It is estimated that around 8% to 15% of people in the UK have issues with their jaw joint.[i] The symptoms of Temporomandibular Joint (TMJ) issues can be very uncomfortable, and usually include headaches and pain around the jaw, ear and temple.  Clicking noises when moving the jaw, difficulty fully opening the mouth, jaw locking when the mouth is open, difficulty sleeping and neck ache are other possible symptoms. Jaw issues can get better by themselves over time, or they can feel much worse when a patient is chewing or feeling stressed. The causes of TMJ dysfunction are varied, and possible reasons include poor posture, bruxism, arthritis and injury.

Determining severity

The severity of the disorder will have a significant impact on possible management and treatment options. The general dental practitioner (GDP) will focus on milder situations, with the majority of patients presenting with TMJ problems falling into this category. For those who have more complex cases, referral to a specialist in the field may be more appropriate. Maxillofacial surgeons will be better equipped to manage a patient with occlusal preoccupation, chronic widespread pain, disc displacement without reduction, severe psychological distress or those who have already undergone several unsuccessful treatments.[ii]

Treating mild cases

For patients experiencing mild symptoms, the GDP is able to provide various therapeutic options, which may be relatively simple and often be undertaken by the patient from home. It is recommended[iii] that patients suffering with jaw pain stick to a soft diet for one to two weeks, as this will reduce chewing and make jaw movement less painful. They should also actively avoid parafunctional activities such as nail biting and chewing gum. It is also suggested that they massage the jaw muscles where pain is experienced, using heat packs or warm flannels to help relax the muscles. Reduction of stress by minimising potential causes can help as well, ultimately leading to less bruxism during sleep.

Practitioners should also recommend jaw exercises to help reduce the ‘clicking’ effect of TMJ. The following example can be uncomfortable at first, but  become easier over time and be completed twice per day:

The patient should close their mouth, and move the tip of the tongue from the palate to as far back as it will go, with the teeth together. Keeping the tongue in this position, the patient should slowly open the mouth until the tongue is barely touching, holding this position for five seconds. This is usually repeated for five minutes at a time.[iv] The goal is for this exercise to be completed with no clicking, and aims to strengthen the ligaments around the jaw.

Useful tools

As with any area of dentistry, patient education is the key to helping individuals understand their TMJ issues and their role in preventing progression of the problem. Providing resources that they can access in their own time to do further research may be helpful as well, so they can process the information and come back to the practice with questions. 

Some patients may also benefit from physical tools to assist their jaw rehabilitation exercises, such as the OraStretch Press[v] distributed by Total TMJ. This innovative yet easy-to-use device helps the user to open their mouth wider, and more comfortably over time. With continuous use of the OraStretch Press, a typical patient can gain 1-2 mm per week in range of motion. These exercises enable patients to maximise their range of motion, reduce joint pain, and develop jaw muscle strength. 

Aside from providing proven results for a range of patients, products such as this also afford clinicians extra confidence that their patients are correctly addressing their TMJ disorders. They encourage patients to perform the exercises at home quickly, easily and safely asper their professional guidance.

Improving quality of life

Managing jaw pain can greatly improve a patient’s quality of life. When someone is in pain and discomfort every day, it can affect their nutrition, their social lives, their self-esteem and their overall wellbeing. By offering relief from this pain, GDPs can strengthen their rapport with patients significantly. What’s more, minor TMJ issues are often simple to manage and resolve if treated early, so talking to patients as soon as TMJ concerns arise is crucial.

For more details about Total TMJ and the products available, please email karen@totaltmj.co.uk 

[i] King’s College Hospital. NHS Foundation Trust. Temporomandibular dysfunction (TMD). Information for patients. https://www.kch.nhs.uk/Doc/pl%20-%20869.1%20-%20temporomandibular%20dysfunction%20(tmd).pdf [Accessed March 2022]

[ii] Doncaster and Bassetlaw Hospitals. NHS Foundation Trust. Department of Oral & Maxillofacial Surgery. Referral Guidelines. 2015. https://www.england.nhs.uk/north/wp-content/uploads/sites/5/2016/04/omfs-refl-guide-dbh.pdf [Accessed March 2022]

[iii] Conville RM, Moriarty F, Atkins S. The management of temporomandibular disorders: a headache in general practice, British Journal of General Practice. 2019; 69 (687): 523-524. DOI: https://doi.org/10.3399/bjgp19X705977

[iv] TMJ Exercises, Oxford University Hospitals NHS.  Available online at: https://www.ouh.nhs.uk/patient-guide/leaflets/files/12128Ptmj.pdf [Accessed March 2022]

[v] OraStretch Press System. https://www.craniorehab.com/orastretch [Accessed March 2022]

Moving into implant dentistry can be a great choice for your career.

