TMJ is the quick way of referring to your Temporomandibular Joint. Pardon the pun, but that’s quite a mouthful! What is this joint, what does it do, and, if your Drs. Darrin and Greg Gremban and our team have told you that you have a TMJ disorder, what can we do to help?

The Temporomandibular Joint

Your two temporomandibular joints are amazing works of anatomical design. These are the joints where the temporal bone in the skull meets the mandible bone of the jaw, and allow our mouths to open and close, move back and forth, and slide from side to side. Muscle, bone, and cartilage work together to provide easy movement and to cushion the joint. But sometimes, the joint doesn’t work as smoothly as it should, and this can lead to Temporomandibular Joint Disorder, or TMD.

When Should You Suspect You Have TMD?

You might have TMD if you experience any of these symptoms:

• Painful chewing
• Pain around your TMJ, or in your face or neck
• Earaches
• Changes in your bite
• Jaws that are limited in movement or lock open or shut
• Clicking, popping or grating noises when you open and shut your jaw

There are many conditions linked to TMD. If you grind your teeth at night, have arthritis in the jaw, have suffered an injury or infection in the area, or have problems with your bite, for example, you might be more likely to have TMJ problems. If you suspect you have TMD, or suffer from any of the symptoms listed above for an extended period, give us a call.

Treating TMD

During your visit to our Eagle River office, we will check your medical history, and examine your head and neck. We can take an X-ray or scan if needed for further examination of the joint. Because there is no real scientific agreement yet about the best way to treat TMJ disorders, a conservative treatment plan is often best. If you do show signs of TMD, we might first suggest relaxation techniques, over-the-counter pain relievers, or the use of ice packs or moist heat compresses. A change to a softer diet can help, and you should stop chewing gum and making any exaggerated jaw movements.

If these self-care practices aren’t effective, we might suggest a nightguard. This appliance is a comfortable and flexible mouthguard custom fitted for you, and will bring relief from teeth grinding when worn at night. If this treatment is not effective, talk to us about other options.

Luckily, most cases of TMD are temporary and don’t become worse over time. But any persistent discomfort is a good reason to visit us. Whether you have TMD, or any other problem causing you pain in the head or jaw, we want to help.

Snoring may not be something you take seriously. You might even laugh or joke about it. But the fact is, anytime you or your partner snore to the point of waking, it could be a sign of serious health problems.

Sleep Apnea and Its Effects

Sleep apnea is a sleep disorder that is potentially dangerous, and the most common symptom is loud snoring. Breathing repeatedly starts and stops throughout the night, and you wake up feeling tired. Other serious effects from sleep apnea could be potentially dangerous to your health if left unaddressed.

Besides losing a good night's sleep, you may experience difficulty concentrating. Depression, risk of heart attack, irritability, high blood pressure, memory loss, sexual dysfunction, and chances of stroke all increase when sleep apnea is not treated.

Sleep apnea occurs when the muscles in the back of the throat relax to the point of inhibiting natural breathing. The muscles used to support the soft palate relax and the airway closes, causing breathing to stop for ten to 20 seconds. This lowers the oxygen level in the brain. As the brain senses the inhibited oxygen levels it rouses the sleeper awake so the airway can reopen. Normally, the reawakening is so brief the person won't remember it.

If you think you may have sleep apnea, visit our Eagle River office and let Drs. Darrin and Greg Gremban determine what treatment is needed. Without it, you could risk losing more than a restful night's sleep.

Prevention and Treatment

Anyone can develop sleep apnea, but it is more common among middle-aged adults who are overweight. Drs. Darrin and Greg Gremban can help you determine the cause and suggest positive treatment.

A common treatment for apnea is the placement of oral devices that are designed to help keep the airway open. By bringing the jaw forward, the device opens the airway and thereby discourages snoring. We are experienced in sleep apnea appliances, and Drs. Darrin and Greg Gremban can prescribe a fitted device and monitor its success with follow-up therapy.

A continuous positive airway pressure mask, known as a CPAP, is among the other treatment options. A mask is fitted over the mouth and forces oxygen through the throat while you sleep. The pressure holds the soft tissue and throat muscles open.

Our professionals at Gremban & Gremban Dental can advise you of other ways to prevent sleep apnea, including weight loss, avoiding alcohol, or alternative sleeping positions. We can help you sleep return to easy sleep, knowing you are safer and healthier during your resting hours.

