Study Finds Chronic Periodontitis May Be Associated With Higher Risk of Alzheimer's Disease

Good Morning, Dr. DeBerardinis August 18, 2017

Editor's Note The ADA Morning Huddle compiles news stories from a wide range of sources to let you know what the general media is saying about dentistry, whether or not it agrees with the ADA’s views. Publication of an article in the Morning Huddle in no way implies ADA’s endorsement, agreement, or promotion of a particular article.

Dentistry in the News Study Finds Chronic Periodontitis May Be Associated With Higher Risk Of Alzheimer’s Disease. Reuters (8/17, Boggs) reports that research suggests chronic periodontitis may be associated with “an increased risk of developing Alzheimer’s disease.” The article reports that while investigators “found no overall link between periodontitis and Alzheimer’s,” their research found people with periodontitis “for 10 or more years were 70 percent more likely than people without periodontitis to develop Alzheimer’s disease.” The study team concluded, “Our findings support the notion that infectious diseases associated with low-grade inflammation, such as chronic periodontitis, may play a substantial role in the pathogenesis of Alzheimer’s disease.” The findings were published in Alzheimer’s Research and Therapy.         MouthHealthy.org provides additional information on periodontitis.

FROM THE ADA New Program Name, But Same Great Options For Members With Student Debt Did you hear Darien Rowayton Bank (DRB) — the student loan refinancing program endorsed by the ADA — now calls its student loan program Laurel Road? Even with a new name, the program is the same. Qualifying ADA members can continue to refinance existing federal and private loans at a lower rate and receive an extra 0.25 percent discount on their loan rate. If you’re interested in joining your fellow members who are saving an average of $33,000 over the life of their loan by refinancing with Laurel Road, visit ADA.org/MyDebt today. Connect with ADA: Visit ADA News

