Chronic Pain and Addiction: What are Your Thoughts?

A Huffington Post article discusses the opioid epidemic in the United States. This epidemic continues to increase dramatically with over 2 million Americans struggling with abuse of an opioid pain reliever. This Huffington Post article discusses the effects of chronic pain and how addiction can grow from this. Let’s take a closer look:

The Article

An estimated 100 million Americans experience chronic pain. This chronic pain can be caused by an injury, with the most common complaints of headaches, neck pain, facial pain, lower back pain, and others. Unfortunately, though, many times the pain can be enigmatic and complex or difficult to diagnose. When this happens, treatment might seem too out of reach for many patients, who then result to pain medications, such as opioids, to cope.

Women and Pain

Women are more likely to suffer from chronic pain and TMD than men. Temporomandibular joint disorders can have a wide effect on the jaw, head, and neck, and can be attributed to headaches. TMD can also be linked to pain in the ears and can be caused by:

  • Bruxism
  • Poor Body Structure
  • Growth abnormalities
  • Trauma
  • Hormones
  • Stress
  • Problems in the brain and nervous system

This pain can also lead to further complications, such as sleep disturbances. With 42 million people reporting pain or physical discomfort disrupting their sleep throughout the week, it is important to provide our patients with proper treatment. Through proper treatment we can hope that we can eliminate or decrease opioid use and addiction among women.

Let’s keep an eye on this topic and see what more we can do as dentists and craniofacial pain specialists. But before I end, I want to know what your thoughts are on this topic? Should we be doing something more?

The Painful Truth About TMD and How to Help

As you already know, temporomandibular joint disorders (TMD) refer to a cluster of conditions that are often characterized by pain in the temporomandibular joint (TMJ) or its surrounding tissues. The surrounding tissues might include the neck, head and even shoulders. Conditions involving the TMJ are so common among the adult population that up to 75 percent show at least one sign of TMD upon examination. Let’s take a look at some of the instances in which TMD can cause further complications and how to educate your patients.

Further Complications

Evidence continues to be available about TMD and how it can be worsened by other conditions. Today, it has been shown that anxiety, stress, and other emotional disturbances may worsen TMD. Some of the common signs of TMD include:

  • Jaw pain
  • Limited or painful jaw movements
  • Headaches
  • Neck pain or stiffness
  • Clicking or grating within the joint
  • Inability to open mouth without pain

It has been shown that about 55 percent of patients with chronic headaches who were referred to a neurologist actually have signs of TMD. Without the education on TMD, signs and symptoms often go overlooked and no treatment can be found.

As a dentist, you can put an end to the misdiagnosis of TMD by completing further education. You can also educate your patients on self-care techniques and referral for non-invasive treatment should be considered [1].

Improvement with Treatment

Signs and symptoms of TMD improve over time with at-home care, and with oral appliance therapy from the dental office. Previous studies have even show that as many as 50% of patients improve in one year and 85% improve completely in three years. Encourage conservative treatment before any invasive options are considered. It is important to treat your patients properly without causing further complications.

Contact my office to learn more about TMD and available treatment options, as well as upcoming lectures for continuing your education.

 

 

 

 

1. Lindsay, J. (2016). TMJ Disorder-The Painful (but Helpful) Truth. Pain.

TMD Could be Interrupting Our Patients’ Sleep

Approximately one in every four people who regularly visit their dentist has a condition called bruxism, which is an involuntary movement of the jaws when a person is sleeping. And, about 80% of those who do grind their teeth each night are unaware they are doing it. It can happen occasionally to some people without causing any severe damage, while others it can cause a lot of harm to their teeth. Unfortunately, though, those who experience regular teeth grinding face the possibility of dental problems and sleep disorders. One complication that can arise is temporomandibular joint disorder (TMD).

What is TMD?

TMD is a problem occurring within the jaw, jaw joint and the surrounding tissues. The TMJ is a hinge joint which attaches the lower jaw to the temporal bone of the skull found in front of the ear on the sides of the head, which allows for jaw movement and enables yawning, talking and chewing. When teeth grinding occurs at night, the TMJ can become damaged from the pressure causing a chain reaction to the surrounding tissues resulting in pain, injury and or joint degeneration.

The Sleep Apnea and TMD Connection

Approximately 75% of people with TMD have signs that suggest a sleep breathing disorder, such as sleep apnea. A narrow upper arch of teeth is 90% predictive of OSA and a retruded chin in 70% predictive of OSA.

In other words, teeth grinding and TMD can affect more than just the jaw–it can be an underlying cause for sleep apnea and other sleep disorders. The tongue which is attached to the lower jaw acts as a pad when the jaw is not aligned under normal circumstances. When TMD is present, it is possible for the jaw to move and for it to become misaligned, which affects the bite and general size of the mouth. This change in size can result in the inability of the mouth to properly accommodate the tongue.

When less space is available, the tendency is for the tongue to fall to the back of the mouth, which, in turn, creates a blockage in the air pathway. This obstruction then leads to episodes of pauses in breath or shallow breathing known as sleep apnea.

To learn more about TMD and the connection with sleep apnea, feel free to contact my office or attend an upcoming lecture.

Let’s Talk About Bruxism

I cringe at the thought of bruxism, or teeth grinding, don’t you? There is a significant need for treatment of bruxism, and even sleep bruxism–don’t worry, we will cover it shortly.

What is Bruxism or Sleep Bruxism?

Bruxism is a term used to describe gnashing and grinding of the teeth that occurs without a functional purpose. Whether a patient’s teeth grinding is due to a nervous habit, stress or unknowingly, bruxism can cause a lot of damage to their teeth, as well as health. Bruxism affects both children and adults, but is most common among 25-44 year olds.

There are two prominent reasons why people grind their teeth at night:

  1. Stress – this is particularly evident for women
  2. Genetics – grinding teeth can be something inherited by family

In 2005, sleep bruxism was categorized as a sleep related movement disorder and defined as an oral parafunctional activity characterized by tooth grinding or jaw clenching during sleep, which is usually associated with sleep arousals. So, why do we care about microtrauma? Because of breakage of dental restoration, tooth damage, induction of temporal headaches and temporomandibular joint disorders (TMD).

Long Term Damage

In comparison to five years ago, dental and orthodontic practices have seen an increase in patients coming into their office with teeth grinding complaints. Whether a person is waking up with a sore jaw, or have been told by their sleep partner that they have been grinding their teeth at night, studies found that nearly 70% of bruxism cases are caused by anxiety. With cases on the rise, whether it is bruxism or sleep bruxism, it is more important than ever to begin treatment and screening immediately.

Take charge of your patients’ health by screening for bruxism. To learn more, contact my office or sign up for an upcoming lecture.