Anyone who’s suffered from TMJ pain knows how debilitating it can be. While it may start with a little soreness at the temples or popping when you yawn, it can quickly progress into daily migraines, difficulty eating, and permanent damage to the teeth. If you suspect you may have TMJ disorder, here are 8 symptoms that shouldn’t be ignored.
What Is TMJ Disorder?
Although people often refer to TMJ disorder as TMJ, this abbreviation is for the joint that causes the pain—the temporomandibular joint. When this joint is causing pain or not functioning properly, the condition is known as TMJ disorder, also known as TMD or TMJD.
It’s believed that around 10 million Americans suffer from TMJ pain. Although the joint in question is quite small, it can cause a tremendous amount of pain. The TMJ acts as a sliding hinge that connects the jaw to the skull. Think about how many times a day you eat, open your mouth, speak, yawn—when your TMJ is dysfunctional, each of those movements can cause the joint to become aggravated and painful.
Common Symptoms of TMJ Disorder
There are some symptoms of TMJ disorder that are unmistakable. Clicking and popping in the jaw, for example, are very rarely anything other than TMJ disorder. Other signs of the disorder are easy to confuse with different health issues. Headaches can be misdiagnosed as migraines; earaches are usually thought to originate in the ear canal, not a joint located near it. To diagnose TMJ disorder, we take a step back and look at all of your symptoms to piece together the puzzle. Here are signs that you could have TMD:
Headaches
Headaches from TMJ disorder may come and go or they may be chronic as the disorder progresses and worsens over time. These headaches usually feel as if they’re originating behind the eyes and because of this, they’re often misdiagnosed as migraines.
Earaches
The temporomandibular joint is located just above the ear, so when it becomes inflamed, it can cause earaches. If you suffer from frequent earaches without any other symptoms, it’s possible that the cause could be TMJ disorder and not an infection in your ears. When the TMJ is acting up, you may also have a feeling of fullness in the ears and even dizziness since the body’s sense of balance comes from the inner ear.
Clicking and Popping Sounds
When you yawn, do you hear or feel your jaw pop? If you’re eating chewy food like crusty bread or caramel candy, does your jaw make clicking sounds? Do you feel like you need to “adjust” your jaw sometimes by popping it? These are all signs that you could have TMJ disorder. Like any other joint in the body, the temporomandibular joint should not make sounds when it’s in use. Noises from this joint are a clear sign that something is wrong.
Locked Jaw
If your jaw gets locked in the open or closed position, this too is another sign that the temporomandibular joint is not functioning properly. It’s important to get prompt treatment if you experience this symptom often.
Jaw Pain
TMJ-related jaw pain can be felt at the temples and it may extend all the way down to the sides of the upper jaw and beyond. Sometimes instead of pain, patients experience a feeling of discomfort, often described as feeling as if their jaw is out of alignment.
Facial Pain
When the temporomandibular joint is particularly inflamed, it can even cause pain elsewhere in the face—the cheeks, under the eyes, even the forehead. TMJ pain can be like a vicious circle: muscle tension can cause TMJ pain, then TMJ pain can also cause even more muscle tension, which is felt elsewhere in the face.
Shoulder and Neck Pain
It’s not uncommon for patients with TMJ disorder to experience pain in the neck and shoulders too. Like facial pain, this is also related to the muscle tension that leads to and is caused by TMJ disorder. Poor posture can cause TMJ pain, but poor posture can also be a reaction to TMJ pain.
Changes to Teeth
Teeth grinding and jaw clenching are both causes of TMJ pain. If you notice that your teeth look worn down or have chips or cracks you don’t remember getting from an injury, it could be a sign that you also have TMJ disorder. Patients may also feel that their upper and lower teeth no longer fit together properly—this can indicate that the temporomandibular joint dysfunction is so severe that the jaw is no longer aligned as it should be.
Causes to TMJ Disorder
In order to effectively treat TMJ disorder, it’s important for us to determine the underlying cause whenever possible. While treating the symptoms can bring temporary relief, it’s only by treating the cause of TMJ disorder that we can come up with a lasting solution. Reasons for TMJ pain include:
- Facial trauma or other injury to the temporomandibular joint
- Arthritis
- Congenital birth defects or other structural problems with the jaw
- Teeth grinding and jaw clenching (often as a reaction to stress)
- Erosion of the joint
- Orthodontic treatment
- Poor posture
At your first appointment for TMJ pain, we’ll discuss the symptoms you’re experiencing and conduct a thorough exam that includes feeling the temporomandibular joint while you open and close your mouth, checking for tenderness and swelling surrounding the joint, and examining the teeth for signs of wear due to teeth grinding. If we suspect that there is physical damage to the joint itself, you may also need x-rays or even a CT scan or MRI.
Stress is an important factor in TMJ pain. You might not even realize it, but stress and anxiety can cause dramatic physiological changes in the body. Your jaw may be clenched as you sit at the computer working, or you might be one of the many people who grinds their teeth at night and has no knowledge of it. Stress can cause muscle tension throughout the body, including the muscles surrounding the temporomandibular joint. While it’s not a direct cause of TMJ pain, it’s certainly a complicating factor and it causes many physical conditions that lead to TMJ dysfunction.
Sometimes, an underlying cause for TMJ disorder cannot be diagnosed; this doesn’t mean that treatment isn’t possible, but it may take a little more trial-and-error. This is why it’s important to find a TMJ treatment provider that takes the time to listen to your symptoms and come up with a personalized treatment plan just for you.
TMJ Disorder Treatment in NYC
There are several possible treatment options for TMJ pain. The simplest step to start with is self-care at home, particularly if your TMJ pain is not chronic. Treat your jaw pain with hot or cold therapy—or a combination of both—using compresses. Cold therapy using an ice pack works best, but some patients with muscle tension find relief from warm compresses. When your TMJ feels aggravated, switch to a soft foods diet and avoid gum and foods that require a lot of chewing. There are even exercises you can do to relax your jaw if muscle tension due to jaw clenching is causing your TMJ pain.
