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Happy 15 Years to Us!

Fifteen Years ago this month, we opened Tammy Kussman, DDS.

It’s unbelievable but true, and we could not have done it without each and every one of you. As a matter of fact, 75% of new patients are referred by existing patients.

To show our appreciation, we are offering a $30 credit to referred patients AND the referrer!

Schedule your next appointment online or call us at (615) 346-3007.  Be sure to follow us on Facebook, for up to date scheduling information.

Here’s to serving you another 15 years, Thank You!

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Preventative Dental Care for Children

 

A child’s first tooth erupts sometime between the ages of 6 & 12 months. The Academy of General Dentistry suggests scheduling your child’s first dental appointment within 6 months of your child’s first tooth eruption.

Many parents wonder about the importance of maintaining a child’s Primary Teeth (Baby Teeth) when they will eventually be replaced by Permanent Teeth (Adult Teeth). Primary teeth serve several important functions. Decay in Primary Teeth can lead to enamel defects and weaker Permanent Teeth. Moreover, Primary Teeth save space for a child’s Permanent Teeth to erupt. Loss of a primary tooth too early can eliminate space needed for the Permanent Tooth to erupt and may result in orthodontic surgery.

Healthy oral hygiene habits and regularly scheduled checkups help ensure that your child’s adult teeth develop properly.

Follow these oral hygiene preventative steps and help protect your child’s dental health.

• Clean your infant’s gums with a clean wet cloth

• As soon as the first tooth erupts begin brushing with a small soft bristled brush

• Use a pea-size amount of fluoride toothpaste

• Make sure to brush your child’s teeth at night

• Have your child drink water containing fluoride

• Children should brush after sugary treats or drinks

• Supervise your child while flossing until age 10

Speak with us about any questions or concerns you may have. We are happy to answer your questions.

Schedule your child’s dental appointment by calling (615) 346-3007 or contact us online.

 

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Introducing Under Armour Performance Mouthwear™

More than 5 million teeth are knocked out in sporting activities each year. While this number is staggering, the American Dental Association estimates that more than 200,000 oral injuries are prevented every year thanks to the use of  sports mouthguards. We feel Under Armour® Mouthwear offers our clients the best protection with the most choices available.

According to the ADA, “Mouthguards are used most commonly in contact sports, such as boxing, football, hockey and lacrosse, but findings show that even in noncontact sports like basketball, gymnastics or skateboarding, mouthguards help prevent mouth and jaw injuries.”

Armourbite We offer the following styles of Under Armour Performance Mouthwear, Dr. Kussman and her staff can help you decide which is right for you.

UA’s ArmourBite™ Mouthpieces are fitted, sitting close to the skin for a streamlined fit without the squeeze of compression. Designed for all non-contact sports, they are comfortable, form-fitting and uniquely shaped to help maintain optimal spacing between your teeth and counteract the negative effects of clenching. The low-profile design has minimal to no impact on normal speech, is worn on lower teeth and Made In The USA.

UA’s ArmourBite™ Mouthguards are safe and custom built.sitting close to the skin for a streamlined fit without the squeeze of compression. Designed for all contact sports, the Patented ArchFit System and Polymer Shrink provides a comfortable fit and the ability to talk and breathe easily. A convertible strap/strapless tether is available. ArmourBite™ Mouthguards meet NFHS rules (except Clear), are Latex-free, and Made In The USA.

Under Armour Mouthguards offer the same great fit, comfort, and retention as the premium ArmourBite Mouthguard, but without the patented performance technology. It’s the clear choice if you simply need world-class protection for contact sports. The Upper mouthguard helps protect teeth and reduce impacts from blows to the jaw.

Contact us today to schedule an appointment for your Under Armour Performance Mouthwear™.

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Cerec Same Day Crowns


Introducing CEREC Same Day Crowns – With the exciting new Cerec, crowns are done in a single appointment, start to finish. Cerec technology is a computer aided design (CAD) technology that allows patients to have their crown or caps shaped and fabricated within the same 90 minute visit. No more waiting weeks for lab work. No more second appointments and additional shots! Easy on your schedule and incredibly convenient and fast!

Schedule an appointment, today!