Performing dental implant procedures to the highest standard is what you want and Ucer Education has a course that aims to teach you to do so. The Postgraduate Certificate (PG Cert) in Implant Dentistry is a 12-day course that runs over 12 months and it is designed to provide clinicians with gold standard training – enabling you to perform implant procedures with confidence.

In this course you will gain core knowledge and skills that you’ll be able to put into practice at Ucer Education’s state-of-the-art clinical facilities. As well as this, the multi-system course is led by Special Oral Surgeon Professor Cemal Ucer who will demonstrate extensively single, partial and multiple implants, immediate protocols, and more!

Start your journey to becoming an expert in implant dentistry and sign up today!

For more information on the PG Cert in Implant Dentistry from Ucer Education – supported by Geistlich, Megagen, Neoss, Implants and General Medical – please visit www.ucer.education and ucer-clinic.dental or call Prof Ucer on 07767 645331

Email ucer@oral-implants.com

In recent years, the demand for aesthetically pleasing results in dentistry has grown significantly. There are various reasons for this but the most popular influences have been put down to the advancements in technology, the introduction of social media, and an aging population. Clinicians are now concerned about providing their patients with the best possible solutions for their restorative needs.

The Social Media Impact

The turn of the century saw a huge surge in technology and with it came social media. People were thrilled to be able to connect with friends across the world and stay in touch. However, as time progressed and social media became a constant buzz in everyone’s pockets it soon became clear that constant connection isn’t necessarily good for people. In fact, social media has been linked to decreased, disrupted, and delayed sleep and has been associated with depression, memory loss, poor academic performance, and more.[i]

In particular, the impact on beauty standards has had a monumental effect on society. These days you can be overwhelmed with the constant reminder of what people view as beautiful simply by scrolling through your Instagram feed, for example.[ii] When people don’t meet these perceived beauty standards, the general population start to demand that they do. One beauty standard that has prevailed, rather than being deemed as toxic and unattainable like many others, is to have a great looking smile. This demand has been met time and time again as the profession has continued to develop its technologies. These days, chipping a tooth, for instance, is no longer permanent as aesthetic restorations are readily available to patients.

Understanding the Personal Affects

People can seek restorative treatments for a variety of reasons – they might have chipped their tooth, lost a tooth, or maybe poor oral health has led to them needing a filling to restore the tooth. Whatever the reason may be, it’s important to understand that your patient may be suffering from more than just the inconvenience of a chipped tooth, for instance – their Quality of Life (QoL) can be greatly affected too.

Poor looking teeth, or compromised functionality, can exacerbate social withdrawal, isolation, and low self-esteem.[iii] A patient’s speech and ability to eat can also experience a negative impact. Generally, the Quality of Life of the patient is in decline when suffering from such afflictions. A study revealed that the effect of poor oral health on QoL has a negative impact on a broad range of physical, social, and psychological aspects.[iv] Another study revealed that patients consider their QoL significantly affected when their ability to eat and be comfortable is compromised.[v] This can be even more problematic for patients than they may first realise because not being able to eat properly can lead to other health issues – this is especially important to consider with elderly patients as they are more vulnerable to sickness.

Options, Options, Options

There are a range of restorative dental treatments to offer patients but best practice would be to ensure the treatments you have available meet their needs. One study showed that, on average, 36% of dentists make referrals for specialist restorative treatment.[vi] This is on top of the restorative work they do in house which can include fillings, composite, bridges, crowns, and more. This makes it clear that restorative dental treatment is in high demand.

Some of the most sought-after dentists are those that patients deem the most skilled.[vii] Offering a range of high-quality restorations is a sure way to exhibit your skills to patients. Of course, many treatments are already available to patients. In recent years, restorative aesthetic treatment has increased in popularity – now people want their fillings to appear invisible and they never want to be reminded of the time they chipped their front tooth. Statistics show that 50% of 18-24-year-olds have either already had their teeth whitened professionally or feel that they probably would have them whitened by a professional; 44% of 25-49-year-olds also said the same.[viii] This indicates that as society develops people are caring more and more about their aesthetic appearance; this is especially clear as the same study revealed that more older people would not get this kind of treatment.