For patients who have arthritis, it may be necessary to loop in a rheumatologist so we can treat the pain you’re experiencing and also the underlying cause of it. Some patients with arthritis, erosion of the joint, or a traumatic injury need to have the temporomandibular joint replaced in order to get permanent relief.
The most common treatment for TMJ pain are splints that help reposition the jaw while you sleep. Sometimes known as night guards, these splints are very effective, particularly for patients who clench their jaws and grind their teeth at night. Another non-invasive treatment for TMJ disorder is physical therapy. Often, we recommend both of these treatment options, along with self-managed care at home.
Because one of the underlying factors at play with TMJ pain is stress, it’s important to manage your anxiety levels as well. Consider yoga, meditation, and incorporating more relaxing self-care activities into your day.
Ultimately, because TMJ disorder has so many potential causes, there’s rarely a one-size-fits-all solution to TMJ pain. When you get TMJ disorder treatment from Smiles on the Upper Westside, you’ll always get a personalized approach based on your unique situation and needs. We work closely with other medical professionals and therapists when needed, taking a holistic approach that yields better results than those of practitioners who use the same treatment protocol for every patient they see with TMJ pain.
Schedule an Appointment at Smiles on the Upper Westside
Do you have TMJ pain? Are you experiencing any of the symptoms above and think it could be TMJ disorder? Let’s work together to figure out the underlying cause of your TMJ pain and develop a personalized treatment plan that has you back to feeling like your old self again. Contact us today at 212-222-5225 to schedule an appointment for a consultation with Upper West Side Dentist, Dr. Massiah.
If you’re considering orthodontic treatment as an adult, you’re likely weighing your options between Invisalign and traditional braces. Many patients wonder if Invisalign is really as effective as braces or if the trade-off for a more discreet orthodontic treatment is one that doesn’t work as well. Ultimately, the decision is up to you—you’ll have to take your lifestyle and personal preferences into account to decide which option is best. Here are some things to consider.
Appearance
Most adult patients who opt for Invisalign do so because it allows them to undergo the orthodontic treatment they need without having to flash a mouthful of metal every time they smile. Invisalign aligners are made with thin, clear plastic that fits flush against your teeth. Even when you’re having a conversation with someone sitting or standing a few feet away, they’re unlikely to notice that you’re wearing aligners.
Ceramic braces are certainly less noticeable than traditional metal braces, but the wire is still visible when you smile. Lingual braces, which are applied to the backs of the teeth, are another more discreet orthodontic treatment, but they’re much more costly than Invisalign aligners. When it comes to appearance, Invisalign is superior to the alternatives.
Comfort
Comfort is another advantage of Invisalign. Braces can feel bulky on your teeth; you have to go to the orthodontist every month to get them adjusted and tightened, which can be painful. Invisalign aligners are made with a comfortable, unobtrusive plastic material that feels more natural than braces. While you’re likely to feel some tightness and discomfort when you switch from one set of aligners to the next, the process is much less uncomfortable than that of having the wires on braces tightened.
Convenience
Invisalign aligners have less of an impact on your daily routines and habits than traditional braces. With Invisalign, you can continue to eat all of your favorite foods because you’ll remove your aligners before meals and snacks. This means that no foods are off limits. With braces, you can’t have popcorn, gum, or chewy candies. Even a surprising number of healthy foods can cause damage to your braces, including nuts, apples, carrots, and steak.
You can also maintain your regular oral hygiene routine with Invisalign. Remove your aligners and brush and floss like normal. Having braces means adding time to your oral hygiene routine because brushing and flossing both take longer and require extra care.
Results
Invisalign and traditional metal braces both do an excellent job correcting bite issues and straightening teeth. There are very few cases in which Invisalign isn’t an option. For most patients, braces and Invisalign work equally well and the decision comes down to what you’re looking for in an orthodontic treatment.
Learn More About Invisalign
Are you considering straightening your teeth with Invisalign? If you’re wondering whether Invisalign is the best choice for you, contact us today at 212-222-5225 to schedule a consultation.
It might seem like an inconsequential decision, but choosing the right kind of toothbrush is actually more important than most people think. With the wrong type of brush, you can cause your gums to recede, leave plaque buildup on your teeth, or erode away the enamel and cause stains.
The best way to know which toothbrush is right for you is to talk to us at your next oral exam appointment. You may have special needs that can be addressed with a specific type of brush. What follows are recommendations for patients who have healthy teeth and gums, with no oral health concerns.
Buying a Manual Toothbrush
A manual toothbrush (also known as a disposable toothbrush) is the old-fashioned kind that’s powered by you and not a battery. When it comes to buying a manual toothbrush, people usually fall into one of two categories: they either grab whatever is cheapest or they stare at the seemingly infinite possibilities in the oral care aisle and agonize over which one is best. You don’t need to stress about which brush to choose, but you should put at least some thought into it. Here’s what to consider when making your decision:
Look for the ADA Seal
Not all toothbrushes are approved by the American Dental Association. If you’re shopping at a dollar store or even for eco-friendly toothbrushes made with bamboo or charcoal-infused bristles, your brush might not be ADA approved. Look for the ADA seal on the packaging and if you don’t see it, don’t buy it.
When you see the ADA seal, you can feel confident knowing that the toothbrush is safe, effective, and meets the American Dental Association’s high standards. Cheap brushes imported from abroad may have bristles that fall out, wear out quickly, or even damage your tooth enamel. ADA-approved toothbrushes have bristles with rounded tips that don’t cause damage or scratches and that won’t fall out easily, and a handle that won’t snap in half while you’re brushing.
Buy the Right Size
This can be a little tricky to judge since toothbrushes are sold in packages and you can’t exactly test one out in your hand before making your purchase. A brush needs to have a sufficiently long handle so it can be held comfortably and it can reach all the way to the back of the mouth. The brush head should not be so big that it makes it difficult to maneuver and clean all those hard-to-brush areas—one-inch tall and a half-inch wide is about the maximum size for a brush head.
Skip the Hard Bristles
Some patients don’t know that hard bristles are bad news for teeth and gums. Others know that hard bristles aren’t recommended, but they can’t stop themselves from buying these brushes anyway—they swear they’re the only way they can get their teeth clean and that soft bristles leave their teeth feeling full of plaque.