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ScanX Digital X-ray System

Our practice is committed to bringing the safest and highest quality of care to our patients. The installation of our new digital X-ray system continues that commitment. Using the state-of-the-art ScanX system enables us to provide greatly improved diagnostic capabilities to our patients while significantly lessening their exposure to radiation by up to 80 percent over the old film X-rays. We know this will be very important to many.

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Orthodontic Treatment Options

Teeth Problems That Can Be Caused By A Bad Bite

Crooked, crowded and overlapping teeth can cause a wide range of problems, including:

  • Tooth decay and gum disease – teeth that are not in proper alignment are hard to clean, particularly if they overlap. A build-up of plaque can cause tooth decay and gum disease.
  • Wear and tear – the teeth of the upper and lower jaw are meant to come together in a specific way, with the upper teeth slightly protruding over the lower teeth. If they are misaligned, the action of chewing may grind the teeth unevenly.
  • Jaw injury – the jaw joint is called the temporo-mandibular joint, which is also known as the TMJ. A bad bite may place stress and strain on this joint; this can cause localized problems such as pain, headaches as well as clicking or grinding noises when the jaw opens and closes.
  • Speech impediments – many sounds are made with the tongue against or near the teeth. Misaligned teeth or jaws can interfere with speech.
  • Self-confidence – a person may be reluctant to smile due to misaligned teeth.

How We Diagnose Orthodontic Problems

Problems with teeth and jaw alignment are identified using a number of tests, including:

  • Dental X-rays both inside and outside the mouth
  • Photographs both inside and outside the mouth
  • Duplicate your bite in stone casts using impression materials

Initial Planning

Once the problems are diagnosed, we create a step-by-step corrective plan. Any existing dental findings will likely need to be addressed before orthodontic treatment can begin. For instance, any decay must be treated and a dental cleaning must be performed. Also, teeth that are causing crowding may need to be removed before orthodontic treatment can be started.

Types of Treatment Options

The range of corrective orthodontic devices includes:

  • Braces – Braces are the most efficient and accurate way of moving teeth. Brackets are cemented to each tooth that needs to be moved with special dental glue and are typically made of a clear ceramic material or stainless steel. These brackets act like a handle on the tooth so that it can be moved into its correct position when force is applied to the brackets. Visits to our office every few weeks are needed to adjust the forces on the teeth as the teeth are slowly moved into a desired position.
  • Elastics or rubber bands are sometimes used in orthodontic treatment. Elastics are helpful in aligning the upper and lower jaws. When help is needed to move teeth, elastics may be stretched from these teeth and attached to a bracket on either the upper or lower teeth. It’s important to wear the elastics as instructed or orthodontic treatment will take longer.
  • Headgear – if the teeth need extra pressure, headgear and bands may be worn. Basically, tensioned rubber bands are hooked to the braces and connected to a strap worn around the head, usually at night.

Risks of Orthodontic Treatment

Some of the risks of orthodontics include:

  • Dental hygiene problems – braces and wires make cleaning the teeth more difficult. This can cause decay, discoloration and permanent marks.
  • Mouthguards – It is strongly recommended that you obtain a special mouthguard if you play sports involving contact with another player.
  • Relapse – teeth have fibers attached to the roots and those fibers have memory, which can caused properly aligned teeth to rotate out of alignment once the force on the teeth are removed. When wisdom teeth appear, also known as third molars, this can also caused properly aligned teeth to relapse. It is important that you wear your retainers for the prescribed time after fixed treatment has ended.
  • Soft tissue injury – the braces may dig into the gums or cheeks.

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Scaling & Root Planing

We remove the plaque through a deep-cleaning method called scaling and root planing. Scaling means scraping off the tartar from above and below the gum line. Root planing gets rid of rough spots on the tooth root where the germs gather, and helps remove bacteria that contribute to the disease.

Medications

Medications may be used with treatment that includes scaling and root planing, but they cannot always take the place of surgery. Depending on the severity of gum disease, we may still suggest surgical treatment. Long-term studies will be needed to determine whether using medications reduces the need for surgery and whether they are effective over a long period of time. Here are some medications that are currently used:

Medication

What is it?

Why is it used?

How is it used?