Dental Benefits Delta Dental Names Chief Information Officer, President of Enterprise Operations Claims. In a release on PR Web (8/16), Delta Dental of California and its affiliates announce the selection of Kirsten Garen as chief information officer and senior vice president. The release states that “Garen will be responsible for all technology strategy, applications and services for the group of companies that includes Delta Dental of California, Delta Dental Insurance Company, Delta Dental of New York, Inc., Delta Dental of Pennsylvania and their affiliates, which collectively operate in 15 states plus the District of Columbia.”         A second release on PR Web (8/17) states Delta Dental Insurance Company and its affiliates named Khaled Ghaly as vice president of enterprise operations claims. The release states that Ghaly “will oversee claims activity for the group of companies in 15 states, the District of Columbia and Puerto Rico. Collectively, the companies process more than 36 million claims annually.” Advertisement What reaction do you want? Profluorid Varnish is a thin and tasteful transparent 5% sodium fluoride varnish comes in a non-messy SingleDose delivery system. Available in FOUR great flavors (Caramel, Melon, Mint and Cherry) with no aftertaste or discoloration of teeth. It adheres well to moist surfaces and sets quickly in the presence of saliva. With a high immediate fluoride release it relieves hypersensitivity…Watch Video Health and Safety Allure Shares Tips To Help “Neutralize Damage” When Consuming Acidic Beverages. Allure (8/16, Kinonen) states that in addition to soda and other sweetened beverages, “bubbly alcoholic drinks, like champagne and Prosecco, are acidic” and may erode enamel, especially if consumed frequently. The article shares several tips to help “neutralize the damage” when consuming acidic beverages to include rinsing the mouth out afterward; drinking through a straw to minimize contact with teeth; pairing the beverage with cheese, which can help buffer the acids; and practicing good oral hygiene.         The Oral Health Topics on ADA.org provides additional information on dental erosion for dental professionals. MouthHealthy.org provides additional information for patients on nutrition and dental health. Coverage Continues: Gum Disease Associated With Increased Cancer Risk In Postmenopausal Women. Cosmopolitan (8/15, Cook) reports that a studyanalyzed “almost 66,000 postmenopausal women aged 54 to 86” over eight years, finding those with a history of periodontal disease were 14 percent more likely to develop cancer than “those with healthy teeth and gums,” and the highest risk was for esophageal cancer. The researchers found gum disease was also associated with a higher risk of developing breast, gallbladder, lung, and skin cancer. The article reports that the research did not establish a cause-and-effect relationship, and more research is needed.         The Daily Star (UK) (8/17, Hampson) reports that researchers “believe bacterial pathogens in the oral cavity” may explain the association between periodontal disease and cancer.         In a Science in the News article, the ADA (8/11) discussed the study and its limitations. The article stated the study “provides evidence that women diagnosed with periodontal disease are more likely to later be diagnosed with cancer,” which “supports a need for further research in the field, most especially whether treating periodontal disease can reduce cancer risk.” Vermont Awarded Over $800,000 For Community Health Centers. Vermont Business Magazine (8/17) reports that as part of the $105 million in funding that the Health Resources and Services Administration is awarding to community health centers around the country, Vermont is receiving $816,251 for 11 federally qualified community health centers. The article reports that community health centers offer a range of services, including dental care. Dental Industry Digital Trends Discusses Dentacoin. Digital Trends (8/16, Martindale) states that “of all the technological leaps Bitcoin and other cryptocurrencies have enabled, arguably their biggest impact has been the creation and proliferation of blockchain technology.” The article discusses Dentacoin, a new blockchain concept designed for the dental industry. According to the article, Dentacoin “pitches itself as a way to improve dental health, cut out insurance companies as middle men, and foster cooperation between dentists and patients.” Article Shares Data On Images Taken In Dental Practices. Dr Bicuspid (8/17, Boechler) examined data showing the number of images taken in dental practices across the United States, finding “the percentage of comprehensive dental exams that included a radiograph hit a six-year low in 2016.” Global Dental Implants And Prosthetics Market Expected To Experience Growth. A release on Open PR (8/17) states the global dental implants and prosthetics market is expected to experience growth through 2024, according to a new market report. Charitable Dentistry Salute To Smiles Program Offers Care To Veterans. WGBA-TV Green Bay, WI (8/16, Engebretson) reported that Dr. David LeMoine of Bay Oral Surgery & Implant Center “teamed up with other ex-military oral surgeons to provide the Salute to Smiles program,” which provides free dental care to veterans. The article reported that “this year, six veterans were chosen to receive desperately needed dental procedures, at no cost, to improve their health and quality of life.” Dr. LeMoine said, “It’s really a great feeling because there are so many that are so very, very deserving.” Dr. Bob Villwock of Bellevue Family Dentistry added, “A person’s personality suddenly bubbles to the surface. They’ve been keeping it inside, because they didn’t feel confident about their smile or talking with people, looking at people, and to see that change is really remarkable.” Thursday's Lead Stories  • ADA Approves Of President Trump’s Statement Declaring Opioid Crisis A National Emergency.  • Delta Dental Foundation Launches “Water’s Cool At School” Program In Ohio.  • Limit Sugar Consumption To Help Reduce Cavity Risk.  • Electric Toothbrushes May Be Good Alternative For Some People.  • Deadline To Apply For Dental Products Standard Award Is Nov. 1.

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ADA Morning Huddle is a digest of the most important news selected from thousands of sources by the analysts of BulletinHealthcare. This service is being provided to quickly disseminate news items of interest to American Dental Association members. This complimentary copy of ADA Morning Huddle was sent to drleah@hillcrestdentalgroup.net as part of your membership. View BulletinHealthcare’s privacy policy. Neither BulletinHealthcare nor the American Dental Association is liable for the use of or reliance on any information contained in this briefing. The presence of advertising does not endorse, nor imply endorsement of, any products or services by ADA. For more information about the American Dental Association, please see www.ada.org/en, or call 312-440-2500. American Dental Association | 211 E. Chicago Ave | Chicago, IL 60611 Copyright © 2017 by BulletinHealthcare | 11190 Sunrise Valley Drive, Suite 20 | Reston, VA 20191

Drinking Fluoridated Tap Water Encouraged

Good Morning, LISA PARNOW August 14, 2017

Editor's Note The ADA Morning Huddle compiles news stories from a wide range of sources to let you know what the general media is saying about dentistry, whether or not it agrees with the ADA’s views. Publication of an article in the Morning Huddle in no way implies ADA’s endorsement, agreement, or promotion of a particular article.