Unless your dentist tells you otherwise, there’s no reason to buy hard-bristled toothbrushes. Even medium-bristled toothbrushes aren’t really needed. Stick with soft bristles. As long as you use proper brushing technique, they’ll get your teeth just as clean as the harder bristles.
When you purchase toothbrushes with hard bristles—and especially when you brush with a lot of pressure, which many people do—you put your gums at risk. Over time, your gums may begin to recede. Although the type of gum recession caused by brushing with hard bristles isn’t as dramatic as that of gum disease, it can expose the root surface of your teeth and cause painful tooth sensitivity.
Hard bristles also damage the tooth enamel, particularly when you brush hard too. Tooth enamel protects teeth from cavities, so when your enamel is worn away, it makes it easier for bacteria and decay to attack your teeth. Worn off enamel is also a contributing factor to stains because without its protective barrier, tea, coffee, red wine, and other foods and drinks that stain can more easily penetrate the teeth.
Other bristle advice: multi-level or angled bristles perform better than flat-bristles when it comes to removing plaque, but no matter which type of bristles you end up choosing, none of them perform well when they’re worn out and frayed. Replace your brush every three to four months!
Buying an Electric Toothbrush
Electric toothbrushes are fantastic for your teeth and, generally speaking, they do a better job than manual toothbrushes. That’s not to say that manual brushes don’t work well too; it’s just that electric toothbrushes make the job easier. They’re better able to loosen plaque from the surfaces of your teeth and with their built-in timers, you’ll be able to ensure that you’re brushing the recommended two minutes.
Just like with manual toothbrushes, it’s important to look for the ADA seal of acceptance to make sure the product you’re buying is safe, dependable, and effective. Electric toothbrushes go through even more rigorous testing than manual toothbrushes in order to earn a seal from the American Dental Association. They are sent to an independent laboratory for safety testing and manufacturers are required to prove that the brush is safe for use on the teeth and soft tissues of the mouth through clinical trials.
Here are some things to consider when buying an electric toothbrush:
Cost
Electric toothbrushes vary greatly in terms of price. There are battery-operated ones that are only a few dollars more than manual toothbrushes and rechargeable models that cost hundreds of dollars. The good news is that you don’t have to break the bank to get a decent electric toothbrush. In general, even the most inexpensive electric brush is better than a manual brush in terms of loosening plaque from tooth surfaces.
When evaluating cost, don’t forget to check the price of replacement brush heads for the model you’re considering. (If you’re prone to forgetting when it’s time to switch to a new toothbrush, you might want to buy a brush with a subscription service for brush head replacements.)
Features
The most basic type of electric toothbrush simply turns on and off. If you have room in your budget to upgrade, there’s a whole host of options available. Here are some features to look for:
- Different modes for sensitive teeth, gum care, whitening, tongue cleaning, etc.
- A built-in timer so you know when you’ve brushed for two minutes
- A travel case to make it easy to bring your brush with you
- An app to track your brushing
- A sensor that alerts you when you’re using too much pressure
- Built-in toothbrush sanitizers to kill bacteria
Type of Movement
There are different types of electric brushes that move in different ways. A side-by-side moving brush is the most basic type of electric toothbrush and the kind that’s most affordable. As its name suggests, the bristles move from side to side rather than oscillating or vibrating.
Other types of electric toothbrushes include counter oscillation, rotation oscillation, circular, and ultrasonic. Rotation oscillation brushes have been shown in clinical trials to remove more plaque than manual toothbrushes. They can be as fast as 8000 strokes per minute, allowing you to brush thoroughly with a minimal amount of pressure.
Bristles
Just like with a manual brush, electric toothbrushes have brush heads with different types of bristles. Always choose soft bristles. In fact, if you have a manual toothbrush with soft bristles now and you feel like it’s not doing a good job removing plaque from your teeth, try switching to an electric toothbrush with soft bristles—you’ll be pleasantly surprised by what a difference it makes.
Other brush head options include bristles for whitening, gum care, sensitive teeth, plaque buildup, orthodontia, and more. As long as the brush head you choose has soft bristles, feel free to choose any replacement brush head that fits your needs.
Best Toothbrushes for Children
The guidelines for buying a toothbrush for children are much the same as buying for adults. First, always make sure you buy a toothbrush with the American Dental Association seal of approval to ensure that it’s safe and effective. Children, like adults, should use brushes with soft bristles and, because children’s mouths are smaller, the brush head should be smaller too.
Children can also benefit from using electric toothbrushes. Many kids have trouble brushing for two minutes, so the built-in timer can be a helpful reminder to them—it can even make brushing more fun.
Why It Matters
When you brush well at home, it means you’ll spend less time at the dentist’s office. While we’re always happy to see you, we have a feeling you’d probably prefer a short dental cleaning every six months rather than having to come in frequently for dental work. Brushing is important, but brushing with the right tools also matters.
Schedule an Appointment
If you have questions about which type of toothbrush is right for you, feel free to ask your dentist or hygienist at your next appointment. We’re always happy to make toothbrush and toothpaste recommendations. To schedule an appointment at Smiles on the Upper Westside, contact us today at 212-222-5225.
When a dental emergency strikes, it can be hard to think clearly. You or your loved one is in pain, there might be bleeding or missing teeth—even the best of us have trouble staying calm, cool, and collected in such circumstances.
We hope that when reading this article, you’re not currently dealing with an emergency situation. Read the tips carefully so you know what to do when you, your child, or someone else you know has a dental emergency. If you are coping with a dental emergency right now and you’ve happened upon this post, read through it and call us (or, if you’re not near our Upper West Side dentist, call your local dentist) for assistance.
Here are dental emergency do’s and don’ts to remember:
Do Stop Any Bleeding First
As with any medical crisis, your first priority should be to stop bleeding. Of course, a little blood mixed with saliva is nothing to be too concerned about, but if you or someone else is bleeding profusely, use a clean, cold washcloth to apply firm, direct pressure to the site of the injury to slow or stop the bleeding. Lean forward, not back, to keep blood from flowing down into the throat. Do not lie down and do not stand up, as you may risk fainting—instead, stay seated until bleeding is under control.