Upgrade Your Dentistry

Offering a range of restorative treatment is a great place to start when you want to enhance the options you give to your patients. However, ensuring that you’re using the best quality products can also decrease your treatment time and increase your patients’ satisfaction. In particular, BRILLIANT EverGlow^® from Coltene is a highly aesthetic and long-lasting hybrid composite that will leave your patients’ teeth looking and feeling amazing. This universal composite has exceptional polishability and sculptability. Plus, the versatile shade system with three translucency levels means you can match the shade to a range of patients’ teeth. What’s more, is that the composite can be used effortlessly to improve your workflow.

In summary, the demand for aesthetic and restorative dental treatment has increased in recent years for a variety of reasons. People care more about aesthetics than they ever have before and that means some expectations have become the norm. Your patients want great looking teeth now more than ever and they’re counting on you to provide them with the best.

For more on COLTENE, visit www.coltene.com,
email info.uk@coltene.com or call 0800 254 5115.

[i] www.mcleanhospital.org. (n.d.). How Does Social Media Affect Your Mental Health | McLean Hospital. [online] Available at: https://www.mcleanhospital.org/essential/it-or-not-social-medias-affecting-your-mental-health#:~:text=When%20people%20look%20online%20and [Accessed 25 Jan. 2022].

[ii] Levine, M. (2017). Perception of Beauty. [online] Google Books. BoD – Books on Demand. Available at: https://books.google.co.uk/books?hl=en&lr=&id=Gv2PDwAAQBAJ&oi=fnd&pg=PA145&dq=social+media+impact+on+societal+beauty+standard&ots=kiEFulh7Cn&sig=jVKU5DMa-b0adQ56xuZTlSskBrY#v=onepage&q=social%20media%20impact%20on%20societal%20beauty%20standard&f=false [Accessed 25 Jan. 2022].

[iii] Kisely, S. (2016). No Mental Health without Oral Health. The Canadian Journal of Psychiatry, 61(5), pp.277–282.

[iv] Needleman, I., McGrath, C., Floyd, P. and Biddle, A. (2004). Impact of Oral Health on the Life Quality of Periodontal Patients. Journal of Clinical Periodontology, 31(6), pp.454–457.

[v] McGrath, C. and Bedi, R. (1998). A study of the impact of oral health on the quality of life of older people in the UK- findings from a National Survey. Gerodontology, 15(2), pp.93–98.

[vi] Nixon, P.J. and Benson, R.E. (2005). A Survey of Demand for Specialist Restorative Dental Services. British Dental Journal, [online] 199(3), pp.161–163. Available at: https://www.nature.com/articles/4812577 [Accessed 26 Jan. 2022].

[vii] Ungureanu, M.-I. and Mocean, F. (2015). What Do Patients Take into Account When They Choose Their dentist? Implications for Quality Improvement. Patient Preference and Adherence, 9, p.1715.

[viii] Stewart, C. (2020). Opinion on Teeth Whitening in Great Britain 2020 by Age. [online] Statista. Available at: https://www.statista.com/statistics/1132103/opinion-on-teeth-whitening-in-great-britain-by-age/ [Accessed 26 Jan. 2022].

CPD courses don’t have to consist of sitting in a lecture room for hours. IAS Academy offers a learning experience that is hands on, engaging, and supportive too.

Here’s what Ana Simoes had to say about their experience on the Anterior and Posterior Composite Course:

“I was interested in this course because every dentist uses composite on a day-to-day basis. I wanted to learn tips and tricks on providing more predictable and aesthetic composite for anterior and posterior fillings. I was hoping to improve the contour of my restoration in both shape and anatomy. I also wanted to improve my composite bonding skills and all of these aspects were addressed on the course.

“The structure of the course was great because it had a good balance between theory and practical – Dr Shiraz is extremely knowledgeable with a vast experience on delivering conferences around the world. He showed great interest in teaching us as much as he possibly could within the available time. He was very approachable and having a small group of dentists there for support was great – there was always an opportunity to ask questions and clarify any doubts.

“It was very engaging; there was never a dull moment! I really enjoyed learning some of the techniques and have already been implementing some of the tips learned. I also got a Venus composite kit to take maximum advantage and put what I’d learnt into practice.

