Family Dentistry of Ocean City
Robert W. Yaskin, D.M.D. LLC
421 15th Street
Ocean City, NJ 08226
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Eating is one of the pleasures — and necessities — of life, but people who suffer from temporomandibular joint disorders (TMD) may find eating no pleasure at all — and they may not be eating the right nutritional balance of foods.
TMD is a collection of conditions that affect the jaw joints, connecting muscles and other related facial structures. If you've been diagnosed with TMD, you're probably not only acquainted with severe pain, but also difficulty opening your jaw as widely as normal. This can make it difficult to chew certain foods.
There are a number of effective treatments for TMD, including thermal therapy (hot or cold packs), joint exercise, medication or surgery (as a last resort). But these treatments often take time to make a noticeable difference. In the meantime, you may still need to change what and how you eat to ensure you're getting the nutrients your body needs.
The overall strategy should be to soften and reduce the chewing size of your food. With fruits and vegetables, you'll want to peel and discard any hard or chewy skins, and then chop the fruit flesh into smaller pieces. Steam or cook vegetables like greens, broccoli or cauliflower until they're soft and then chop them into smaller portions. You might also consider pureeing your fruit (and some vegetables) to make smoothies with ice, milk or yogurt, or vegetable-based soups.
Treat meat, poultry or seafood in much the same way, especially biting sizes. Besides cooking meats to tenderness, include moisteners like broths, gravies or brazing liquids to further make them easier to chew.
Dairy foods are an important source of nutrition: eat milk-based products like yogurt or cheese as much as you can handle. If you have problems with these or also nut butters, then consider meal replacement beverages like instant breakfast or whey protein beverages.
And don't forget whole grains. Although some can be hard to chew, you can prepare them in hot cereal form (like oatmeal) to tenderize them. You can also prepare thin bread toast and cut into smaller pieces.
Hopefully, your treatment will bring your TMD symptoms under manageable control. Until then (and after, if need be) adjust your diet to eat the foods that keep you healthy.
Eating disorders cause more than psychological harm. The binge-purge cycle of bulimia or the self-starvation patterns of anorexia can also injure the physical body, especially the mouth.
For example, nine in ten people with bulimia will experience tooth enamel erosion from stomach acid entering the mouth from induced vomiting. Although purging is less frequent with anorexic patients, one in five will also develop erosion.
An eating disorder isn't the only reason for enamel erosion: you can have high acid levels from over-consuming sodas, energy drinks or certain foods, or not properly brushing and flossing every day. But erosion related to an eating disorder does produce a distinct pattern in the teeth. When a person vomits, the tongue moves forward and presses against the bottom teeth, which somewhat shields them from acid contact. This can create less erosion in the lower front teeth than in others.
Eating disorders can cause other oral effects. Stomach acid contact can eventually burn and damage the mouth's soft tissues. The salivary glands may become enlarged and cause puffiness along the sides of the face. The use of fingers or other objects to induce gagging can injure and redden the back of the throat, the tongue and other soft tissues.
It's important to stop or at least slow the damage as soon as possible. To do so requires both a short– and long-term strategy. In the short-term, we want to neutralize mouth acid as soon as possible after it enters the mouth, especially after purging. Rather than brushing, it's better to rinse out the mouth with water or with a little added baking soda to neutralize the acid. This will at least help reduce the potential damage to enamel.
In the long-term, though, we need to address the disorder itself for the sake of both the person's overall well-being and their oral health. You can speak with us or your family physician about options for counseling and therapy to overcome an eating disorder. You may also find it helpful to visit the website for the National Eating Disorders Association (nationaleatingdisorders.org) for information and a referral network.
If you would like more information on how eating disorders can affect health, 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 “Bulimia, Anorexia & Oral Health.”
Regular dental visits are an important part of maintaining healthy teeth and gums. But it’s what goes on between those visits — daily hygiene and care — that are the real ounce of prevention.
Here are 4 things you should be doing every day to keep your mouth healthy.
Use the right toothbrush and technique. Brushing with fluoride toothpaste at least once every day is a must for removing plaque, a thin film of bacteria and food particles which is the main cause of dental disease. Your efforts are more effective if you use a soft-bristled, multi-tufted brush that’s replaced often, especially when bristles become splayed and worn. To remove the most plaque and avoid damaging your gums, brush with a gentle, circular motion for at least two minutes over all tooth surfaces.
Don’t forget to floss. Your toothbrush can get to most but not all the plaque on your teeth. Flossing — either with flossing string, pre-loaded flossers or a water irrigator — helps remove plaque from between teeth. Don’t rely on toothpicks either — they can’t do the job flossing can do to remove plaque.