Don’t Panic
The second priority? Try not to panic. As mentioned above, we understand that it’s difficult not to panic when faced with a dental emergency, but it’s important to keep your wits about you so you can take charge of the situation. If you’re the one with the injury and someone else is nearby, have them support you as you take care of the injury. If you’re caring for a child or someone else, help them breathe through any pain and distress; by staying calm yourself, you can help them stay calm too.
Don’t Worry About Finding Knocked Out Baby Teeth
Oh, the stories we’ve heard about parents on their hands and knees looking through blades of grass to find a baby tooth knocked out during soccer or baseball practice. If they do end up finding the tooth, we have to tell them that all their hard work was for nothing—we don’t reattach baby teeth that have been knocked out. If your child is near an age when the tooth would fall out naturally, we leave it be; if they’re younger, we will use a space maintainer to help keep room for the adult tooth to erupt in a few years.
Instead of focusing on finding the tooth, have your child rinse with water, clean any soft tissue damage and cuts, and use a cold compress for swelling. Give us a call so we can examine your child’s mouth to make sure there are no additional injuries. If you do end up finding the tooth later, save it for the tooth fairy.
Do Try to Find Pieces of a Broken Tooth
While you don’t have to look for a baby tooth, you should look for broken tooth pieces if your tooth has chipped. Why? They can often be bonded back onto the tooth. This works best if there’s a clean break, rather than many small shattered pieces. If you’re able to find them, place them in a small cup of milk and bring them in to our office when you come in for your appointment.
Don’t Touch the Root of the Tooth
If there’s one thing you remember from this article, let it be this: don’t touch the root! Grab the tooth by the crown (the portion visible above the gumline) instead if you or someone else knocks an adult tooth out. There are delicate periodontal cells on the roots of our teeth and grabbing them by the root can damage these cells, making the chances of successful re-implantation less likely.
What else should you do if an adult tooth has been knocked out? After locating it and picking it up by the crown, gently rinse it in milk or water to remove any debris. If you feel like you’re able to, hold the tooth by the crown and try to insert it back into the empty socket, then bite down on a clean piece of gauze to hold the tooth in place. If you can’t reinsert the tooth, put it in a small cup of milk (or, failing that, saliva) and bring it to our office.
The good news is that when prompt action is taken, adult teeth can be successfully reinserted. Those periodontal cells on the root of the tooth help the gum tissue surrounding it reattach securely.
Do Keep Knocked Out Teeth in Milk
We’ve mentioned milk a few times already and you’ve likely heard that advice before. It’s not an old wives’ tale—milk has a similar chemical composition as saliva, which is why it’s a good choice for keeping teeth moist until your dental appointment. It’s important that your tooth doesn’t dry out, so if you don’t have milk, use saliva or even water if you need to—just don’t wrap it up in a tissue and bring it in to us.
Don’t Hesitate to Go to the Emergency Room
If you’ve suffered significant facial trauma or your bleeding is uncontrolled, head to the nearest emergency room. You’ll be able to get treatment faster and a hospital is better equipped to handle blood loss, broken facial bones, and other complications. Once the situation is under control, you can make an appointment with our office to address any concerns with your teeth and gums.
Do Take Toothaches Seriously
Many patients deal with toothaches by ignoring them; when they can’t be ignored anymore, they start using over-the-counter pain relievers on a daily basis to alleviate the discomfort. Eventually, the pain is so severe, you have a dental emergency on your hands.
The first step in home treatment for a toothache is to floss around the tooth in question; often, sudden toothaches are the result of something lodged between two teeth. If this doesn’t make a difference, schedule an appointment—you may have a cavity, abscess, or another problem with the tooth that needs to be addressed.
Don’t Use Aspirin for Pain
On the topic of over-the-counter pain relievers, when choosing one to take for dental pain, don’t use aspirin. If you’re bleeding, aspirin can make it difficult for the bleeding to stop because it thins the blood. And if you’re not bleeding, it’s still not a good idea to take aspirin because if you come to our office for emergency treatment, that may cause bleeding and we want to make sure your blood can clot quickly after a dental procedure.
If pain is severe enough that you need to use medication, choose Tylenol (acetaminophen). For toothaches, an over-the-counter topical oral numbing gel may be used in moderation.
Do Use Cold Compresses
Cold compresses work. It’s a good idea to keep a few in your freezer at all times, that way when one starts to get warm, you’ll have another ready-to-go. Before using an ice pack, wrap it in a towel to prevent injury to the skin. Ice packs are effective at reducing pain, swelling, and inflammation. If pain and swelling persist, use the ice pack for 15 minutes at a time, then take a 15 minute break before applying it again. Continue with this until you begin to feel better.
Do Take Steps to Avoid Common Dental Emergencies
An ounce of prevention is worth a pound of cure. While these tips don’t do you much good if you’re reading this article in the midst of an emergency, they can help you prevent a future one. Here are some common mistakes people make that lead to emergency situations:
- Don’t use sharp objects to clean your teeth. If there’s something stuck between two teeth, use floss to remove it.
- Don’t use your teeth to open packaging.
- If you or your child participates in contact sports, use a mouthguard to protect the teeth from injury.
- Don’t chew on ice or anything else that’s hard and can cause damage.
- If you have children, don’t allow them to bite on hard toys (unless they’re babies who are still teething!) or run with things in their mouths.
- Visit the dentist regularly for routine exams and dental cleanings to prevent decay, periodontitis, and other issues that can lead to dental emergencies.
Do Call Our Office to Schedule an Appointment
Day or night, weekday or weekend, even on holidays, call our office when you have a dental emergency. If it’s outside of our regular office hours, follow the message for instructions on how to proceed. We’ll see you as soon as we possibly can and also help coach you on steps to take at home to care for the injury prior to your visit. Contact us at 212-222-5225 to schedule an appointment today.
Once you’ve made the decision to pursue dental implants as a solution for your missing teeth, the next step is finding the right doctor for the job. At Smiles on the Upper Westside, Dr. Massiah and his team are highly trained and have the experience needed to help you achieve the beautiful smile you’ve always wanted.
