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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 Drs. Schofield and Dad 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 Drs. Schofield and Dad at our Grapevine 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.

If you’ve been following a vegetarian or vegan diet, you know that there’s much more to living a healthy life than simply avoiding meat products. Making sure your diet includes enough protein, as well as any nutrients that are primarily available in animal products, takes planning, and there’s no one-menu-fits-all solution.

Why? Because there’s no one menu that will suit all vegetarians. Specific vegetarian diets can allow for many different options:

• Vegan—a plant-based diet which excludes meat, fish, dairy, and egg products
• Ovo-vegetarian—includes eggs as a dietary option, but no dairy
• Lacto-vegetarian— includes dairy as a dietary option, but no eggs
• Lacto-ovo-vegetarian—a meat-free diet which allows both dairy products and eggs

If you are a pescatarian, who eats fish on occasion, or a flexitarian, who sometimes includes meat in a meal, your menu options are even broader.

So let’s look at the big picture—a healthy vegetarian diet is really more concerned with the foods you do eat for nutrition rather than the foods you don’t. You can create a meal plan rich in all your essential nutrients with a little research, no matter which type of vegetarian diet is your go-to choice.

And while you’re constructing your ideal menu guidelines, don’t forget about your dental nutrition!

In terms of keeping your teeth and gums their healthiest, what important vitamins and minerals are often missing from vegetarian and vegan diets? Let’s look at three of them.

• Calcium

Calcium is essential for maintaining strong bones and tooth enamel. Without enough calcium, a weakened jawbone leads to loose, and even lost, teeth. The acids in our food and the acids created by oral bacteria also weaken the minerals in enamel, including calcium. These weak spots can eventually become cavities. A diet rich in calcium not only supports the bones holding our teeth, but can even help repair, or remineralize, enamel which has been weakened by acidic erosion.

For vegetarians who include dairy in their diets, dairy products are a great way to include calcium. Milk, cheese, and yogurt are traditional and rich sources of this mineral.

For vegans, it’s a bit more challenging, but still doable! Non-dairy foods providing calcium include dark green vegetables (kale, broccoli, spinach), certain types of tofu, and fortified cereals, juices, and non-dairy milks.

• Vitamin D

Now you’re ready to put that calcium to work by making sure you have enough vitamin D in your diet. Vitamin D not only helps keep our bones healthy, it also enables our bodies to absorb calcium. Bonus—it’s been linked to better gum health in several studies.

So how to get more vitamin D? If you eat dairy, most dairy products have been fortified with vitamin D. If eggs are a part of your diet, egg yolks are a great source. Pescatarians can enjoy the benefits of vitamin D from fatty fish such as tuna and salmon.

Because we get most of our vitamin D from sun exposure or foods derived from animals, plant-based foods are not a practical way to obtain the vitamin D you need. But, just as non-vegetarians can get plentiful vitamin D from fortified dairy products, vegans also have options. Try adding cereals, juices, and non-dairy milks fortified with this essential nutrient to your diet, or take a vegan vitamin D supplement.

• Vitamin B12

Vitamin B12 is essential for healthy red blood cells, nerve cell development, brain function, and DNA production. (This is why it’s especially important for pregnant and nursing women.) Vitamin B12 can also impact your oral health. A B12 deficiency can cause a swollen, sore, or inflamed tongue, loss of taste, and gum, tongue, and mouth ulcers.

Unfortunately, vitamin B12 is reliably found only in animal foods and nutritional yeasts. If you would prefer an egg-free and dairy-free diet, look to B12 supplements or B12-fortified cereals, plant-based milks, energy bars, and other vegan options. This is a good subject to discuss with your physician, because even supplements and fortified foods might not provide enough B12.

In fact, Drs. Schofield and Dad can be vital resources when you’re planning your healthiest vegetarian diet. The next time you visit our Grapevine office, ask for recommendations for supplements if you’re concerned that diet alone can’t provide for all of your nutrition essentials. Finally, care should be taken to ensure that, even with supplements, you get the proper amount of the vitamins and minerals you need.

As a vegetarian, you are used to the concept of care. Whether it was concern for nutrition, the planet, the animal world, or another reason that drew you to a vegetarian diet, be sure to care for your body as well as your dietary choices. Careful planning can ensure a diet which supports not only your general health, but your oral health, for a lifetime of nourishing—and well-nourished—smiles.

Is this a trick question? After all, you and your family probably already know quite a lot about cavities:

• It all begins when bacteria-filled plaque sticks to teeth and starts to attack enamel. How?
• Because the bacteria in plaque use the sugars and other foods we eat to produce acids.
• These acids gradually weaken teeth by dissolving minerals that help make up our enamel (a process called demineralization).
• Over time, a hole, or cavity, develops in the tooth surface.
• Left untreated, bacterial decay can spread to the inside of the tooth, creating a more serious cavity.