Prescription antimicrobial mouthrinse A prescription mouthrinse containing an antimicrobial called chlorhexidine To control bacteria when
treating gingivitis and after gum surgery
It’s used like a regular mouthwash
Antiseptic “chip” A tiny piece of gelatin filled with the medicine chlorhexidine To control bacteria and reduce the size of periodontal pockets After root planing, it’s placed in the pockets where the medicine is slowly released over time.
Antibiotic gel A gel that contains the antibiotic doxycycline To control bacteria and reduce the size of periodontal pockets We place it in the pockets after scaling and root planing. The antibiotic is released slowly over a period of about seven days.
Antibiotic micro-spheres Tiny, round particles that contain the antibiotic minocycline To control bacteria and reduce the size of periodontal pockets We place it in the micro-spheres into the
pockets after scaling and root planing. The particles release minocycline slowly over time.
Enzyme suppressant A low dose of the medication doxycycline that keeps destructive enzymes in check To hold back the body’s enzyme response
— If not controlled, certain enzymes can break down gum tissue
This medication is in pill form. It is used in combination with scaling and root planing.
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TMJ - Temopromandibular Joint Information

Temporomandibular joint and muscle disorders, commonly called “TMJ,” are a group of conditions that cause pain and dysfunction in the jaw joint and the muscles that control jaw movement. We don’t know for certain how many people have TMJ disorders, but some estimates suggest that over 10 million North Americans are affected. The condition appears to be more common in women than men. TMJ is referred to by different names such as TMD, TMJ disorder, and TMJ dysfunction.

For most people, pain in the area of the jaw joint or muscles does not signal a serious problem. Generally, discomfort from these conditions is occasional and temporary, often occurring in cycles. The pain eventually goes away with little or no treatment. Some people, however, develop significant, long-term symptoms.

What is the temporomandibular joint?

tmj

The temporomandibular joint connects the lower jaw, called the mandible, to the bone at the side of the head, which is the temporal bone. If you place your fingers just in front of your ears and open your mouth, you can feel the joints. Because these joints are flexible, the jaw can move smoothly up and down and side to side, enabling us to talk, chew, and yawn. Muscles and ligaments attached to and surrounding the jaw joint control its position and movement.

When we open our mouths, the rounded ends of the lower jaw, called condyles, glide along the joint socket of the temporal bone. The condyles slide back to their original position when we close our mouths. To keep this motion smooth, a soft disc lies between the condyle and the temporal bone. This disc absorbs shocks to the jaw joint from chewing and other movements.

The temporomandibular joint is different from the body’s other joints since the joint actually dislocates after opening past a certain point. The combination of hinge and sliding motions makes this joint among the most complicated in the body. Also, the tissues that make up the temporomandibular joint differ from other load-bearing joints, like the knee or hip. Because of its complex movement and unique makeup, the jaw joint and its controlling muscles can pose a tremendous challenge to both patients and health care providers when problems arise.

What are TMJ disorders?

Disorders of the jaw joint and chewing muscles – and how people respond to them – vary widely. Researchers generally agree that the conditions fall into three main categories:

Myofascial pain, the most common temporomandibular disorder, involves discomfort or pain in the muscles that control jaw function.

Internal derangement of the joint involves a displaced disc, dislocated jaw, or injury to the condyle.

Arthritis refers to a group of degenerative/inflammatory joint disorders that can affect the temporomandibular joint.

A person may have one or more of these conditions at the same time. Some people have other health problems that co-exist with TMJ disorders, such as chronic fatigue syndrome, sleep disturbances or fibromyalgia, a painful condition that affects muscles and other soft tissues throughout the body. It is not known whether these disorders share a common cause.

People who have a rheumatic disease, such as rheumatoid arthritis, may develop TMJ disease as a secondary condition. Rheumatic diseases refer to a large group of disorders that cause pain, inflammation, and stiffness in the joints, muscles, and bone. Both rheumatoid arthritis and some TMJ disorders involve inflammation of the tissues that line the joints. The exact relationship between these conditions is not known.

How jaw joint and muscle disorders progress is not clear. Symptoms worsen and ease over time, but what causes these changes is not known. Most people have relatively mild forms of the disorder. Their symptoms improve significantly, or disappear spontaneously, within weeks or months. For others, the condition causes long-term, persistent and debilitating pain.

What causes TMJ disorders?