If you’re interviewing a few different providers for your dental implant procedure, make sure whomever you choose can answer the questions listed below.
Am I a candidate for dental implants?
You want to find a doctor who is upfront with you about any potential challenges you might face and what you can expect from the procedure. There are many reasons why dental implants may not be an option for you. Patients with uncontrolled diabetes, women who are pregnant, and anyone who has serious unmanaged health conditions should not have dental implant surgery.
Patients with gum disease, too, need to have their periodontitis treated and under control before getting implants placed. This is because unchecked gum disease can cause bone in the jaw to degrade, and this bone is critical for supporting dental implants. Without sufficient bone support, implants may become loose over time.
If you’ve suffered bone loss in the jaw already, either due to periodontitis, tooth loss, or osteoporosis, you’re also not a candidate for traditional dental implants. You may be able to get mini dental implants (MDIs) instead, which are smaller in diameter than traditional titanium dental implants and therefore require less bone support. Alternatively, you can undergo a bone grafting procedure prior to implant surgery. During this procedure, we make an incision in your gums and place grafting material where we want the bone to form. Your own bone will grow around the bone grafts, creating a stable base for your dental implants to be placed. This process typically takes a few months to complete, although every patient is different.
While you might be eager to undergo dental implant surgery as soon as possible, it’s important to find a doctor who will not compromise or rush through these essential first steps in the process. If you are not a good candidate for implants but your doctor performs the procedure anyway, there is a significant risk of dental implant failure.
What type of dental implant restoration is right for me?
“Dental implants” is used as a catch-all term, but there are many different options when it comes to dental implant restorations. Any doctor you’re considering should be able to help you determine which one is the best choice for you—and explain why they feel this way. The most common dental implant options include:
Single-Tooth Dental Implants – This is the type of restoration most people think of when they think about dental implants. These involve a titanium post that is implanted directly into the jaw bone. An abutment is attached to the implant post, which is used to anchor a crown to complete the restoration.
Implant-Supported Bridges – An implant-supported bridge is used when three or more adjacent teeth need to be replaced. Rather than using an individual implant for each missing tooth, only the two outermost teeth receive implants, which are used as supports for a dental bridge. This solution is more stable than a traditional bridge with crowns as abutments.
Implant-Supported Dentures – Both partial and full dentures can be affixed to dental implants. This provides a more functional restoration than traditional dentures, which must be affixed using adhesive pastes, and can pinch, slip, and cause sores in the mouth.
Full Arch with Only Four Implants – If all of the teeth on a single arch need to be replaced, this restoration can be used to replace them—and it can be placed the same day your teeth are extracted. This type of dental implant procedure may also be an option for some patients who have experienced bone loss, particularly if the bone loss is primarily located in the back of the jaw.
Mini Dental Implants – If there is insufficient room or bone density to support traditional implants, mini dental implants may be a good alternative. They are smaller than traditional implants, allowing them to fit into tight spaces and requiring less support from the jaw.
What are the advantages of dental implants in my situation?
Every dental professional has the talking points about dental implants down pat. What you want to know is why dental implants are right for you and your unique circumstances. A qualified doctor should be able to go beyond the well-known benefits of dental implants and tell you why you make a good candidate for the procedure and how dental implants will improve your life and your oral health.
How much experience do you have with dental implants?
These days, it seems like just about everyone in the dental profession is offering implants. How do you know a doctor really knows what they’re doing?
At Smiles on the Upper West Side, we take a team-based approach to dental implants, collaborating across several specialties in order to provide you with superior results—and eliminating the need to visit multiple dental practices. Dr. Massiah’s knowledge of dental implants has led to him being invited for speaking engagements on the topic. Dr. Smolen is a member of the International Team for Implantology and is the Educational Director of Full Mouth Rehabilitation at NYU’s College of Dentistry. Dr. Narain is a board-certified periodontist, giving him the knowledge to help patients resolve bone and gum issues prior to implant surgery.
What materials and technology do you use for dental implants?
If a practice is offering implants at a price that seems too good to be true, it probably is. Using cutting edge materials and technology may cost more, but the results are worth it. Cheap restorations can look fake and cookie-cutter, while high quality custom-made crowns, dentures, and bridges like the ones used at Smiles on the Upper West Side look completely natural and realistic.
Look for a practice that uses guided implant placement technology during the implant procedure. This allows doctors to create a customized implant placement map prior to your surgery, which shows the precise location for each implant. It also lets you get an accurate preview of your smile before your implants are placed. With this technology, we can produce optimal results for all of our patients.
Other important technologies to look for include cone beam scanner 3D imaging, digital x-rays and intraoral cameras, and electronic medical records to ensure that your documentation and records are never lost or misplaced. Because you’ll be spending some time at the dentist’s office to get your implants, you may also want to find a practice that feels comfortable and that offers amenities like wi-fi and digital flat screen monitors.
Do you have before and after photos?
Practices with extensive experience placing dental implants will be happy to provide you with patient testimonials, references, and before and after photos. Ask for them. Our practice has an online gallery showcasing our doctors’ results; when you come in for a consultation, we can show you before and after photos for patients who have cases similar to yours so you can get an idea of what kind of results you should expect.
If a doctor you’re talking to will not provide references or testimonials and has no before and after photos to show you, it’s a good idea to move on to the next dental practice on your list.
Can you provide me with a cost estimate?
Any practice you’re considering for dental implants should be completely transparent about the costs involved and provide you with an estimate in writing. At Smiles on the Upper West Side, our billing staff will check with your dental insurance provider to see if they will cover all or some of the costs of your implants. In some cases, they may not pay for the implants themselves, but may cover the cost of crowns. Other times, part of the implant procedure will be covered if the implants are needed after facial trauma or if bone loss has already occurred.
Once we know what to expect from your dental insurance provider, we will give you a written estimate of what you will be responsible for paying. We are also pleased to offer our patients CareCredit financing to help them pay for their dental implants.
When it comes to dental implants, don’t seek out a “good deal”—the best deal is a high-quality restoration that makes you feel confident in your smile and stands the test of time.