Dentistry in the News Drinking Fluoridated Tap Water Encouraged. The Daily Mail (8/11, O'Neill) reported that it tested the pH levels of “popular brands of bottled waters,” finding some had a pH level of four. The article stated that beverages with “pH levels closer to zero are more acidic” and may erode dental enamel. The article reported that bottled water may also contain “insufficient amounts of fluoride.” Given this, a dentist quoted in the article discussed the benefits of drinking fluoridated tap water. The article also noted that the American Dental Association encourages drinking fluoridated water to help prevent dental caries.         Business Insider (8/11, Schmalbruch) reported that adding flavor to water, especially citric flavors, can lower the pH level, making it “more acidic.”         Additional information about fluoride and community water fluoridation is available at ADA.org/fluoride. The ADA Catalog also features the Fluoride Nature’s Cavity Fighter brochure. The Oral Health Topics on ADA.org provides additional information on dental erosion for dental professionals.

FROM THE ADA Is Your Practice a Winner? Entries are now being accepted for the 18th annual Dental Office Design Competition. Entries must be completed by August 21, 2017, and winners will be announced in Atlanta at ADA 2017 – America’s Dental Meeting. The Dental Office Design Competition recognizes dental facilities that most effectively express the practice philosophy of its practitioners and demonstrate a thoughtful assembly of design characteristics associated with an up-to-date dental facility. Enter the competition and read about last year’s winners.        Connect with ADA: Visit ADA News

Dental Benefits Medicare Does Not Cover Dental Care. To be prepared for high health care costs, the Motley Fool (8/11, Bieber) stated it is important to understand that Medicare does not cover several health care services, including dental care. Given this, the article stated that people can choose to “purchase a Medicare Advantage or Medigap plan to get supplementary coverage for dental care,” inquire about cash discounts at the dentist, or consider seeking care from a dental school.         In a second article, the Motley Fool (8/12, Maranjian) included understanding the advantages and disadvantages of Medicare Advantage plans among three “smart Medicare Advantage moves.” The article stated that one advantage of Medicare Advantage plans is that, unlike original Medicare, they often “cover hearing, vision and/or dental care.” Health and Safety Proper Oral Hygiene During Pregnancy Advised. Romper (8/11, Mullen-McWilliams) stated that “keeping up with oral hygiene is crucial during pregnancy,” noting that some women develop pregnancy gingivitis due to hormonal changes. The article stressed the importance of preventive dental care, encouraging women who are pregnant to brush and floss daily and visit the dentist regularly.         MouthHealthy.org offers additional information on pregnancy and oral health. Mail-In Braces Programs Discussed. Refinery 29 (8/11, Stieg) considered whether using mail-in aligners is a safe and effective way to straighten teeth, featuring information from Sunil Wadhwa, DDS, PhD, associate professor of dental medicine and director in the division of orthodontics at the Columbia University Medical Center. The article reported that “most mail-in companies will give you between three and 10 months for treatment,” whereas Dr. Wadhwa stated orthodontists will “continue treatment until it’s done appropriately.” The article adds that incorrectly straightening teeth can pose risks, “which is why Dr. Wadhwa says it’s important to see an orthodontist for the safest fix.”         MouthHealthy.org offers additional information for patients on braces. Dental Industry Henry Schein Launches Healthy Lifestyles, Healthy Communities Program. In a release on PRNewswire (8/11), Henry Schein, Inc. stated it has launched its “2017 Healthy Lifestyles, Healthy Communities (HLHC) program, which supports community health centers across the country in their efforts to provide medical and oral health screenings at free health events held in underserved communities.” The release noted that the program supports 14 free community health center events taking place during the summer and fall by providing each with “$5,000 worth of health care products” and “a $5,000 cash grant from the Henry Schein Cares Foundation.” Global 3D Dental Scanners Market Expected To Experience Growth. A release on PRNewswire (8/11) stated the global 3D dental scanners market is expected to experience growth between 2017-2021 due in part to the “rapidly dropping prices” of these products, according to a new market report. ADA in the News ADA Commends President’s Statement On Opioid Abuse. The ADA (8/11) stated in a release that the Association “commends President Donald Trump for his recent public statement acknowledging opioid abuse as a national public health emergency,” adding that his statement “will encourage public health agencies to prioritize their resources to address the problem.” The release noted “the ADA has long recognized the severity of opioid misuse and abuse, and has worked diligently to educate dentists about how they can help mitigate the problem.”         Find out more at ADA.org/opioids. Free Webinar On Dental Benefit Trends Set For Aug. 29. The ADA News (8/11) reported that a free ADA webinar, Trends in the Dental Benefits Market, will take place Aug. 29 from noon to 1 pm CDT. The article noted that Evelyn F. Ireland, executive director of the National Association of Dental Plans, and Jerry Berggren, director of research and information for the National Association of Dental Plans, will lead the webinar and discuss “current trends in the dental benefits market and the underlying factors that drive those trends.”         To register for the webinar, visit readytalk.com. The webinar will be available online after Aug. 29.         The ADA Center For Professional Success offers additional information about dental benefits online. Also in the News More States Raise Tobacco Buying Age To 21. The Washington Times (8/10, Richardson) reported “the movement to raise the tobacco buying age to 21 has caught fire,” noting that last week Oregon Gov. Kate Brown signed legislation that makes the state “the fifth to increase the legal age for cigarette and vaping purchases from 18 to 21.” The article noted that “Hawaii became the first state to raise the minimum legal sales age for tobacco products in June 2015, followed by California in May 2016,” and “more than 250 localities, including New York City in October 2013, also have raised the legal age.”         For more information on the ADA’s advocacy efforts on tobacco visit ADA.org/tobacco. Saturday's Lead Stories  • Working Together Against Oropharyngeal Cancer.  • Charcoal Teeth Whitening Method May Damage Enamel.  • ADA Member Seeking Bone Marrow Transplant Starts Treatment.

