Tue 12 Feb 2008
This week brought two new patients that have locked jaws. Their “TMJ joints” either have been displaced or they are having muscle spams. There was a significant differences in age as well as both sexes.
So what do we do? First, I always start with a full exam. This includes history of the injury or event along with full dental exam. I check muscles and all the related supporting structures to get an idea of the extent of the problem.
A word about x-rays: I recommend a complete set of x-rays as well as additional x-rays of the TMJ. For the x-rays of the TMJ, there is a single cone x-ray called an I-Cat. The I-Cat gives a great hard tissue view of the bone. If I need additional information after I see the I-Cat, I may request an MRI. This kind of X-ray will fill in the blanks of soft tissue information that the I-Cat will not have.
With the combination of the exam, history and supporting documentation can give me a great idea as to the health of the TMJ and a prognosis. Having an accurate diagnosis is what dictates treatment and projected outcome. Based upon this information, I design and make a TMJ splint. A well designed TMJ splint is essnetial for TMJ treatment as well as for aiding in the diagnosis.
Locked jaws are nothing to waste about time about. One of hte most important factors determining recover is the time lapse between the event and a visit to your dentist. Time is critical. The sooner care is started the better the chance of complete recovery. I am pleased to say that I expect these two patients from last week to make good recoveries.
2 Responses to “Jaw Locked”
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March 26th, 2008 at 8:18 pm
Dr. Sperbeck,
I am using the comments section as suggested by your dd A., whom I know from a message board online. I hoped you might be able to address a few questions about dental care for children. A recent discovery of cavities in my children prompts my asking:
would a root canal be necessary in a seven year old child?
should all cavities be filled, even small cavities in primary teeth?
is mercury in fillings acceptable for primary teeth which will be falling out within five years or so?
what can I do specifically so that we don’t have cavities like this again?
Thanks for any time you may be able to spend in addressing these questions.
March 26th, 2008 at 9:44 pm
Dear Laura,
Let me try to answer your questions as listed.
1. Should root canals be appropriate for a 7 year old?
Root canals are use when the nerve of the tooth is damaged or dead. This will cause the leakage of toxins into the body. Usually an abscess is the result with a variety of consequences. Root canals for children fall into the either for permanent teeth or baby teeth. if it is for a permanent tooth it is usually a very good idea. If it for a baby tooth it depends on how much longer the tooth is needed before its eventual loss. Baby teeth serve many purposes. Baby teeth are important in helping jaws develop and holding the place for the soon to be present permanent teeth. So should baby teeth be root canaled the answer is maybe. Your dentist will be able to answer the pros and cons for treatment.
2. Should all cavities be filled?
Again the answer is usually. If the tooth is not in hopeless condition and there is continued need for the tooth then the answer is yes. With a baby tooth I usually try to gage the size of the cavity with the expected time for the loss of the tooth. If the cavity will not grow to big and cause nerve damage or affect the tooth next to it I will not repair it. I always inform the parent so they can be in the decisions.
3. Should Mercury fillings be used?
Mercury fillings are also known as Amalgam fillings. The material is approximately 50% mercury and 50% silver. I do not believe it should be used for any reason. Mercury is very dangerous for children and women in the child bearing years. Once mercury enters and is absorbed in the body it is very difficult to remove not to mention the expenses for removal. There are other materials that will restore the teeth as well with out the possibility of risk.
4. How to prevent cavities?
This is a great question. Prevention is where the battle should be fought. So your areas to concentrate on are:
A. Control diet. Everything that can cause cavities should be controlled. The list is numerous but the management is doable.
B.Good oral hygiene with toothbrush and floss. These are very inexpensive and have a huge bang for your buck.
C. The use of sealants. Very under utlized.
D. Oral hygiene instruction from your dentist. Always ask them or the hygenist for an evaluation. Each hygiene appointment should be a learning time. Patients should clean their own teeth professionals should instruct.
E.Frequent hygiene appointments with a dental checkups each visit. This is the standard in our office.
F. X-rays routinly taken. The are invaluable to help in prevention of serious problems. If you can, have digital x-rays taken.There is a significant reduction in the exposure of the x-ray.
I hope this helps.
Regards,
Dr. Sperbeck