Learn More About Dental Implants
Dr. Massiah and the team at Smiles on the Upper West Side look forward to meeting with you to answer any questions you might have about getting dental implants. To schedule an appointment for a consultation, contact us at 212-222-5225 today.
If you’re human, you’ve had bad breath at some point in your life. Our patients are sometimes embarrassed to ask us about bad breath, but there’s no reason to feel that way––no one wants to have bad breath, but often the causes are out of your control. It may also be a sign of a more serious issue, which is why it’s important to take bad breath seriously and schedule a comprehensive dental exam to figure out the root cause.
Here’s what you need to know about bad breath.
Causes of Bad Breath
To know how to prevent bad breath, also known as halitosis, it’s important to understand the underlying cause. Here are the most common causes of bad breath:
Your Diet
We’d never ask you to give up garlicky hummus or everything bagels, but if you’re looking for the cause of your bad breath, it might just be in the food you eat. Garlic, raw onions, cruciferous vegetables like cabbage, curry, and other foods with strong odors can cause bad breath for up to three days. Your morning cup of coffee may also be contributing to your halitosis.
Most of us aren’t willing to forego our favorite foods and daily coffee fix, but when you’re aware that they cause bad breath, you can skip the garlic before your next important work meeting or blind date and indulge when you’re planning on spending the day at home bingeing on Netflix.
Smoking
Smoking cigarettes causes bad breath in a number of different ways. First, the smell of the cigarette smoke itself can linger on your breath. Smoking also dries out your mouth, one of the most common reasons for halitosis. Finally, smoking is one of the leading causes of gum disease, which is another source of odor from the mouth.
Gum Disease
Related to dental hygiene, plaque that is not removed from teeth turns into tartar, a sticky residue that cannot be removed by brushing. Tartar harbors bacteria, which irritates the gums; it also causes pockets, a term used for gaps that form between the teeth and gums where more tartar, plaque, food particles, and bacteria can collect. These areas, too, cannot be cleaned with brushing, so the build-up causes bad breath that worsens over time. Once pockets have formed, the only solution is a periodontal procedure called scaling and root planing. At our practice, we can perform this procedure using a laser for a more comfortable experience.
Dry Mouth
Dry mouth is a common cause of bad breath because saliva works to dilute and wash away bacteria and food particles throughout the day. When there is not enough saliva to effectively perform this function, bacteria and food become concentrated and cause odor.
Sinus and Throat Problems
Some causes of bad breath are better addressed by an ear, nose, and throat specialist or allergist rather than by a dentist. Allergies can cause mouth breathing, which in turn causes dry mouth and bad breath. Chronic sinus infections and postnasal drip both cause odor; upper and lower respiratory infections, tonsillitis, and bronchitis are also causes of halitosis. If your bad breath seems to emanate from the back of your mouth or tongue, it’s a sign that the odor is not coming from your teeth or gums.
Another reason you might have bad breath is tonsilloliths, also known as tonsil stones. Comprised of bacteria and food debris, these small calcified “stones” form in the crypts of your tonsils and can cause a foul odor that is not remedied by any of the solutions outlined below. When tonsil stones are a persistent problem, your ear, nose, and throat doctor may recommend getting your tonsils removed as a solution.
Other Health Conditions
There are other health conditions that can be a source of bad breath. These include gastroesophageal reflux disorder (GERD), kidney disease, liver disease, and diabetes. If you’ve tried the tips below and you haven’t gotten any results and you’ve eliminated all of the potential causes listed above, it’s time to make an appointment with your primary care provider for a physical.
4 Ways to Protect Against Bad Breath
Now that we’ve outlined the reasons you may have bad breath, it’s time to discuss potential solutions for it.
Prevent Dry Mouth
Dry mouth has many different causes. If you have allergies, sleep with your mouth open, or suffer from chronic sinus issues, you may breathe from your mouth instead of your nose, which causes dry mouth. Certain medications and radiation treatments also decrease the amount of saliva in your mouth. Unfortunately, many of these reasons for dry breath are not easily remedied; you can’t stop taking your medications and while sinus issues and allergies can be resolved, it’s not an overnight process.
Staying hydrated will go a long way to help with dry mouth, which in turn will improve bad breath and protect against tooth decay and gum disease. Rather than drinking soda, juice, coffee, or tea, opt for water and carry a bottle with you wherever you go. Limit the amount of alcohol you drink and switch to an alcohol-free mouthwash that has been formulated for dry mouth. When drinking water isn’t an option, choose sugar-free lozenges or gum over hard candies to keep your mouth lubricated.
Brush Two Minutes, Twice a Day
Since oral hygiene is a significant factor when it comes to bad breath, one of the first steps to take if you have halitosis is to overhaul your dental care routine. The best defense against bad breath is a good offense, which means brushing for two full minutes, twice a day, and flossing at least once a day.
You may think you’re brushing for two minutes, but if you’re not timing it, it’s likely that you’re not––two minutes is longer than most people think it is. Electric toothbrushes are fantastic because they have built-in timers, but failing that, use your phone or a kitchen timer in your bathroom to time yourself as you brush. Divide your mouth into quadrants, spending 30 seconds brushing each one. Make sure you brush the fronts, backs, and all chewing surfaces of your teeth.
Flossing should be done once a day, preferably at night to remove any stray food particles and debris that has accumulated between your teeth throughout the day. Floss gently, all the way up to the gum line, working the string back and forth as you go.
An antimicrobial mouthwash can freshen your breath too, but be sure that it’s alcohol-free. A mouth rinse made with alcohol may make your breath feel fresh and minty in the short-term, but in the long-term, it will result in a dry mouth.
Another tool to consider adding to your oral care arsenal is a tongue scraper. While the research on the value of tongue scraping is mixed (it seems to freshen breath temporarily, but the effects don’t last all day), many patients swear by them and feel that their breath is better after using a scraper. If that anecdotal evidence isn’t enough to persuade you to invest in a scraper, at the very least spend a few seconds brushing your tongue with your toothbrush after you’ve finished brushing your teeth.