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ADA Morning Huddle is a digest of the most important news selected from thousands of sources by the analysts of BulletinHealthcare. This copy of ADA Morning Huddle was sent to supervisor@hillcrestdentalgroup.net as a guest subscription, at the request of an ADA member. These guest subscriptions are available by ADA Member invitation only and are intended for the immediate teams of ADA members. Neither BulletinHealthcare nor the American Dental Association is liable for the use of or reliance on any information contained in this briefing. The presence of advertising does not endorse, nor imply endorsement of, any products or services by ADA. For more information about the American Dental Association, please see www.ada.org/en, or call 312-440-2500. American Dental Association | 211 E. Chicago Ave | Chicago, IL 60611 Copyright © 2017 by BulletinHealthcare | 11190 Sunrise Valley Drive, Suite 20 | Reston, VA 20191

VIDEO SHOWS EFFECT OF NOT BRUSHING TEETH

Pediatricians Say No Fruit Juice in Child’s First Year

By CATHERINE SAINT LOUISMAY 22, 2017

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The nation’s top pediatricians are advising parents to stop giving fruit juice to children in the first year of life, saying the drink is not as healthful as many parents think.

In the past, the American Academy of Pediatrics had advised parents to avoid 100 percent fruit juice for babies younger than 6 months. On Monday, the group toughened its stance against juice, recommending that the drink be banned entirely from a baby’s diet during the first year. The concern is that juice offers no nutritional benefits early in life, and can take the place of what babies really need: breast milk or formula and their protein, fat and minerals like calcium, the group said.

This is the first time the pediatricians’ group has updated its guidelines on fruit juice since 2001.

“I think this is a fantastic recommendation for infants, and it’s long overdue,” said Dr. Elsie M. Taveras, chief of the division of general pediatrics at MassGeneral Hospital for Children in Boston, who was not involved in the new report. “Parents feel their infants need fruit juices, but that’s a misconception.”

The new recommendations may surprise parents who thought 100 percent fruit juice was healthy for babies, or nutritionally equivalent to fruit itself.

But whole fruit typically has more fiber than fruit juice and is less likely to cause dental decay, said Dr. Steven Abrams, a lead author of the new report and the chairman of pediatrics at the Dell Medical School at the University of Texas at Austin.

Whole fruit is “less of a pure sugar intake,” Dr. Abrams said. “We want kids to learn how to eat fresh foods. If you assume fruit juice is equal to fruit, then you’re not getting that message.”

