth arrive, give our Philadelphia, PA office a call. Early treatment can often prevent future problems and might even lead to faster orthodontic results. At each stage of your child’s growth, we are here to provide your best options for healthy, happy smiles.

Some experiences are great, and we look forward to enjoying them again and again. Others have wonderful outcomes, but you feel no need for a sequel. If you’re wondering whether you need to revisit orthodontic treatment, you’re probably in this second group.

After all, you put in your time as a teenager. All those days in bands and braces, all the adjustments, all that cleaning with little tiny tools in little tiny places. That was a lot of work, and you reaped the rewards of your conscientious orthodontic habits with beautifully aligned teeth and a healthy, comfortable bite.

But now you’ve started to notice that your teeth aren’t quite as beautifully aligned, or your bite’s not quite as comfortable. So, what’s happened? Let’s look at some possibilities, and whether a return to the orthodontist’s office is in order.

• You’ve Lost a Tooth

If you’ve lost a tooth because of injury or decay, that gap is an open invitation for surrounding teeth to move in to fill the void. Whenever you lose a tooth, consider an implant. Implants function, look, and maintain healthy spacing just like natural teeth.

One thing implants can’t do? Move like our own teeth will during orthodontic treatment. Your natural teeth can move because they are held in place within the bone by flexible periodontal ligaments. Implants, on the other hand, are anchored directly to the bone for stability.

If you’re considering new or further orthodontic work and want to replace a lost tooth with an implant, it’s a good idea to talk to Dr. Joseph Brogan to discover the best timing and scheduling for your procedures.

• You’ve Gained a Tooth

Problems with your alignment can also arise if you add a tooth or teeth. If you’re in your late teens or early twenties, wisdom teeth could be in your near future. And a new tooth can throw off the spacing and alignment of your existing teeth.

Talk to Dr. Joseph Brogan about your options if your wisdom teeth are about to make an appearance, and if it looks like your tooth and bite alignment might be affected.

• You’re Getting Older

Our teeth naturally tend to shift as we age. Teeth move forward, causing crowded or crooked front teeth—especially on the lower jaw. There’s even a medical term for this phenomenon: mesial drift. While we don’t know exactly why this drifting occurs, we can treat it.

Adults make up a large—and growing—segment of orthodontic patients. If your teeth have lost their ideal alignment over time, a visit to our Philadelphia, PA office is a great way to bring your youthful smile back. And you’ll probably find your treatment much shorter and more comfortable than it was decades earlier!

• You Haven’t Been Wearing Your Retainer

Remember that word “conscientious” in the second paragraph? You need to wear your retainer conscientiously, for as often and for as long as recommended by Dr. Joseph Brogan.

If you’ve been ignoring a damaged retainer, or you keep forgetting to look for your lost retainer, or you have a perfect, undamaged retainer sitting unworn on your dresser, your teeth can start to shift out of their hard-won alignment within a short time.

Does this mean it’s back to months of bands and adjustments and appointments? Maybe not! See us as soon as you notice any changes in your teeth or bite. When caught early, shifting teeth can be treated much more easily.

What can we do to help you regain your best smile? A lot!

• Treatment Planning

When you need to accommodate implants, wisdom teeth, or other dental work which could affect your tooth alignment, Dr. Joseph Brogan can work with your dentist to make sure your alignment isn’t disturbed in the process. They can also map out a treatment schedule which coordinates your other procedures with any orthodontic treatment.

• Retainer Evaluation/Adjustment

Your retainer is probably a passive retainer, meaning it keeps your teeth in place instead of moving them. If you notice your alignment shifting, or if your retainer is uncomfortable when you try to put it on after a lapse in nightly wear, ask us about a replacement.

• Active Retainers

An active retainer helps move teeth into alignment rather than simply keeping them in place. A new active retainer might be just what you need to correct a slight shift.

• Aligners or Braces

If you have some serious shifting going on, we might recommend a second round of treatment with clear aligners or braces. But there’s good news here, as well! Treatment to correct an orthodontic relapse usually takes less time than it did originally, and treatment options are more comfortable and less noticeable than ever before.