If you wear a retainer, clear plastic aligners for straightening your teeth, or dentures, be sure that you clean them every day, as directed, whether it’s by brushing it with a soft-bristled toothbrush or using a specialized appliance soak. Many people have terrific oral hygiene habits, but their bad breath odor is coming from their dental appliances. Just like on your teeth, plaque and bacteria can build up on retainers, aligners, and dentures.
Quit Smoking
There are many reasons to quit smoking, and bad breath might rank lower on the list than preventing heart disease or lung cancer, but it’s still a valid reason to stop. There’s no question that smoking causes halitosis; as discussed above, the smoke itself causes odor, and it also causes both dry mouth and gum disease, two conditions that create an environment that encourages odor-causing bacteria to thrive.
Don’t Skip Your Routine Dental Exams
When you’re diligent about making dental appointments every six months, we can spot potential issues before they become big problems. Tooth decay and gum disease are two root causes of bad breath; seeing your dentist regularly can prevent both of these conditions. During your biannual appointments, we also thoroughly clean your teeth, removing plaque and tartar to protect your oral health and keep your breath fresh.
Schedule an Appointment Today
Are you worried that you have bad breath? Let us help you identify the cause and find a solution. Contact us at 212-222-5225 to schedule an appointment at our Upper West Side office in New York City.
We see many patients who are in the process of deciding between dental implants and dentures. As you weigh your options, it’s important to consider the following:
Dental Implants Preserve Jaw Bone
You hear it time and time again––dental implants prevent bone loss. But what exactly does it mean and how does it work?
Permanent (adult) teeth are anchored in place by a long root. The presence of this root tells the jaw bone that it’s needed for support. With the root gone, the jaw bone begins to deteriorate because it is no longer needed to support the tooth. When teeth are missing and bone density in the jaw decreases, we see:
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- The onset of facial collapse, a process in which the jaw begins to recede, causing a prematurely aged appearance
- Difficulty biting and chewing
- Other teeth shifting, becoming loose, or even falling out
When you choose dentures over dental implants, you’re replacing the visible portion of your missing teeth, but not the part below the gum line. This means that bone loss in the jaw continues unabated, leading to eventual facial collapse and a weakened bite.
Dental Implants Function Like Natural Teeth
Because dentures only replace the tooth above the gum line, they don’t function as your natural teeth did. Dentures feel unnatural; they may slip, impact your speaking, or rub against your gums, causing sores. To put them on each day, you’ll need to apply messy denture adhesives or creams. They have to be removed for cleaning and because they’re not anchored in place like implants, they don’t have the stability to allow you to eat all of your favorite foods.
In contrast, dental implants look and feel just like natural teeth––so much so that most patients forget they even have them after a while. They’re cleaned and maintained the same way as natural teeth too, with biannual dental visits, brushing, and flossing. They don’t impact your speaking, they don’t require adhesives, and you can eat any foods you like without restriction.
Dental Implants Last a Lifetime
Dentures need to be relined and replaced regularly; as the jaw bone changes shape, your dentures may no longer fit securely. Dental implants are designed to last a lifetime with proper care and maintenance.
Dentures Are More Affordable
Unfortunately, dental implants are not often covered by insurance, while dentures are. Even if you’re paying for your dentures out-of-pocket, though, they are more affordable than dental implants. This is because the process of getting dental implants is more involved, requiring multiple office visits, one or more surgeries, and custom-made artificial teeth to fit your mouth.
If dental implants are not an option for you because of finances, we offer top-of-the-line traditional dentures. We also offer an exciting hybrid option, implant-supported dentures, in which a full or partial denture is anchored in place with implants. Because each missing tooth is not being replaced with its own implant, this procedure is a more affordable solution.
Find Out More About Dentures vs. Dental Implants
If you have questions about which option is right for you, make an appointment today to see our team at Smiles on the Upper Westside. Contact us at 212-222-5225 to schedule a visit.
Even when we take the best possible care of our teeth, problems start to develop as we age. This is why it’s especially important to make those biannual dental exams and cleanings well into your senior years––dentists can spot potential issues before they progress to the point of needing costly restorative care. Below are some of the most common dental problems we see in older adults.
Oral Cancer
Regardless of your age, your dentist checks for signs of oral cancer at every routine dental visit. This is crucial because early signs of mouth, throat, and tongue cancers may be painless or mistaken for other benign conditions, like canker sores. The average age of patients diagnosed with oral cancer is 62; oral cancer claims over 10,000 lives each year, but early detection increases your odds of survival.
To minimize your risk of oral cancer, quit using tobacco in all forms and drink alcohol in moderation, if at all. Wear a lip balm with sunblock year-round when you’re going to be outside and reapply often.
Gum Disease
When plaque builds up in the mouth, it can cause periodontal disease. While the start of gum disease is often painless, it progresses into bleeding and swollen gums and the formation of pockets along the gumline where more plaque and food particles collect. This can lead to the deterioration of gums, bone, and ligaments and, eventually, tooth loss.
Luckily, gum disease is easily treated when caught early. Scaling and root planing treatments clean plaque from teeth and help gums reattach to the roots, eliminating pockets.
Tooth Decay
Gum disease can also lead to root decay. When gum tissue recedes, it exposes the roots of teeth. These roots do not have the same enamel found on the crowns of your teeth, making them more susceptible to decay. Root decay can be painful and lead to tooth loss.
According to the CDC, one in five adults over the age of 65 has untreated tooth decay. It’s important to treat cavities early to prevent decay from spreading and causing pain.
Dry Mouth
While dry mouth can be caused by radiation treatments for cancer in the head or neck and certain diseases, the most common cause of dry mouth for senior patients is medication. There are a number of common prescription medications, from SSRIs for depression and anxiety to diuretics, that cause a reduction in saliva flow. Saliva works to wash away decay-causing bacteria and food debris throughout the day; without sufficient saliva, bacteria thrives in the mouth.
To remedy this at home, use a mouthwash designed for dry mouth, stay hydrated, and use sugar-free gum or lozenges to stimulate saliva production.
Make an Appointment Today
If you have questions about caring for your teeth as you age, make an appointment today to see our team at Smiles on the Upper Westside. Contact us at 212-222-5225 to schedule a visit.
