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Temporomandibular dysfunction (TMD) refers to a diverse range of disorders that relate to muscular function in the jaw and face — the temporomandibular joint (TMJ). That could mean difficulty opening your mouth, pain in the jaw or face, or any sort of problem with the jaw joint.

TMD can be difficult to diagnose because of the varied causes. Whatever the case, an accurate diagnosis from Dr. David Baker helps make treatment as successful as possible.

Most often, jaw problems will resolve themselves within several weeks or months. Surgeries like arthrocentesis, arthroscopy, and open-joint surgery should be a last resort. More conservative and reversible treatments should come first and are in fact the most critical step in the treatment of TMD.

Less invasive treatments like acupuncture and splints can be helpful, but that will depend on your particular case. It’s worth your while to speak with Dr. David Baker at our Portland or Vancouver office to learn about solutions that could work for you.

A combination of treatments will most often produce the greatest relief for TMJ patients. It’s a good idea to avoid activities that overuse the jaws, such as chewing gum or clenching your jaws.

You can be proactive in finding relief for TMD by trying the following remedies at home:

• Eat soft food: When you eat soft and/or blended food, your jaw gets an opportunity to rest. Avoid chewy and crunchy food, and food that requires you to open your mouth wide, like apples or corn on the cob.
• Apply moist heat: A hot water bottle wrapped in a moist towel can help reduce symptoms.
• Apply ice: Applying an ice pack wrapped in a cloth or towel for no longer than 15 minutes may also reduce pain and promote healing.
• Do jaw exercises: A physical therapist can help identify the exercises that will work for you. Jaw exercises have been shown to be an effective treatment method that can be performed at home.
• Relaxation: Actively try to relax the muscles of the face and lips, and let your teeth come apart. Many find meditation, yoga, and slow, deep breathing to be helpful for reducing stress and tension.
• Avoid wide yawns: Keep your fist under your jaw when you feel a yawn coming on, to keep your jaw from opening too widely.

Whew! It’s a hot one! And whenever the temperature soars, you need to stay hydrated, especially when you’re outside or exercising. But all cold drinks aren’t equal when it comes to healthy hydration. Which beverages shouldn’t have a prime spot in your cooler when you’re wearing braces or aligners?

• Soft Drinks

You’re probably not surprised to find soft drinks at the top of the list. After all, sugar is a) a big part of what makes soda so popular, and b) not a healthy choice for your teeth.

Sugar is a favorite food source for the oral bacteria that make up plaque. These bacteria convert sugar into acids, and these acids attack the surface of your tooth enamel. Over time, the minerals which keep enamel strong begin to erode, and weakened, eroded enamel is a lot more susceptible to cavities.

So, what about sugar-free drinks? Does this make soft drinks a better choice? Unfortunately, you can take the sugar out of many sodas, but you can’t take the acids out. Most soft drinks are very acidic, even without sugar, and will cause enamel erosion just like the acids created by bacteria will.

• Fruit Drinks

Fruit juice provides us with vitamins, which is great, but it’s also full of natural sugars and acids. And blended fruit drinks and fruit punches often contain added sugars and added citric acids. Best to choose 100% fruit content and check the labels before you buy. (And you can always get refreshing fruit flavor by adding a slice of fruit to a glass of water.)

• Sports Drinks

You might be surprised to see these on the list—after all, they promise healthy hydration while you’re working out. And hydration is healthy—but sugars and acids aren’t. Even when the label tells you there’s no added sugar, that same label will often reveal high amounts of citric acid. In fact, some sports drinks are more acidic than sodas.

We’ll make an exception, though, for thirsty people who participate in sports or activities that require a lot of physical exercise and produce a lot of sweat. When we sweat, we lose electrolytes, those ionized minerals which help regulate many vital bodily functions. Talk to Dr. David Baker about which sports drinks are best for you if you need to replenish your electrolytes when working out.

So, what’s your best hydration choice on a hot day? Water! It not only hydrates you, it cleans your teeth, it helps you produce saliva, and it often contains tooth-strengthening fluoride. But if you only have sports drinks in the cooler, or if you just want to enjoy a soft drink or a bottle of juice from time to time, no need to go thirsty. We have some ways to make sure your teeth are safer, even with this tricky trio:

• Rinse with water after you drink a sugary or acidic drink. And remember to brush when you get home.
• Be choosy. Check labels for added sugars and acids.
• Don’t sip your drinks all day long. Saliva actually helps neutralize acids in the mouth, but sipping acidic beverages throughout the day doesn’t give saliva a chance to work.
• Use a straw to avoid washing your enamel in sugars and acids.

While sugar and acids are never good for your teeth, it’s especially important to reduce your exposure while you’re in braces or aligners.

• Increased sugar means increased plaque and bacteria, which can collect around your brackets. When plaque isn’t cleaned away, bacterial acids cause mineral erosion, which shows up as white spots on your enamel. You don’t want to see a collection of white spots when those brackets come off!
• Filling a cavity might require the (temporary) removal of part of your braces.
• There’s a reason Dr. David Baker and our team recommend that you only drink water with your aligners on. If you wear them while you drink sugary and acidic beverages, the liquid collects in your aligner tray, literally bathing your teeth in sugar and acid—and speeding up the process of erosion and decay.

You need to keep hydrated when it’s hot. When you’re packing your cooler, choose drinks that are healthy for your entire body, including your teeth and gums. Ask our Portland or Vancouver team for the best choices in cold drinks to make sure you’re getting the hydration you need—without the sugar and acids you don’t!

