Michael Iott Dental Blog

Temporomandibular joint disorder (often shortened to TMJD, TMJ, TMD, or TMJ disorder) is a blanket term that refers to any acute or chronic inflammation of the temporomandibular joints that connect the lower jaw to the skull. These joints are complex and are composed of tendons, muscles, and bones. When the muscles are relaxed and both jaw joints open and close comfortably, we are able to talk, chew, or yawn without pain.

Typical signs and symptoms of TMD include any combination of ear pain, bite problems, headaches, dizziness, tinnitus (ringing in the ear), fullness of the ear (muffled or clogged ears) or locked jaws. Grinding, crunching, clicking or popping sounds of the jaw are very common signs of TMD.

Many behaviors and conditions cause the disorder. Teeth grinding and teeth clenching (bruxism) increase wear on the cartilage lining of the TM joints. Habitual gum chewing, and fingernail biting are common culprits. Chewing on only one side of the jaw can either lead to, or be a result of TMJ problems.

Stress and occupational tasks such as holding the telephone between the head and shoulder can lead to TMD. Malocclusion, or the misalignment of teeth, can lead to or be a cause of TMD. In addition, a history of broken facial bones or jaw fracture can lead to the disorder.

There are a variety of different treatment approaches for TMD. They may include heat, ice, a soft diet, anti-inflammatory medications, physical therapy, stress management, occlusal therapy (“bite therapy”), correction of bite abnormalities, and, in some cases, surgery.

The appropriate treatment for TMD varies from patient to patient, as the causes and severity of the disorder vary. If you suffer from TMD, please contact Dr. Michael Iott & Associates in New York City today to arrange a consultation.

There are many reasons why teeth become darkened or discolored. The vast majority of our clients are aware of some of the possible reasons why they may be experiencing discoloration. Many of the causes are “common sense” – tobacco use, for example, is a sure way to develop darkened or discolored teeth over time. Those who do not partake in commonly known stain-causing agents such as tobacco, coffee, tea, wine, or colas, are often unaware of what might be causing their teeth to become discolored. Let’s briefly discuss a few lesser-known, yet common causes of tooth discoloration.

Poor dental hygiene – No surprises here. Inadequate brushing and flossing allows the buildup of plaque and stain-producing substances (tobacco, coffee, tea, colas, wines, even certain fruits and vegetables such as berries, apples, and potatoes).

Dental materials – Some materials used in dentistry, such as amalgam restorations, especially silver sulfide-containing materials, can cast a gray-black color to teeth.

Disease – Several diseases affect enamel (the hard surface of the teeth) and dentin (the material under enamel). Systemic postnatal infections such as measles, chicken pox, streptococcal infections, and scarlet fever can lead to varying degrees of discoloration. Treatments for certain conditions can also affect tooth color including chemotherapy and head and neck radiation. In addition, certain infections in pregnant mothers can cause tooth discoloration in the infant by affecting enamel development.

Aging – As you age, the outer layer of enamel on your teeth gets worn away revealing the natural yellow color of dentin.

Medications – The antibiotics tetracycline and doxycycline are known to discolor teeth when given to children whose teeth are still developing (before the age of 8). Mouth rinses and washes containing chlorhexidine and cetylpyridinium chloride can also stain teeth. Antihistamines, antipsychotic drugs, and antihypertensive medications also cause teeth discoloration.

Genetics – The brightness and thickness of enamel varies from person to person.

Environment – Excessive fluoride either from environmental sources (high fluoride levels in water) or from excessive use (fluoride applications, rinses, toothpaste, and other supplements) can cause discoloration. A lack of vitamins C and D, calcium, and phosphate may also play a role.

Trauma – Dental injuries can disturb enamel formation in young children whose teeth are still developing. Adult teeth are also susceptible to discoloration by trauma.

There are several options in the field of cosmetic dentistry to correct tooth discoloration. Contact Dr. Michael Iott & Associates today for more information, or to set up a consultation.

Excess gum tissue can create the appearance of short teeth and a "gummy" smile. It can also make your oral health more difficult to manage. A periodontist, or gum specialist, can remove excess gum tissue to give your mouth a new look.

A number of factors can cause "gumminess,” including inadequate normal gum recession, irritation from braces, mouth breathing, medications, and high lip lines.

Gummy smiles are often caused by attrition, a condition where the teeth have been severely worn down. Bad habits such as nighttime teeth grinding (bruxism) can cause this wear. This problem can be corrected by tooth lengthening surgery, topped off with caps or crowns to cover the newly lengthened teeth.

There are three common procedures we use to correct a gummy smile. A gingivectomy/gingivoplasty involves removal of gum tissue. The underlying bone is not exposed. The patient may experience pain during the procedure, but usually not after. A laser may be used during this procedure

Flap Surgery is sometimes required for short or worn down teeth, or for thick or irregular bone contours. Post-operative care includes sutures, or stitches, and a periodontal dressing to cover the healing gums. This surgery tends to bring more discomfort than a gingivectomy.

During a crown lengthening, the cosmetic dentist or periodontist shifts your gums to a position that reveals more of your teeth and less of your gums. This procedure is also known as gum lift or gum re-contouring, and may involve cutting out gum and bone around the teeth.

If you live in the NYC area, and are considering surgery to correct a gummy smile, please contact Dr. Iott & Associates today to arrange a consultation.

The most important part of dental care happens at home. The minimum amount of time you should spend brushing your teeth is 2 minutes twice a day. Proper brushing and flossing helps prevent tooth decay, gum disease, and other dental problems that may lead to extra visits to the dentist’s office. Let’s discuss some quick tips you can follow so you can be sure you are brushing properly.

Hold your brush at a 45-degree angle against your gum line and, in short strokes, brush gently from where the tooth and gum meet to the chewing surface. Brushing too aggressively can cause receding gums, tooth sensitivity, and even loose teeth. Repeat this on all inside and outside surfaces of your teeth.

Clean the chewing surfaces of your teeth using short sweeping strokes, tipping the bristles into the pits and crevices.

Clean the inside surfaces of your top and bottom front teeth and gums with back and forth motions, holding the brush almost vertical.

Gently brush your tongue and the roof of your mouth to remove the decay-causing bacteria that exist in these places.

Use a timer or play a favorite song while brushing your teeth to get accustomed to brushing for a full 2 to 3 minutes. Some electronic toothbrushes are available with built-in timers that let you know when 2 minutes are up.

Please contact Dr. Michael Iott & Associates in NYC with any further questions relating to proper brushing technique.