Trauma to the jaw or temporomandibular joint plays a role in some TMJ disorders. But for most jaw joint and muscle problems, scientists don’t know the causes. For many people, symptoms seem to start without obvious reason. Research disputes the popular belief that a bad bite or orthodontic braces can trigger TMJ disorders. Because the condition is more common in women than in men, scientists are exploring a possible link between female hormones and TMJ disorders.

There is no scientific proof that clicking sounds in the jaw joint lead to serious problems. In fact, jaw clicking is common in the general population. Jaw noises alone, without pain or limited jaw movement, do not indicate a TMJ disorder and do not warrant treatment.

The roles of stress and tooth grinding as major causes of TMJ disorders are also unclear. Many people with these disorders do not grind their teeth, and many long-time tooth grinders do not have painful joint symptoms. Scientists note that people with sore, tender chewing muscles are less likely than others to grind their teeth because it causes pain. Researchers also found that stress seen in many persons with jaw joint and muscle disorders is more likely the result of dealing with chronic jaw pain or dysfunction than the cause of the condition.

What are the signs and symptoms?

A variety of symptoms may be linked to TMJ disorders. Pain, particularly in the chewing muscles and/or jaw joint, is the most common symptom. Other likely symptoms include:

Radiating pain in the face, jaw, or neck.

Jaw muscle stiffness.

Limited movement or locking of the jaw.

Painful clicking, popping or grating in the jaw joint when opening or closing the mouth.

A change in the way the upper and lower teeth fit together.

How are TMJ disorders diagnosed?

There is no widely accepted, standard test now available to correctly diagnose TMJ disorders. Because the exact causes and symptoms are not clear, identifying these disorders can be difficult and confusing. Currently, we note the patient’s description of symptoms, take a detailed medical and dental history, and examine problem areas, including the head, neck, face, and jaw. Imaging studies may also be recommended.

You may want to consult us to rule out known causes of pain. Facial pain can be a symptom of many other conditions, such as sinus or ear infections, various types of headaches, and facial neuralgias (nerve-related facial pain). Ruling out these problems first helps in identifying TMJ disorders.

How are TMJ disorders treated?

Because more studies are needed on the safety and effectiveness of most treatments for jaw joint and muscle disorders, experts strongly recommend using the most conservative, reversible treatments possible. Conservative treatments do not invade the tissues of the face, jaw, or joint, or involve surgery. Reversible treatments do not cause permanent changes in the structure or position of the jaw or teeth. Even when TMJ disorders have become persistent, most patients still do not need aggressive types of treatment.

Conservative Treatments

Because the most common jaw joint and muscle problems are temporary and do not get worse, simple treatment is all that is usually needed to relieve discomfort.

Self-Care Practices

There are steps you can take that may be helpful in easing symptoms, such as:

Eating soft foods.

Applying ice packs.

Avoiding extreme jaw movements (such as wide yawning, loud singing, and gum chewing).

Learning techniques for relaxing and reducing stress.

Practicing gentle jaw stretching and relaxing exercises that may help increase jaw movement.

We can recommend exercises if appropriate for your particular condition.

Pain Medications

For many people with TMJ disorders, short-term use of over-the-counter pain medicines or nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen, may provide temporary relief from jaw discomfort. When necessary, we can prescribe stronger pain or anti-inflammatory medications, muscle relaxants, or anti-depressants to help ease symptoms.

Stabilization Splints

We may recommend an oral appliance called a bruxism splint, stabilization splint, night guard, or bite guard, which is a plastic guard that fits over the upper or lower teeth. Stabilization splints are the most widely used treatments for TMJ disorders. Studies of their effectiveness in providing pain relief, however, have been inconclusive. If a stabilization splint is recommended, it should be used only for a short time and should not cause permanent changes in the bite. If a splint causes or increases pain, stop using it and let us know.

The conservative, reversible treatments described are useful for temporary relief of pain – they are not cures for TMJ disorders. If symptoms continue over time, come back often, or worsen, please let us know.

Surgery

Other types of treatments, such as surgical procedures, invade the tissues. Surgical treatments are controversial, often irreversible, and should be approach with caution where possible. There have been no long-term clinical trials to study the safety and effectiveness of surgical treatments for TMJ disorders. Nor are there standards to identify people who would most likely benefit from surgery. Failure to respond to conservative treatments, for example, does not automatically mean that surgery is necessary.

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