Dr. Man Wai Ng, the dentist in chief at Boston Children’s Hospital, applauded the ban on juice for infants and took a hard-line stance for preschoolers and older children. “One hundred percent fruit juice should be offered only on special occasions, especially for kids who are at high-risk for tooth decay,” she said.

Four ounces of apple juice has no fiber, 60 calories and 13 grams of sugar. By comparison, a half cup of apple slices has 1.5 grams of fiber, 30 calories and 5.5 grams of sugar. The fiber in a piece of fruit also increases fullness.

In terms of sugar and calories, store-bought juice is similar to soda. For instance, four ounces of lemon-lime soda has 12.6 grams of sugar and 46 calories, both slightly less than apple juice.

The new report, published online in the journal Pediatrics, also advised restricting fruit juice to four ounces daily for 1- to 3-year-olds, and six ounces a day for 4- to 6-year-olds. The 2001 guidelines gave parents more wiggle room to decide if four or six ounces daily was appropriate for preschoolers. By contrast, the advice for 4- to 6-year-olds stayed the same.

The latest report curbed the maximum daily intake for older children, aged 6 to 18. It used to be 12 ounces; now only eight ounces are advised.

There is not a convincing link between obesity and children drinking modest amounts of fruit juice. Still, the report said, juice “has no essential role in healthy, balanced diets of children.”

In a statement, Cathy Dunn, a spokeswoman for Gerber, said the company is supportive of the American Academy of Pediatrics’ new advice for infants, and plans to update its website to reposition “all Gerber juices for the toddler milestone, which is 12 months or older.”

Stephanie Meyering, a spokeswoman for the Juice Products Association, a trade group, said that while “juice is not necessary for children under age 1,” real fruit juice “is a nutritious complement to whole fruit in a balanced diet” for toddlers and older children.

Some manufacturers, like Gerber, make juice for infants, marketing it as a way to add vitamin C and flavor variety to a baby’s diet.

But Dr. Abrams said, “You want to be careful about saying ‘Drink juice for vitamins’ because they can be added to anything.”

Another concern is that juice can be a gateway drink of sorts, Dr. Taveras said, adding, “We have studies that show infants who drink more juice in that early life period are more likely to go on to drink soda and sugar-containing beverages.”

Currently, the federal government’s advice on healthful eating, called the Dietary Guidelines for Americans, does not weigh in on juice for very young children. The guidelines, which are compiled by the Agriculture and Health and Human Services Departments, make recommendations only for ages 2 and older. The guidelines count a cup of 100 percent fruit juice the same as a serving of fruit, but urge that at least half of the recommended amount should come from actual fruit.

It is unclear if the next U.S.D.A. guidance will forbid juice for infants. But the very young will be included for the first time in the 2020 guidelines, according to Brooke Hardison, a department spokeswoman.

Some federal assistance programs have already restricted juice for very young children. Since 2009, the Special Supplemental Nutrition Program for Women, Infants and Children, known as WIC, has stopped listing juice as an acceptable purchase on the checks given to new mothers and babies in their first year. A WIC check, voucher or electronic benefit transfer card specifies which foods in what quantities can be bought at stores, so once a baby becomes a toddler, 100 percent fruit juice can be purchased.

In 2010, the Institute of Medicine of the National Academies — a private nonprofit — called for the “omission of fruit juice of any type before the age of 1 year” in federally supported day care centers.

More than 4.2 million children, including those in Head Start, take part in the Child and Adult Care Food Program. By October, child care centers and day care homes will be prohibited from providing fruit juice to infants as part of a reimbursable meal through that program.

Jaw pain: Causes, symptoms, and treatment

Written by Lori Smith BSN MSN CRNPReviewed by Debra Sullivan, PhD, MSN, CNE, COI

Last reviewed: Thu 27 April 2017 Last reviewed: Thu 27 Apr 2017

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Jaw and facial pain is a common problem affecting millions of people worldwide. It causes many treatment challenges in the healthcare community when it comes to diagnosis and treatment.

As there are so many potential causes to jaw pain, correct diagnosis is vital. Doctors need to identify the exact cause in order to provide the best course of pain-relieving treatments.