Mind your habits. We all develop certain behavioral patterns — like snacking, for instance. Constant snacking on foods with added sugar (a major food source for bacteria) increases your disease risk. Consider healthier snacks with fresh fruits or dairy, and restrict sugary foods to mealtimes (and the same for sports and energy drinks, which have high acid levels). Stop habits like tobacco use, excessive alcohol consumption or chewing on hard objects, all of which can damage your teeth and gums and create a hostile environment in your mouth.
Watch for abnormalities. If you pay attention, you may be able to notice early signs of problems. Bleeding, inflamed or painful gums could indicate you’re brushing too hard — or, more likely, the early stages of periodontal (gum) disease. Tooth pain could signal decay. And sores, lumps or other spots on your lips, tongue or inside of your mouth and throat could be a sign of serious disease. You should contact us if you see anything out of the ordinary.
If you would like more information on how to care for your teeth and gums, 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 “10 Tips for Daily Oral Care at Home.”
If you have limited financial resources, learning what it will cost to restore your teeth and gums to good health could be a shock. Dental care can be expensive, especially for treating advanced dental disease.
Properly managing your ongoing dental care can greatly reduce the chances for higher expenses in the future. Here are 3 tips for staying ahead of problems that might cost you dearly tomorrow.
Practice prevention now. Dental disease doesn’t come out of nowhere — it’s the product of a bacteria-rich environment and neglect. You can help eliminate that environment by removing plaque — a thin film of bacteria and food particles built up on tooth surfaces — with daily brushing and flossing. Twice-a-year dental cleanings remove plaque and calculus (hardened plaque deposits) you can’t reach with daily brushing. Reducing sugar (which bacteria feed on) in your diet and treating low saliva flow (which can increase decay-causing acid in the mouth) will round out your prevention practices.
Take care of emerging problems as soon as possible. Dental disease typically doesn’t go away by itself: more likely, it will get worse — and more costly — with time. Don’t wait to see us if you encounter tooth pain or bleeding, tender or swollen gums. In some cases, we can take temporary measures like resin-based fillings in decayed areas that can buy a little time while you prepare for the expense of a more permanent restoration.
Adopt a long-term care strategy. Our goal is for you to have as healthy a mouth as possible.Â To that end, we’ll work with you on strategy and payment plans that address your individual needs. A good strategy puts a priority on treating emergencies or advanced disease first, followed by treating less affected teeth as you’re able to afford it. We may also be able to address your tooth and gum problems with fewer but longer sessions that can help ease pressure on your costs.
Adopting solid hygiene and dietary habits now, visiting us at least twice a year and following a plan to treat problems as they emerge is your best approach for keeping dental care from making a huge impact on your wallet.
If you would like more information on managing your dental health, 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 “Cost-Saving Treatment Alternatives.”
The mouth isn’t an island unto itself — problems there may be indicative of deeper physical or emotional issues. Â The condition of a family member’s teeth and gums, for example, could be signs of bulimia, an eating disorder.
Characterized by food binging and purging through self-induced vomiting, bulimia can also have a severe effect on the teeth. Regular inducement of vomiting introduces stomach acid into the mouth that can attack and soften the mineral content of tooth enamel. As a result, 90% of bulimics develop enamel erosion.
The erosion pattern often differs from that produced by other high acid causes like the over-consumption of sodas. Because the tongue instinctively covers the back of the bottom teeth during vomiting, they’re often shielded from much of the acid wash. Bulimics are much more apt to exhibit heavier erosion on the upper front teeth, particularly on the tongue side and biting edges.
Bulimia and similar disorders produce other signs as well, like soft tissue ulceration or swollen salivary glands that exhibit puffiness of the face. The roof of the mouth, throat and back of the tongue may appear roughened from the use of fingers or objects to induce gagging.
Unlike sufferers of anorexia nervosa who tend to be negligent about their hygiene (which itself increases their risk of dental disease), bulimics have a heightened sensitivity to their appearance. This concern may prompt them to aggressively brush right after purging, which can cause more of the softened enamel to be removed.
Treating the dental consequences of bulimia requires a two-pronged approach. In the short term, we want to lessen the impact of stomach acid by discouraging the person from brushing immediately after purging — better to rinse with water and a little baking soda to buffer the acid and wait about an hour before brushing. We may also suggest a sodium fluoride mouth rinse to help strengthen and re-mineralize the enamel.
In the long-term, though, the disorder itself must be addressed through professional help. One good source is the National Eating Disorders website (nationaleatingdisorders.org). Besides information, the association also provides a toll-free helpline for referrals to professionals.
As with any eating disorder, bulimia can be trying for patients and their families. Addressing the issue gently but forthrightly will begin their journey toward the renewal of health, including their teeth and gums.
If you would like more information on the effect of eating disorders on dental health, 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 “Bulimia, Anorexia & Oral Health.”