That’s the sound Rice Krispies are supposed to make when milk is poured over the popular breakfast cereal.  It’s NOT what’s supposed to happen when your mouth opens or closes.

Creaky, crackling and noisy joints are symptoms that might be predictive of problems that could, if not dealt with, result in limitations of jaw movement such as lock-jaw.  Imagine not being able to open your mouth wide enough to eat a sandwich?  Or, what about not being able to chew without pain?

Some people haven’t been able to eat a Subway sandwich without pounding it down, all their lives.   They just think such limitation is normal.  If you can’t get at least 3 finger widths between your teeth, you might have a TMJ issue.

The jaw joint or TMJ, temporomandibular joint, is unique in the body.  It’s a double joint, with one bone, the lower jaw suspended via a joint at either end.  Movement of the lower jaw position is controlled by these joints and by the muscles, tendons and ligaments that attach to the head, jaws and neck.

Most often, joint sounds are innocuous.  Many people don’t know they have any.  Your dentist should include an examination of your TMJ’s as part of a comprehensive examination.

Sometimes, joint sounds are problematic.   They can be indicative of a misalignment in the joint, arthritis or inflammation.  In a car, such a misalignment will cause the tires to wear out unevenly. The same thing happens in the mouth, as teeth can also wear out.

How does a misalignment of the jaws happen?

The usual reasons are; wear and tear, clenching/grinding, muscle imbalances, sleep position, sleep disturbances, trauma, poor posture, stress, mineral deficiencies/overload and even medications.

Medications?  Every drug has some unintended consequence.  Some of the more common ones that can affect muscles are:

➢ Diuretics (like Lasix and hydrochlorthiazide),

➢ Procardia (for angina and hepertension)

➢ Proventil,  Ventolin, Brethine (for asthma)

➢ Statins like Lipitor and Crestor(for cholesterol)

➢ Evista (used for osteoporosis)

➢ Antidepressants (Paxil, Zoloft, Prozac, Celexa, Lexapro and other SSRI’s which can also be used to treat ADHD)

Millions of Americans take one or more of these medications.  Yet, most people and even most doctors don’t associate the symptoms of muscle issues with these medications.  The most common muscle complaints involve painful leg cramps, which might never be associated with medication use.  But, such cramps and spasms can happen in any muscle.

Another common symptom of “TMJ” is fullness or even ringing in the ear (called tinnitus).  These too can be signs of muscle issues.  And to prove it to yourself, clench your teeth together tightly.  When you do, does the background noise change a little?  That’s because the muscles that close the jaw also have an affect on the ear.

Treatment of “TMJ” involves first making the proper diagnosis. Then appropriate recommendations for treatment can be made, which might include, self-care, medication modification, bite guards, physical therapy, orthodontics, bite adjustments and sleep appliances.

The takeaways here are:

  • Pay attention to joint sounds or changes
  • Bring such changes to your dentist or hygienist’s attention
  • Tell your dentist and hygienist about all the medications you take

Your TMJ’s are too important to take for granted.

Article by:

Dr. Michael Goldberg and the Linhart Dentistry Team

It is well known that fluoride, an element found in most water sources, has numerous dental benefits. It is essential to proper oral care. Fluoride can strengthen teeth and prevent tooth decay by keeping the acid produced by the bacteria in plaque from dissolving the enamel of our teeth. It cannot restore teeth with cavities, but it can prevent cavities, and it also reverses the early stages of tooth decay by allowing tooth enamel to repair, or remineralize, itself. Fluoridated water, toothpaste, mouthwash, and supplement pills are all sources of fluoride.

Proper fluoride intake is an important part of a well-rounded dental health regimen. Infants and young children don’t require as much, however, when carefully monitored, a child’s intake of fluoride is still a beneficial and necessary part of their oral care.

Fluoride Intake for Infants

Infants require the least amount of fluoride of any age group. Fluoride supplements, which are usually prescribed when children live in an area without fluoridated water, are not necessary for infants. For children under six months of age, the water used to prepare a baby’s formula provides sufficient fluoride. Baby formula generally contains fluoride already, with milk-based formulas containing less fluoride than soy-based formulas. Because of this, parents have the option of supplementing the level of fluoride contained in baby formula by preparing their child’s formula with tap water or fluoridated bottled water. If they want to limit their child’s fluoride intake, they can use non-fluoridated bottled water.

Some parents also choose to breastfeed as a way to limit fluoride intake. It should be noted, however, that breast milk contains only very small trace amounts of fluoride, and a breast milk fed baby receives virtually no fluoride exposure. Parents are advised to consult with a dentist to determine how to ensure their infants receive the right amount of fluoride. 

When baby teeth begin appearing, parents can brush their child’s teeth with an infant toothbrush using water and a tiny smear of toothpaste. Children’s teeth should be brushed this way until around age two. 

Fluoride Intake for Young Children

After the age of two, children begin brushing their own teeth, thus regularly ingesting fluoride in their toothpaste . Past this age, most of their fluoride intake comes from water, so children should only use a small amount of toothpaste when they brush. A pea-sized amount is more than sufficient, and children should always use a toothpaste that carries the ADA’s seal of approval. 

Under the age of six, children should not use mouth wash that contains fluoride. Younger children have a tendency to swallow too much toothpaste while brushing, and if they use mouthwash, there is a high likelihood of them swallowing that as well. Parents should supervise young children  when they are brushing their teeth to ensure they are not swallowing their toothpaste. It is around this age when, if a child lives in an area without a fluoridated water supply, a dentist might prescribe fluoride supplements to build their fluoride intake beyond toothpaste. 

Fluoride is a pivotal part of maintaining proper dental health. While fluoride intake needs to be carefully monitored in infants and young children to avoid overexposure, parents should not be deterred from recognizing the benefits. Speaking with a dentist or a pediatric dentist is an excellent way to learn more about caring for children’s teeth, and obtaining more information about fluoride needs. 

We would like to congratulate Lisa Ehrgott for being the winner of our Facebook 100th Like contest! She was randomly selected from the first 100 people who Liked the Dr. Linhart Facebook page, and is the winner of an electric Sonicare toothbrush.

Congratulations to Lisa and a big thank you to everyone else who has Liked and interacted with our Facebook page. We are hoping to use this outlet as a way to better communicate with our patients and make their dental experiences more enjoyable.

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