Contents of this article:

1. Causes
2. Symptoms
3. Diagnosis
4. Treatments

Causes

Teeth grinding and arthritis may be causes of jaw pain but the most commonly reported is temporomandibular joint disorder (TMJ).

There are several possible causes of jaw pain and these may be related to physical injury, nerve problems, or blood vessel problems.

The most commonly reported cause of jaw pain is temporomandibular joint disorder (TMJ). The condition affects up to 12 percent of people. Nearly 5 percent seek medical treatment due to the severity of the problem. Women of childbearing age are most commonly affected by TMJ.

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TMJ collectively describes disorders of the temporomandibular joints, and the muscles responsible for jaw movement. These muscles are known as the masticatory muscles.
Other known causes of jaw or facial pain include conditions, such as:

• Teeth grinding, clenching, or opening the mouth too wide: Most often, teeth grinding and clenching is experienced during sleep and can lead to tooth damage and jaw pain. It can also occur during periods of increased emotional stress.
• Osteomyelitis: This is a condition where an infection in the body affects the bones and associated tissues.
• Arthritis: Arthritic conditions, such as osteoarthritis and osteoarthrosis, which lead to the surface of bones wearing away.
• Synovitis or capsulitis: These are conditions in which the lining of the joint or a connecting ligament becomes inflamed.
• Dental conditions: These can include gum disease, cavities, tooth gaps, damaged teeth, or abscesses.
• Sinus problems: These affect the nasal cavities.
• Tension type headaches: Tension headaches are typically caused by stress and may lead to facial pain.
• Neuropathic pain: This type of long-term pain occurs when nerves become damaged and send pain signals to the brain. This pain can be continuous or occur from time to time.
• Vascular pain: This type of pain occurs when the supply of blood to part of the body is disrupted. It is caused by conditions that include giant cell arteritis and carotid artery dissection.
• Neurovascular pain: This type of pain is caused by conditions that affect both the nerves and the blood vessels, such as migraine and cluster headaches.

Pain can also be caused by lifestyle-related factors, including emotional stress, sleep disturbances, a lack of certain nutrients, or tiredness.

Other conditions that may cause jaw and facial pain include rheumatoid arthritis, hypothyroidism, Lyme disease, multiple sclerosis, lupus, fibromyalgia, and some mental health conditions.

Symptoms

Jaw pain symptoms may include facial pain, earache, jaw locking, toothache, and facial swelling.

The presenting symptoms of jaw pain vary depending on the cause. They may include:

• facial pain that worsens when the jaw is used
• joint and muscle tenderness
• limited range of motion
• jaw alignment issues
• clicking or popping sounds with opening or closing of the jaw
• ringing in the ears
• earaches
• headaches with or without ear pain and pressure behind the eyes
• dizziness
• jaw locking
• dull aching to sharp stabbing pain
• becoming overly sensitive to pain
• vertigo
• toothache
• tension headaches
• nerve-type pain, such as burning
• fever
• facial swelling

Other symptoms may be present and these will depend on the root cause of the jaw pain.

It is important for people to seek prompt medical attention in order to work out the cause of their pain so that a treatment plan can be determined. Doing so swiftly can help prevent long-term complications from occurring. Dentists, oral surgeons, and doctors are able to evaluate jaw pain.

Complications

Complications vary based on the cause and other factors associated with your pain, including the treatments that are used. They may include:

• dental complications
• surgical complications
• infection
• chronic pain
• emotional distress
• changes in eating habits

Diagnosis

In order for a doctor to diagnose and treat the cause of jaw pain, they will need to perform certain tests.

The following tests may help them to find out more about the cause of jaw pain, including:

• physical exam, including assessment of the nerves, neck bones, jaw, mouth, and muscles
• complete medical and pain history
• certain laboratory tests, such as an erythrocyte sedimentation rate blood test, used in the diagnosis of conditions involving pain
• certain radiology imaging procedures, such as X-ray or MRI
• psychological and psychiatric screening

Other tests may be needed if a clinician suspects that the jaw pain is caused by a particular disease. They will discuss what they recommend for diagnosing the cause of any jaw pain as necessary.