“My general experience with IAS Academy has always been very positive, the mentors are always fully supportive and have a genuine interest in helping us, providing a good online structure to make it easier to get advice outside the course. The appliances are reliable, good quality, and the ordering system is easy and quick. The Anterior and Posterior Composite Course is brilliant and would benefit any dentist no matter what their main area of interest may be.”

For more information on IAS Academy membership and upcoming training courses, please visit www.iasortho.com or call 01932 336470 (Press 1)

 As our society continues to evolve and innovate, digital solutions to our problems are becoming more commonplace. After all, with the vast majority of individuals now owning a smartphone in the UK (55.5 million people)[i] it makes sense that companies are looking at ways to harness this technology in inventive ways, including revolutionising how we look at healthcare.

One particularly interesting development that has emerged in recent times is the concept of digital therapeutics. Effectively, digital therapeutics is the use of apps to help manage certain conditions, for example insomnia and depression. The goal of these technologies is to help people put control of these conditions in their own hands, allowing self-management and reducing the chance of condition-related hospital visits. These apps go through the same rigorous testing as medicines, including randomised clinical trials.

There are a number of these apps that have already seen great results. For example, there is a programme named Sleepio that has been specifically developed to help people improve their sleep if they suffer from insomnia or usually have to rely on sleeping pills and other methods to get the rest they need. Through a combination of setting sleep goals and filling out an in-depth questionnaire about their habits, the app assesses peoples’ needs and then generates a tailored programme for them to follow, which is supplemented with weekly lessons with a virtual “sleep expert”. Once people follow this regime, their sleep should start to improve, and the app has plenty of evidence to support it, with a respectable 76% of users achieving clinical improvement in their insomnia after 5 weeks.[ii]

Another app that has seen some great response is Daylight. Designed to help people manage anxiety and full of techniques and tips to encourage individuals to “get out of their head”, this app is advertised as an adjunct to usual medical care. Much like Sleepio, Daylight has seen impressive results, with 71% of users improving their anxiety issues.[iii]

So, with evidence supporting digital therapeutics, could we reasonably expect this technology to be able to help with dentistry?

Dental apps, as you’re probably aware, are nothing new. There are plenty of software programmes out there that are designed to encourage children to clean their teeth, learn oral health facts and address other issues. However, to my knowledge, there are currently no approved digital therapeutic apps that have been designed especially for dental needs. This may be a case of the technology not being there yet – and the fact that dentistry is much more about preventive care than management these days. But what if an app could be developed to help people who are at higher risk of caries or who have previously suffered from periodontitis?

The core aim of the app could be to monitor certain aspects and directly send this information to dentists – potentially helping us to keep a closer eye on high-risk patients and allowing them to feel more involved in the oral healthcare journey.

I think the main hurdle that would need to be overcome is that, unlike conditions such as insomnia and anxiety, dental problems would likely need photo monitoring to assess the condition of the dentition as part of the process. There are further limitations too – even if a phone camera could capture extraordinary detail and be viably harnessed by users to take photos, as dentists we know that not all problems are visible and a physical examination is often paramount to truly understanding the extent of any issues.

In light of this, I believe that if digital therapeutics were to be adapted to have a dental focus, current technological limitations would mean they would have to be utilised as behavioural adjuncts for general oral health. However, as technology is evolving so fast, who knows what the future has in store? Looking at the data supporting dental therapeutics in other areas, it’s clear that there are opportunities here to be grasped once the technology makes it possible.

In the end, even if our smartphones are able to perform extraordinary functions, I believe that in the case of dentistry, these apps will always be secondary to proper in person examination. Much like teledentistry, there are definitely situations where this sort of care could be introduced and even potentially help minimise the pressure on dental services. We just need to wait for technology to catch up and someone to design an app that can make a difference on a clinical level – a goal that is likely to be met in the near future.

For further information please call EndoCare on 020 7224 0999

Or visit www.endocare.co.uk

[i] Cybercrew. How Many People Own A Smartphone in the UK? Link: Water Regulations Advisory Scheme [Last accessed March 22].

[ii] Sleepio. Clinical Evidence. Link: https://www.bighealth.com/research/ [Last accessed March 22].

[iii] Big Health. Daylight. Link:  https://www.bighealth.com/daylight/ [Last accessed March 22].