Which Is It--Your Teeth, Your Jaw, Or Your Muscles?

Had a patient come in, complaining of some intense pain in her lower left back tooth that not even medication could help.  My instincts screamed "ROOT CANAL" for the hurting tooth, but I let my doctor brain put the brakes on that line of thinking and I thoughtfully worked through the examination.  In the end, there was no treatment recommended. WHAT?!?!? A dentist doesn't want to carve up a patient?

That scenario is more common than you think. I have treated head and neck pain for years, and I have learned about how pain can be referred from non-tooth sources. Problems with blood vessels, facial nerves, skin, and muscles can elicit tooth pain, and vice versa. These relationships are called bi-directional trigger points. 

Take the example of the primary muscles of chewing.  Not only do we use them to chew, we also use them to clench our teeth in times of stress. Wherever and whatever the nature of the stress (bruxism, apnea to name a couple), our muscles can become inflamed, and pass pain onto the nerve pathways of the teeth. The pictures below will show how upper teeth and lower teeth can be affected.

Conversely, I have anecdotal cases of patients with jaw or muscular or facial pain that is not felt in the teeth, but comes from abscessing, decayed, or inflamed teeth.

I have successfully used bite guards, night guards, Botox in the muscles, and sleep breathing appliances to deal with these aches and pains. 

I Can't Breathe, And My Teeth Are Shrinking!

Years ago, I could swear people were coming to me with signs of freshly ground tooth enamel or broken teeth and crowns. I could literally watch the teeth being carved down over the course of hygiene visits. So I would ask them if they were aware of a habit that would make that happen. "No," they would shrug. "I don't." The only thing I and my patients could agree on was that they didn't grind their teeth during the day.

I know tooth wear is not typical. In fact, our brains do not allow our teeth to touch, even when we eat. If they do touch, it's called parafunction, or an abnormal function. So I was puzzled for a long time. It's frustrating when you know there's a reason for an occurrence, but you can't identify it.

What I started to recognize around 2005 was that patients informed me more often about obstructed breathing in their medical histories. Then I started to make a tally of which of these patients had tooth damage  and which didn't. And then I compared them to the patients who were not claiming obstructed breathing disorders. I noticed that all patients I saw who had a sleep breathing disorder were manifesting tooth wear.  The literature showed that this was occurring in a cause-and-effect fashion: When your airway closes, your brain instructs your jaw to move to open your airway. Your teeth can be in the way, and over time, will suffer damage in attempts to remedy obstructed airflow.

We work closely with specialists to determine if you have a breathing disorder, and we treat sleep breathing disorders with oral appliance therapy. We just so happen to treat teeth as well. Call us to schedule an appointment today.

Treat Blood Pressure By Treating Apnea

A patient walked in to see me last week, middle aged gentleman, energetic, talkative, friendly. Not the least bit stressed-out from all outward appearances. But his blood pressure was 210/130!  His readings came down modestly as we sat and talked.  But I booked him a visit at his primar care doctor's office before he left. Upon examination, I recognized he had lots of risky physical characteristics and a positive history for sleep breathing obstruction. I told him he could manage his blood pressure by managing his breathing.  His eyebrows went up.

It's true--blood pressures are reduced in patients treat their obstructive sleep apnea. The atricle I attached goes on to describe the study was performed with patients using oral appliance therapy.

I am a member of the AADSM--The American Academy of Dental Sleep Medicine.  Call today to begin your treatment.