Treatments

If the cause of jaw pain is an infection, antibiotics may be prescribed by a healthcare professional.

Treatment of jaw pain depends on what the cause is. Treatment methods are varied and may include the following:

• antibiotics if the jaw pain is caused by an infection
• surgery to remove damaged bone, treat an affected nerve, or to diagnose the problem
• use of a mouth protector, such as a mouth guard
• physical therapy
• muscle relaxants or tranquilizers to aid in relaxing the affected muscles
• antidepressants, which can sometimes help treat painful conditions
• topical capsaicin, which is helpful in treating some nerve-related conditions
• steroid injections to decrease inflammation or swelling
• antiviral therapy to treat viral infections, such as herpes zoster
• pain medication
• oxygen therapy and some prescription medications to treat cluster headaches
• certain blood pressure medications when migraines are being treated
• root canal treatment, a procedure to treat infections within teeth
• tooth extraction if the cause is from an abnormal or infected tooth
• vapo-coolant spray to relieve painful areas of muscle, called trigger points
• injections with local anesthetics
• stretching to stretch and sooth the affected muscles
• relaxation therapy
• soft diet to avoid excessive jaw movement and crunching
• moist heat application or cold therapy
• massage or acupuncture
• use of correct posture to avoid neck and back strain

Other treatments are available to treat jaw pain, and their use is determined by the cause of the pain. Doctors can discuss the best method for treating pain with each person, based on their unique situation.

Prevention

Knowing the trigger of any jaw pain is important to prevent the pain from returning.
Some basic preventive measures may be useful, and these include:

• avoiding crunchy foods, gum, chewing fingernails, or other hard objects
• eating soft or liquid foods, such as soup or pasta
• taking smaller bites of food
• avoiding caffeine
• trying massage, meditation, and aerobic exercise
• taking calcium and magnesium supplements, if appropriate
• avoiding yawning
• sleeping on the back or side, avoiding stomach sleeping
• avoiding grinding teeth
• avoiding carrying bags on the shoulders for too long, switching shoulders frequently
• using correct posture
• seeking regular dental care

People should always speak to their doctor to determine the safety of any preventive measure to ensure it is appropriate for their unique situation.

When to see the doctor

It may be necessary for people to seek medical care for jaw pain if they are experiencing symptoms, such as:

• failure of home remedies to treat jaw pain
• jaw pain that interferes with a daily routine
• irregular jaw motion
• jaw joints making sounds when moving
• neck or upper back pain
• eye pain
• headaches
• ringing in the ear
• dental problems, such as broken or worn teeth

People should speak with a dentist or doctor about jaw pain in order for diagnosis and treatment of the underlying condition.

Written by Lori Smith BSN MSN CRNP

Proper Toothbrush Storage Really Matters

Your toothbrush is home to plaque, blood and even fecal matter.

Yes, you're probably scrubbing poop particles all over your pearly whites.

Miryam Wahram, author of The Hand Book: Surviving in a Germ-Filled World, said a toothbrush “could be much worse than a toilet seat” in terms of germs. A 2012 study by Manchester University in England says it's much worse — more than 10 million bacteria call your toothbrush home.

"There are real concerns, if you have it in the bathroom," she said. "As you flush the toilet it, you expose your toothbrush to germs from the fecal matter."

MythBusters found toothbrushes sitting outside a bathroom can be speckled with fecal matter, too. In fact, toothbrushes right out of the box can harbor bacteria because they aren't sold in sterile packaging.

Before you toss your toothbrush in horror, know that most germs (including those from a toilet plume) won't hurt you as long as you are using toothpaste. Not brushing would do a lot more damage to your health.

How you store your toothbrush is often what really matters. The American Dental Association recommends rinsing toothbrushes with tap water after use and air drying. Covering brushes contains moisture, which could harbor more bacteria.

The best way to prevent toilet water from splashing your toothbrush? Close the lid before you flush, Wahram said.

Germaphobes could also rinse toothbrushes in antibacterial mouthwash or toothbrush sanitizer (but, the ADA says those don't really make a big difference).

To keep germs at bay, don't let anyone else use your toothbrush and buy a new one every three to four months (or earlier if the bristles become frayed).