My Blog

Posts for: August, 2018

By Lawrence Marini, D.D.S.,PC
August 21, 2018
Category: Oral Health
Tags: tmj disorders  
3TipstoMakingMealtimeEasierDuringTMDFlare-Ups

If you suffer from a temporomandibular (“jaw joint”) pain disorder (TMD), you know any activity involving jaw movement can be uncomfortable. That includes eating.

But avoiding eating isn’t an option—which means you may be attempting to minimize discomfort during flare-ups by choosing soft, processed foods that don’t require a lot of jaw force. While this may certainly ease your TMD symptoms, you might also be cheating your health by eating foods not optimally nutritious.

It doesn’t have to be a trade-off: with a few simple techniques you can still eat whole, natural foods while minimizing jaw joint pain. Here are 3 tips for making mealtime less stressful during TMD flare-ups.

Cut food into manageable bite sizes. Preparing your food beforehand will make a big difference in how much effort your jaws exert as you eat. Make sure all your food portions of vegetables, fruits or meats are cut or prepared into small, manageable bite sizes. It also helps to remove the tough outer skin of some fruits and vegetables or to mash other foods like potatoes or beans.

Use cooking liquids to soften food. For foods that aren’t naturally moist, you can add liquids to soften them and make them easier to chew. Incorporate gravies, sauces or marinating liquids into your meal preparation to help soften tougher foods like poultry, meats or some vegetables.

Go easy with your chewing and biting motion. The strategy here is to minimize jaw movement and force as much as possible. While preparing your food as mentioned before will help a lot, how you bite and chew will also make a big difference. Limit your jaw opening to a comfortable degree, take small bites and chew slowly.

Managing a jaw joint disorder is an ongoing process. When practiced together with other treatments like therapy or medication, eating deliberately can help make life with TMD easier.

If you would like more information on coping with jaw joint disorder, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “What to Eat When TMJ Pain Flares Up.”


By Lawrence Marini, D.D.S.,PC
August 11, 2018
Category: Dental Procedures
Tags: orthodontic treatment   tads  
AnchorsMakealltheDifferenceinSuccessfulOrthodonticTreatment

Orthodontics shares a principle with the classic tug of war game: if you want things to move in the right direction you need a good anchor. Anchors help braces and other appliances apply constant pressure to misaligned teeth in the direction they need to go to correct a malocclusion (poor bite).

Orthodontic treatments work in cooperation with an existing oral mechanism that already moves teeth naturally in response to biting forces or other environmental factors. The key to this mechanism is an elastic tissue known as the periodontal ligament that lies between the tooth and the bone. Besides holding teeth in place through tiny attached fibers, the ligament also allows the teeth to move in tiny increments.

Braces’ wires laced through brackets affixed to the teeth exert pressure on them in the desired direction of movement –the periodontal ligament and other structures do the rest. To maintain that pressure we need to attach them to an “anchor”—in basic malocclusions that’s usually the back molar teeth.

But not all malocclusions are that simple. Some may require moving only certain teeth while not moving their neighbors. Younger patients’ jaws and facial structures still under development may also need to be considered during orthodontic treatment. That’s why orthodontists have other anchorage methods to address these possible complications.

One example of an alternate anchorage is a headgear appliance that actually uses the patient’s skull as the anchor. The headgear consists of a strap running around the back of the head and attached in front to orthodontic brackets (usually on molar teeth). The pressure it exerts can trigger tooth movement, but it can also help influence jaw development if an upper or lower jaw is growing too far forward or back.

Another useful anchorage method is a tiny metal screw called a temporary anchorage device (TAD) that is implanted into the jawbone above the teeth through the gums. Orthodontists then attach elastic bands between implanted TADs and specific braces’ brackets or wires to exert pressure on certain teeth but not others with pinpoint accuracy. After treatment the TADs can be easily removed.

Using these and other appliances allows orthodontists to customize treatment to an individual patient’s particular malocclusion. With the right anchor, even the most complex bite problem can be transformed into a beautiful and healthy smile.

If you would like more information on orthodontic treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Orthodontic Headgear & Other Anchorage Appliances.”


By Lawrence Marini, D.D.S.,PC
August 01, 2018
Category: Oral Health
Tags: antibiotics  
IfYouvehadJointReplacementyoumayNeedAntibioticsBeforeDentalWork

If you’ve had a total joint replacement or similar procedure, you will want your surgeon to decide if you need to take an antibiotic before you undergo dental work. This is a precaution to prevent a serious infection known as bacteremia.

Bacteremia occurs when bacteria become too prevalent in the bloodstream and cause infection in other parts of the body, especially in joints and bone with prosthetic (replacement) substances. It’s believed that during invasive dental procedures bacteria in the mouth can enter the bloodstream through incisions and other soft tissue disruptions.

Joint infections are a serious matter and can require extensive therapy to bring it under control. Out of this concern, the use of antibiotics as a prophylactic (preventive measure) against bacteremia once included a wide range of patients for a variety of conditions and procedures. But after an in-depth study in 2007, the American Dental Association concluded that the risks for many of these patient groups for infection triggered by a dental procedure was extremely low and didn’t warrant the use of antibiotic premedication therapy.

As a result, recommendations for antibiotic therapy changed in 2009, eliminating many groups previously recommended for premedication. But because of the seriousness of joint infection, The American Academy of Orthopedic Surgeons still recommends the therapy for joint replacement patients about to undergo any invasive procedure, including dental work. It’s especially needed for patients who also have some form of inflammatory arthritis, a weakened immune system, insulin-dependent diabetes, hemophilia, malnourishment or a previous infection in an artificial joint.

The guidelines for antibiotic premedication can be complex. It’s best, then, to speak with both your orthopedic surgeon and us about whether you should undergo antibiotic therapy before you undergo a dental procedure. The ultimate goal is to reduce the risks of any disease and to keep both your mouth and your body safe from infection.

If you would like more information on the use of antibiotics in dental care, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Premedication for Dental Treatment.”