Bad breath, scientifically called halitosis, is a problem no one wants to have. Not only is bad breath unpleasant to others and makes a negative impression, it can also be a sign of underlying oral health issues.
If you want to banish bad breath and keep it away for good, you’ll need to make some changes and develop some good oral health habits. Here are 7 ways to prevent bad breath and keep it away.
1. Brush Your Teeth More Often.
How often do you brush your teeth? Once in the morning? Once at night? If you’re suffering from bad breath you may need to increase your brushing frequency to make sure you’re brushing away plaque from your teeth that feeds the bacteria that cause bad breath.
2. Floss Your Teeth.
Do you floss your teeth in addition to brushing? This is a commonly forgotten oral hygiene step, but it is one that can make a big difference in your breath. Even if you’re brushing regularly, you need to floss in order to reach and remove the plaque that builds up between your teeth and under the gum line.
3. Use Mouthwash.
Swishing with mouthwash at least once a day or between meals can eliminate bad breath by killing the bacteria in your mouth. Mouthwash, because it is a liquid, is able to reach even the smallest nooks and crannies of your mouth like in between teeth and in the pockets in your gums. Make sure you choose one that is designed to eliminate bacteria, not just cover up bad breath with a mint flavor.
4. Chew Sugarless Gum.
Chewing gum in between meals can also help to freshen bad breath. But be sure to chew sugarless gum because sugar feeds the bacteria in your mouth that are causing the bad breath, which only makes it worse.
5. Keep Your Mouth from Getting Dry.
A dry mouth is more likely to cause bad breath, so keep your mouth moistened as much as possible by drinking plenty of water throughout the day. You can also use a humidifier in your home during the dry season to help prevent dry mouth. Avoid smoking and using tobacco products because they also cause mouth dryness.
6. Scrape/Brush Your Tongue.
A lot of the bacteria that causes bad breath actually live on your tongue, hiding among the bumps and taste buds. When you brush your teeth be sure to brush your tongue as well to remove as much of the bacteria as possible. Or use a tongue scraper, which is a device that is designed to remove bacteria from your tongue by making one sweep across the width of your tongue from back to front.
7. Visit Your Dentist Regularly.
Chronic bad breath can be a sign of an oral health issue, such as gum disease or cavities. Your dentist can treat the underlying issue causing your bad breath by cleaning your teeth, scraping your gums, filling cavities, and other corrective or restorative procedures.
Visit Smiles on the Upper West Side
If you truly want to banish bad breath and keep it away for good, proper oral care is an absolute necessity. Dr. Massiah and the staff at Smiles on the Upper West Side want to help eliminate your bad breath by treating it at the source. With regular cleanings and care from a dentist, your breath can stay fresh with just the basic at-home oral care between appointments and the 7 tips listed above.
Call (212) 222-5225 today to make an appointment at Smiles on the Upper West Side or request an appointment.
When you are missing a tooth, you have three options: you can get a dental implant, a dental bridge, or just leave it be. We don’t recommend the third option–doing nothing is certainly an option that works for every budget, but when a tooth isn’t replaced, it can alter the shape of your face, impact your speech patterns, cause problems with biting and chewing, and allow your remaining teeth to shift and become misaligned.
Now that we’ve narrowed things down to dental implants vs. bridges, let’s go over what exactly these options are and the pros and cons of each.
What Are Dental Implants?
Dental implants are the preferred treatment for missing teeth. Unlike a dental bridge, dental implants replace both the root and crown of a tooth, which makes implants much more stable. While most of our patients are aware of single tooth dental implants, with a titanium root and porcelain crown, you can also have implant-supported dentures and a full arch with only four implants.
When three or more teeth in a row are missing, an interesting hybrid option is the implant supported bridge. With this device, the two outermost missing teeth each receive a dental implant and these implants act as supports for the bridge in the middle that replaces the remaining missing teeth. The implant supported bridge offers more stability than a traditional bridge, but is a more affordable option than replacing all of the missing teeth with their own implant.
The Pros and Cons of Dental Implants
The Pros of Dental Implants:
- With their strength and durability dental implants perform most like natural teeth.
- Because they replace the root of the tooth, implants can reverse jawbone loss and ensure that your bite is strong.
- Implants are the best option to restore your natural smile.
- With proper maintenance, dental implants can last a lifetime.
- When there is significant decay or weakness in the teeth surrounding a missing tooth, implants are the best option.
The Cons of Dental Implants:
- The procedure is more involved than getting a bridge–you can expect to spend more time at our office.
- If you’ve already experienced jawbone loss, you may need bone grafting prior to implant placement.
- Dental implants are more expensive than bridges.
- Dental implants are not always covered by insurance.
What Are Dental Bridges?
Dental bridges comprise of two abutments, or supports, on surrounding teeth, with a pontic, or false tooth, joining the two together. In a Traditional Bridge, the abutments are usually dental crowns placed onto two teeth adjacent to the missing one, but a more affordable option is the Maryland Bridge, which cements a metal or porcelain framework onto the abutment teeth to hold the crown in place. A Cantilever Bridge is used when the third molar is missing and there is only one adjacent tooth to serve as the abutment.
Another option is the implant supported bridge, which we discussed above.
The Pros and Cons of Dental Bridges
The Pros of Dental Implants:
- Dental bridges are usually at least partially covered by dental insurance, if not fully.
- Bridges are more affordable than dental implants.
- The process of getting bridges is easier and requires less time off of work.
- Dental bridges are an option when there is bone loss or other complications.
The Cons of Dental Bridges:
- Dental bridges typically last only 5 to 15 years, even with good maintenance.
- Bridges are not as strong as dental implants, which can make for a weaker bite.
- Bridges require work on surrounding teeth, while dental implants do not.
- Because bridges do not replace the root of the missing tooth, bone loss may continue unabated.
Dental Implants vs. Bridge: Which Is Right for You?
Reading through this article about the pros and cons of dental bridges and implants may have given you some idea about which option is best for your situation. The only true way to know whether you’re better off with dental implants or bridges is to make an appointment with a qualified dentist, like one from our team at Smiles on the Upper Westside.
We’d love to meet with you to discuss options for replacing your missing teeth. Contact our NYC dental practice at 212-222-5225.