Traditional braces and oral piercings—does the inevitable meeting of metals pose any risks? Let’s look at some of the potential problems with oral piercings, and you and Dr. David Baker can decide if you should take a break from jewelry while you’re in treatment.

• Tooth Damage

Enamel is the strongest substance in our bodies, but when up against constant contact with metal? It’s not a fair fight.

Tongue piercings, especially, cause problems for your teeth. Whenever you speak or eat—even while you’re sleeping!—your tongue is making contact with your teeth. This continual tapping of metal on enamel can chip and crack teeth and damage fillings. A serious fracture could mean a root canal.

You’re getting braces to create a more attractive, healthy smile, so keeping your teeth intact is a priority.

• Gum Problems

Your gums are affected by orthodontic treatment. As the teeth move, the gums, ligaments, and bone around them adapt and even reshape over time. You might notice when you first get your braces, or when you go in for an adjustment, that you have a few days of swollen, sensitive gums afterward. You might also find that you are at greater risk of gingivitis, because it can be harder to keep plaque away from your gumline until you perfect your brushing and flossing skills.

Oral piercings bring their own gingival dangers. Jewelry in the tongue or lip can rub against gum tissue, especially around your lower front teeth. As the gum tissue continues to be irritated and inflamed, it pulls away from the teeth. This process is called gum recession.

Receding gums expose the tops of your roots to cavity-causing bacteria. They make you more sensitive to hot or cold foods. Pockets between gums and teeth can harbor infections that threaten the tooth itself.

Caring for your gums during braces is important for your dental health. Since people with oral piercings have a much higher rate of gum recession that those without, why add one more risk factor to your oral health?

• Metal vs Metal

Lip and tongue piercings can make contact with traditional brackets and wires, especially if you have a habit of playing with them. And let’s not forget lingual braces! Lingual braces are almost invisible because their brackets and wires are custom fitted to the back of your teeth. Whenever you speak or eat, you’ll be taking the chance that a tongue piercing will damage these custom-made appliances.

Dr. David Baker can tell you if your piercings are in any danger of interfering with your braces, but even if you’re planning on aligners, there are additional reasons to consider retiring your oral jewelry. Dental associations and medical associations discourage oral piercings because they can damage teeth and gums. And there’s more. Oral piercings can lead to swelling, bleeding, allergic reactions, infection, and nerve damage.

The reason you’re considering braces is because you want a healthy, attractive smile. Don’t let a tiny piece of jewelry make your life and your treatment more difficult! Do some research and talk to our Portland or Vancouver team about your oral piercings, and come up with a solution that’s best for your health and best for your smile.

Even though it’s called a “permanent retainer,” your fixed retainer isn’t necessarily meant to last a lifetime. But with care, it should last just as long as you need it, keeping your teeth perfectly aligned after your orthodontic treatment is complete. Why is this retainer the one to choose for challenging alignments?

A fixed retainer is often used for teeth which were very crowded or had large gaps before treatment, especially along the bottom teeth, which tend to shift more. With a permanent retainer, a custom fitted wire is attached with a bonding adhesive to the back of each of the selected teeth. This design makes sure that the teeth can’t shift out of place while your bones and ligaments strengthen around them.

Occasionally, though, your permanent retainer isn’t quite as permanent as it should be. If you think your fixed retainer is becoming “unfixed,” what clues should you look for?

• Broken wire

A clearly broken wire can be obvious, or you might discover it when you notice pain or irritation caused by the end of a wire poking around your tongue or mouth.

• Loose bond

The orthodontic adhesive used to bond the wire to each tooth can come loose as the result of an accident, an unfortunately chewy treat, or simply with the passage of time.

• Shifting teeth

You might not notice anything wrong with your retainer, but what you do notice is that your once-straight teeth have started shifting back to their old positions. If you see any movement in your teeth, your retainer might need repair.

What should you do?

• Give our Portland or Vancouver orthodontic office a call! It’s important to act promptly to prevent further retainer damage, oral discomfort, and tooth misalignment.
• Rinse with warm water if your mouth is irritated.
• If a wire is poking you, call us for advice on gently pushing it back into place.
• Orthodontic wax can protect your teeth and tissue from detached wires.
• If you have a clear retainer, wear it until you can come in. If you don’t have one, and you can’t see us immediately, ask if an over the counter moldable retainer is a good idea to help keep your teeth aligned in the meantime.

One benefit of a fixed retainer is that it’s almost invisible because it’s behind your teeth. But this hidden location can also make it difficult to notice potential problems. Fortunately, there are some proactive steps you can take to help your permanent retainer—and your bite—stay healthy:

• Avoid foods which are sticky, hard, or chewy. If a food can damage traditional braces, it can damage your retainer.
• Wear protective gear like mouthguards and helmets when you’re active—they protect more than just your retainer!
• Ask your dentist to examine your retainer adhesive’s staying power whenever you have a checkup.

If you notice a detached wire or loose adhesive or see your teeth shifting, give Dr. David Baker a call. It’s important to act promptly to fix a fixed retainer, because your teeth and bite alignment are in jeopardy when you delay. And always bring your retainer (or retainer pieces) with you in case we can repair it.

Permanent retainers don’t necessarily last forever. But whether your fixed retainer is going to be with you long-term, or whether you’re going to transition to a removable retainer in the future, let’s make sure your permanent retainer is just as “permanent” as it needs to be!