Drs. Schofield and Dad might discover an unexpected cavity at a regularly scheduled dental exam at our Grapevine office, but there are also some symptoms that should have you calling for an appointment. A cavity can cause sensitivity when eating something hot or cold, or it can be painful, or you might even notice visible discoloration or damage to the tooth surface.

So, if your child has any of these symptoms, it’s a cavity, right? It might be—but it might not. Sometimes, because the symptoms are similar, what we suspect is a cavity is really enamel erosion.

The bacteria-created acids weaken enamel. But it’s not just bacteria that subject our teeth to acids. Acidic foods are one of the leading causes of tooth erosion.

And while we expect damage from a lifetime of acidic foods and beverages to catch up with us as we age, the fact is that erosion is becoming a problem even for young children. How is this possible? Let’s look at some food chemistry.

Our normal saliva pH level is around a 7, which is neutral. Any number lower is acidic; any number higher is alkaline. Acidic foods have a low pH (the pH of lemon juice, for example, measures between 2 and 3), and can reduce our normal, neutral pH level. When saliva pH levels drop to 5.5 or lower, tooth enamel starts to demineralize, just as it does when exposed to the acids from oral bacteria.

Regularly snacking on citrus and other acidic fruits, fruit juices, flavored drinks, sour candies, and other acidic foods can cause enamel erosion. Especially erosive are sports drinks, energy drinks, and colas, because they contain some combination of citric acid, phosphoric acid and/or carbonation.

So, when might you suspect enamel erosion? Your child might be sensitive to hot or cold foods, or feel pain, or even have noticeable enamel loss or pitting. Even though these symptoms may not have been caused by plaque and bacteria, acidic erosion from our diets leaves weakened enamel just as vulnerable to cavities and decay.

How to avoid erosion?

• Serve acidic foods sparingly, or as part of a meal. This helps our saliva pH stay in the neutral zone.
• Balance acidic foods with low-acid choices to neutralize acids and restore a normal pH balance. For example, mix those acidic berries with a banana.
• Use a straw! These are not only fun, but this simple solution keeps erosive drinks from bathing young teeth in acids.
• Encourage your child to drink water instead of an acidic beverage, or drink it afterward to rinse acids away. The pH of pure water? A perfect, neutral 7. And by using tap water instead of bottled water, you’ll be providing fluoride, which helps strengthen enamel.
• What about brushing right after eating or drinking something acidic? Ask Drs. Schofield and Dad if your child should rush for the brush. We may recommend waiting 30 minutes or so after an acidic treat to give the teeth time to remineralize. Otherwise, brushing might cause more wear and tear on enamel.
• Finally, while foods are often the source of acid erosion, medical conditions can cause erosion as well. Talk to us about ways to minimize erosion while addressing these medical needs.

Be proactive. Ask your Drs. Schofield and Dad about healthy drinks and snacks for healthy teeth. Make sure to keep on top of brushing and flossing, and stick with fluoride toothpastes. And visit our Grapevine office regularly for exams and cleanings.

There’s really no trick to it—preventing enamel erosion helps keep your child’s teeth structurally strong and cavity-free for a lifetime of beautiful and healthy adult smiles.

One word no one likes to hear is “cavity!”

For those patients of ours wearing braces, hearing that word is especially problematic, considering that delaying any dental work may result in delaying treatment time.

We often blame candy as the culprit behind tooth decay, but other foods and drinks that kids consume can be just as harmful to their teeth, and can lead to cavities and tooth decay. Keeping your teeth or your child’s teeth from decay during treatment starts with a proper diet, and today, our team at Grapevine Kids will explain the negative effects that candy and other treats, including peanut butter, raisins, fruit juice, and chewy fruit snacks, have on your child’s teeth as he or she undergoes orthodontic treatment. Keep in mind that half of your child’s sugar intake may be coming from beverages that he or she drinks. A major offender is soda, but be mindful of fruit juices as well.

While sugar is known to sit in your child’s teeth and in between and under brackets and wires after consumption, it is important to know sugar is not the only cavity-causing culprit. Carbohydrates, starches, acids, and any food that is chewy or sticks break down into sugars, and can promote tooth decay.

So, what are the alternatives?

Candy such as dark chocolate, sugar-free gum, or anything that contains xylitol, a sugar substitute, is not as harmful for your teeth as hard, chewy, or sticky sweets. Sugar-free gum or gum that contains xylitol are known to reduce levels of bacteria on teeth.

And if you’re still looking for something to snack on, we recommend cutting up easy-to-eat fruits and vegetables. You would also be surprised how much eating a banana or sipping on a glass of water helps you curb snack cravings.

If you’re one of those folks who just can’t stay away from sweets, we encourage you to brush your teeth immediately afterward and swish water in your mouth.

Whatever you eat, Drs. Schofield and Dad and our team want you to remember to brush often, floss regularly, and visit your general dentist as your treatment progresses. If you have any questions about sugary foods or drinks, please give us a call or ask us during your next adjustment visit!