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. Cassy Wiggins 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 Parker, CO 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.

When does an underbite need surgery? The short answer is: when Dr. Cassy Wiggins and our team recommend surgery as the best way to give you a healthy, functional bite. But let’s take a longer look, and see just why your doctors might come to that conclusion.

• First, what exactly is an underbite?

In a perfect bite, the upper and lower jaws align, well, perfectly. Upper teeth overlap lower teeth very slightly, upper and lower teeth meet comfortably, and jawbones and joints function smoothly. When the alignment is off, it causes a malocclusion, or “bad bite.”

When we talk about an underbite, or Class 3 malocclusion, it means that the lower jaw protrudes further than the upper jaw. This protrusion causes the bottom teeth and jaw to overlap the upper teeth and jaw.

• What causes an underbite?

Sometimes an underbite is caused by childhood behaviors while the teeth and jaw are developing, including tongue thrusting or prolonged thumb-sucking and pacifier use. (Working to stop these behaviors before they affect tooth and jaw formation is one of the many good reasons children should have regular visits with their dentists and pediatricians.)

Most underbites are genetic, however, and tend to run in families. It’s estimated that from five to ten percent of the population has some form of underbite. The lower jawbone (mandible) might be overdeveloped, the upper jawbone (maxilla) might be underdeveloped, both bones could be affected, or, sometimes, tooth size and placement might cause an underbite. These irregularities in jaw shape and size and/or tooth crowding are not something that can be prevented, and require professional treatment.

• Why? What’s the problem with an underbite?

Even a minor underbite can cause difficulties with biting and chewing. A more severe underbite can lead to speech problems, decay and loss of enamel where the teeth overlap, mouth breathing and sleep apnea, persistent jaw and temporomandibular joint pain, and self-confidence issues.

• Can’t my dentist treat my underbite?

Most probably not. A very mild underbite can be camouflaged cosmetically with veneers, but this does not address the cause of the underbite, and will not work for moderate or severe underbites.

• Can my orthodontist treat my underbite?

Dr. Cassy Wiggins will create an underbite treatment plan after a detailed study of each patient’s individual dental and skeletal structure. Treatment options will vary depending on the cause of the underbite, its severity, and even the patient’s age.

Early intervention is especially important for children who show signs of an underbite. That’s why we recommend that children visit our Parker, CO office by the age of seven.

If an underbite is caused by tooth misalignment or crowding, braces can reposition the lower teeth. Sometimes extractions are necessary to make room for proper alignment.

If the cause is due to jaw structure, children’s bones are still forming, so treatment can actually help correct bone development. Palatal expanders, headgear, and other appliances are various methods of encouraging and guiding bone development.

But braces and appliances aren’t effective for every patient with an underbite, and especially in patients (usually those in their late teens and older) when the jawbones are already fully formed. In this case, we might suggest coordinating treatment with an oral and maxillofacial surgeon.

• What does an oral and maxillofacial surgeon do?

An oral surgeon has the training, experience, and skill to help correct an underbite by surgically reshaping and repositioning the jawbone. This corrective jaw surgery is called orthognathic surgery.

• What will happen during orthognathic surgery?

Your treatment will be tailored to your specific needs. Two of the common surgical procedures for treating an underbite involve repositioning the upper jaw to lengthen it and/or reshaping the lower jaw to shorten it.

Bone is sometimes removed or added, small bone plates or screws are sometimes used to stabilize the bone after surgery—your surgeon will let you know exactly which procedures will give you a healthy, functional bite. The surgery itself is most often performed under general anesthesia and requires a brief stay in the hospital.

• How will my orthodontist and oral surgeon coordinate my treatment?

Correcting a Class 3 malocclusion can take time. Your oral surgeon will work together with Dr. Cassy Wiggins to analyze the interrelationship of teeth, bones, and joints to determine dental and skeletal problems, and will develop the best treatment plan possible to create a healthy alignment.

• So, when does an underbite need surgery?

Sometimes, a minor underbite can be corrected with braces and appliances alone. A serious underbite, however, will often require the specialized skills of both Dr. Cassy Wiggins and an oral surgeon.

And, while it’s not the primary purpose of surgery, corrective jaw surgery and orthodontics can also make you happier with your appearance and boost your self-confidence. Achieving a lifetime of beautiful, comfortable, and healthy smiles—that’s the answer to your question.

We’ve all heard that biting your nails is an awful habit, but you many wonder- really- what’s so bad about it? Recently, our team at Summit Orthodontics found an interesting article that discusses how biting your nails affect your teeth and oral health.

Nail biting, also known as Onychophagia, is a common habit among various age groups, including primarily children, teens and young adults. Nail biting is generally triggered by stress and most often decreases with age. That being said, nail biting is unsanitary, unattractive, as well as unhealthy for your teeth!

Here’s why:

• It’s unsanitary. Your nails are dirty, almost twice as dirty as your fingers! Hence, biting your nails is just asking for germs and bacteria.

• No good things come to your teeth. Nail biting causes your teeth to constantly be chewing, which is not good for them. This excessive motion wears your teeth down faster than a non-nail biter’s and puts a large amount of stress on your front teeth- contributing to teeth misalignment.

• Braces don’t love it either. Braces already put pressure on teeth, nail biting ads unnecessary pressure, further stressing your teeth and weakening their roots.

• It can be costly. Nail biting can result in up to $4,000 in additional dental bills over one lifetime, according to the Academy of General Dentistry (AGD). Yikes!

What can you do about it?

Now that you know how harmful nail biting can be, it’s time to take action to break your nail biting habit. Try to be conscious of your fingernails and to keep them looking good- this will help you resist the temptation. Ask Dr. Cassy Wiggins or visit the article for tips on how to break a nail biting habit.

Good luck!

Your friends at Summit Orthodontics

At Summit Orthodontics, we know good dental health requires only a few minutes a day. We thought we’d provide some practical advice on how to improve your or your child’s smile between your adjustment visits with Dr. Wiggins.

Start by brushing your teeth twice a day. Proper brushing techniques are an essential part of maintaining good oral health during your orthodontic treatment, as well as preventing gum disease. More care and time are needed to adequately brush your teeth when you are wearing braces. Brushing daily helps remove decay-causing plaque from tooth surfaces. Please consult Dr. Cassy Wiggins if you would like us to review brushing techniques with you or your child. The use of a mechanical toothbrush such as a Sonicare or Oral B can aid in removing plaque around braces. Flossing daily will also prevent plaque to build up between the teeth and prevent stains between your teeth. Research has shown the bacteria of gum disease has been linked to coronary artery disease, stroke, diabetes and memory loss. Lastly, we encourage you to throw away old toothbrushes and replace them every 2 or 3 months, or after an illness.

We hope this helps! If you have any further questions about any of these tips, please contact Summit Orthodontics or ask your general dentist during your next scheduled visit! Or, ask us on Facebook!