Talk to Dr. Joseph Brogan about an orthodontic sequel if you have any concerns about changes in your bite or alignment. You might need only a simple retainer adjustment or a short time in clear aligners or traditional braces to make your smile its best and healthiest once again. And this time, remember to wear your retainer to make sure there’s no need for Orthodontics—Part III!

It’s a new year, and it couldn’t come fast enough for many of us! Let’s do our part to make this a better year in every way—and you can start by making this the year you quit smoking once and for all.

You know that smoking is very damaging to your body. Smokers are more likely to suffer from lung disease, heart attacks, and strokes. You’re at greater risk for cancer, high blood pressure, blood clots, and blood vessel disorders. With far-reaching consequences like this, it’s no surprise that your oral health suffers when you smoke as well.

How does smoking affect your teeth and mouth?

• Appearance

While this is possibly the least harmful side effect of smoking, it’s a very visible one. Tar and nicotine start staining teeth right away. After months and years of smoking, your teeth can take on an unappealing dark yellow, orange, or brown color. Tobacco staining might require professional whitening treatments because it penetrates the enamel over time.

• Plaque and Tartar

Bacterial plaque and tartar cause cavities and gum disease, and smokers suffer from plaque and tartar buildup more than non-smokers. Tartar, hardened plaque which can only be removed by a dental professional, is especially hard on delicate gum tissue.

• Bad Breath

The chemicals in cigarettes linger on the surfaces of your mouth causing an unpleasant odor, but that’s not the only source of smoker’s breath. Smoking also dries out the mouth, and, without the normal flow of saliva to wash away food particles and bacteria, bad breath results. Another common cause of bad breath? Gum disease—which is also found more frequently among smokers.

• Gum Disease

Smoking has been linked to greater numbers of harmful oral bacteria in the mouth and a greater risk of gingivitis (early gum disease). Periodontitis, or severe gum disease, is much more common among smokers, and can lead to bone and tooth loss. Unsurprisingly, tooth loss is also more common among smokers.  

• Implant Failure

Tooth implants look and function like our original teeth, and are one of the best solutions for tooth loss. While implant failure isn’t common, it does occur significantly more often among smokers. Studies suggest that there are multiple factors at work, which may include a smoker’s bone quality and density, gum tissue affected by constricted blood vessels, and compromised healing.

• Healing Ability

Smoking has been linked to weakened immune systems, so it’s harder to fight off an infection and to heal after injury. Because smoking affects the immune system’s response to inflammation and infection, smokers suffering from gum disease don’t respond as well to treatment. Smokers experience a higher rate of root infections, and smoking also slows the healing process after oral surgeries or trauma.

• Dry Socket

Smoking following a tooth extraction can cause a painful condition called “dry socket.” After extraction, a clot forms to protect the tooth socket. Just as this clot can be dislodged by sucking through a straw or spitting, it can also be dislodged by the force of inhaling and exhaling while smoking.

• Oral Cancer

Research has shown again and again that smoking is the single most serious risk factor for oral cancer. Studies have also shown that you reduce your risk of oral cancer significantly when you quit smoking.

• Consequences for Orthodontic Treatment

Finally, if this is the year that you’re investing the time and effort needed to create an attractive, healthy smile with orthodontic treatment, don’t sabotage yourself by smoking!

Cosmetically, smoking doesn’t just discolor your tooth enamel—tar and nicotine discolor your aligners and braces as well. If one of the reasons you chose clear aligners or ceramic brackets is for their invisible appearance, the last thing you want is yellow aligners and brackets.

More important, smoking, it’s been suggested, can interfere with your orthodontic progress. When blood vessels are constricted, your gums, periodontal ligaments, and bones can’t function at their healthy best, moving your teeth where they need to be steadily and efficiently. This means that your treatment could take longer. And if your smoking has caused gum disease, you might have to put any orthodontic treatment on hold completely until it’s under control.

Quitting smoking is a major accomplishment that will improve your life on every level. It’s always a good idea to talk to Dr. Joseph Brogan for strategies to help you achieve your wellness goals for the new year. Make this the year you stop smoking, and the year your health improves in countless ways because you did.