At Gremban & Gremban Dental, we know that hormones affect a woman's mood, but did you know they can also impact the health of a woman’s mouth? Women are susceptible to gum disease at different times in their lives, and research shows that hormonal highs and lows are part of the problem. According to studies, there are five situations in women’s lives during which hormone fluctuations make them more susceptible to oral health problems: puberty, their menstrual cycles, pregnancy, menopause, and birth control pill usage. So just what happens and how can you help protect your oral health? Drs. Darrin and Greg Gremban and our team have outlined the five hormonal situations and provided a few tips and tricks to fending off potential issues.

Puberty - The surge of hormone production that occurs during puberty can increase the blood flow to the gums and change the way gum tissue reacts to irritants in plaque. As a result, a woman's gums may bleed during the act of brushing and flossing.

Monthly menstruation cycle - Hormonal changes (especially the increase in progesterone) occur during a woman’s menstrual cycle. These changes can lead to red swollen gums, swollen salivary glands, canker sores, or bleeding gums.

Pregnancy - Hormone levels tend to fluctuate during pregnancy. As a result, women are at greater risk to develop a condition called gingivitis, the early form of gum disease. Drs. Darrin and Greg Gremban may recommend more frequent professional cleanings during your second or early third trimester to help reduce the chance of developing gingivitis. Please let us know if you are pregnant during your visit.

Menopause - Women are known to experience numerous oral changes as they age. These oral changes can include greater sensitivity to hot and cold foods and beverages, a burning sensation in your mouth, or dry mouth. Dry mouth, also known as xerostomia, can result in the development of tooth decay and gum disease because saliva is not available to moisten and cleanse the mouth. It is important to know that dry mouth can also result from many prescription and over-the-counter medications. The gradual loss in estrogen that occurs with menopause also puts older women at risk for loss of bone density, which can lead to tooth loss. Receding gums, which expose more of the tooth surface to potential tooth decay, can be a sign of bone loss in the jawbone.

Birth control pills - Some birth control pills contain progesterone, which increases the level of that hormone in the body. Women who take pills with progesterone may develop inflamed gum tissue due to the toxins produced from plaque. Be sure to tell us if you are taking an oral contraceptive during your visit.

To prevent gum disease, we recommend:

• Brushing your teeth at least twice a day with a toothpaste containing fluoride
• Flossing at least once a day
• Eating a well-balanced diet
• Avoiding sugary or starchy snacks

Drs. Darrin and Greg Gremban and our team at Gremban & Gremban Dental encourage you to visit our Eagle River office and practice good oral health habits at home.

They’re refreshing and tasty. They’re easy to find and pretty cheap. They help us get through a long day or a long workout. They’re everywhere.

We know it’s hard to say no to an energy or sports drink. That’s why Drs. Darrin and Greg Gremban and our team want to make sure you know the effects that energy and sports drinks can have on your smile and overall oral health. You might just think twice next time you crave one.

There’s a common misconception that sports and energy drinks are somehow healthier than soda beverages. None is particularly good for you, but because sports and energy drinks have higher acidity levels, they put you on a fast track to enamel erosion, which can lead to cavities over time. However, studies show that energy drinks may be the worst of the bunch.

In a study published in General Dentistry, the energy drinks that showed the highest acidity levels were 5-hour Energy, Monster, Rockstar, and Red Bull Sugar free. These drinks almost doubled in acidity when compared to sports drinks. The sports drinks that came in second as far as acidity levels go were Powerade, Gatorade, and Propel.

You may be thinking, “What's the big deal; lots of other drinks damage your teeth, too,” and you’re right. Even all-natural beverages like orange juice and other fruit juices, which are advertised as full of vitamins, contain acid that damages tooth enamel. The point here is that moderation is key.

We certainly encourage you to choose a glass of orange juice over an energy drink, but if you feel like you just can’t give up your sports and energy drink habit, then please consider the following tips:

• Limit yourself to a certain number of said beverages a week and stick to it.
• Rinse with water after consuming an energy or sports drink.
• Brush your teeth after an hour of downing the drink, so your mouth has time to return to its normal pH level.

If you have any questions, don’t hesitate to give us a call at our Eagle River office. Shoot us a message on Facebook, or let us know on your next visit!