The Role of Oral Health in TMJ Disorders

SUMMARY

The health of the teeth and gums can play a role in TMJ disorders by influencing the stability of the bite and the state of tension in the jaw muscles.

DENTAL HEALTH AND BITE STABILITY
Dental diseases can destabilize a bite by causing teeth to shift.  A cavity on one side of a tooth can cause the neighboring tooth to tip into the space, which causes the opposite side of that neighboring tooth to tip upward in a way that interferes with the bite, which causes the jaw muscles to change their firing pattern in order to avoid the bite interference.  Gum disease can shift a tooth by changing the shape of its bony socket. A stable bite is a fundamental requirement for TMJ health.
 
DENTAL HEALTH AND JAW MUSCLE TENSION
Dental diseases reflexively increase jaw muscle tension, because the teeth form a joint between the upper and lower jawbones, and joints are wired with protective reflexes that respond to any noxious input from the joint by increasing the tonus in whatever muscles cross that joint. Cavities and gum disease can thereby trigger jaw muscle tightness.  Sometimes the clenching or grinding feels like scratching an itch. 
 
Keeping your mouth healthy requires cleaning your teeth after you eat, massaging your gums frequently, and getting good routine dental care.  The goal is not to sterilize your mouth or kill as many germs as possible, but to grow and maintain a healthy oral microbiome which protects your tissues from pathogens much like a healthy garden prevents weeds.  Your oral microbiome health is affected not just by how often you brush and floss, but also by what you eat, how much stimulation your gums receive, and your overall state of health. 
 
CAVITIES
Cavities occur mostly in young people when bacteria digest sugars in plaque and trapped food, producing acid which eats holes in the enamel and dentin wherever the food gets trapped, primarily in the spaces between the teeth or in the valleys on the tops of the teeth during the first two decades of life.  Cavities can occur again when older people undergo dry mouth (common side effects of drugs), which prevents saliva from rinsing away the acids created by bacteria in plaque that accumulates at the gumlines and root surfaces.  
 
GUM DISEASE 
In adulthood, mouths become more alkaline (less acidic), and they tend to deposit minerals to form calculus (tartar) rather than dissolving minerals to form cavities.  The gums of older people have usually receeded far from the bite table, leaving large spaces where food gets trapped and where plaque (the white paste of flour and water) can accumulate at the gumlines and between the teeth.  When plaque remains undisturbed, it picks up minerals from saliva and hardens to form a structure much like a coral reef - with tunnels and crypts where bacteria can hide.  This is the same material that your dentist scrapes off your teeth when you get them cleaned.   
 
PREVENTION
Preventing gum disease requires not only regularly removing food and plaque, - it also requires gum massage.  Our gums evolved with an almost constant source of rhythmically alternating compression and release from chewing tough food on a bite table that stayed close to the gums, because the teeth wore down as the gums receded.  Each chew compressed the gums, which pumped out the old blood, and each release let in new blood.  Today, most of our food is too soft to provide much massage from chewing, and any tough chewing that we undertake occurs far from the gums, which have receeded far from the bite table.  Therefore healthy gums require additional massage.     
 
RUBBER TIPS 
The best way to provide gum massage is by using the rubber tips that were on the end of every toothbrush for the better part of a century, until they were removed for marketing reasons - they last too long.  Rubber tips are still available, but they must be purchased separately.  Teeth are like glass, and this little pointed cone of rubber cleans them like a squeege cleans a windshield.  It should be rubbed along the gumline from one tooth to the next and pushed into the space between each pair of teeth until it briefly blanches the gums.  The gums turn white when they lose the old blood, and they turn pink again when new blood flows back in to replenish the tissues.  In this manner, gum massage provides an accessory circulatory pump for the most critical periodontal areas.   
 
FLOSSING
Flossing is one way (along with bristle brushes and water picks) to remove food that has become stuck between adjacent teeth.  If you have areas in your mouth that trap food when you eat, you need to find a way to get the food out shortly afterwards.  You cannot wait until you brush your teeth before bed, or you'll get gum disease or a cavity.
 
TOOTHPASTE
Most toothpaste contains an abrasive, flouride, a foaming agent, and a sweetener.  Abrasives help scour the surfaces, flouride is one of the minerals that helps harden the surfaces of teeth, and foaming agents feel good but are unnecessary.  Some toothpastes also contain herbs and essential oils or whitening agents, designed to make your teeth feel clean and fresh.  Salt and baking soda are helpful for preventing cavities in those who are still cavity prone, because they buffer the acids that microbes produce to drill holes through the enamel.  
 
CLAY
Bentonite clay is a good alternative for those who want a more natural toothpaste.  It is sufficiently abrasive, and it contains flouride in about the same proportions it exists in the earth.  In fact, the amount of daily flouride that prevents dental decay is similar to the amount that our ancestors received daily just from their food and water.  We evolved on this big rock (earth) with the constant presence of almost 100 minerals that were in all our water and food.  Our bodies were designed to be able to pick out from that supply whichever minerals they needed, including flouride.  Today we know of our need for about 8 minerals, mostly from experiments in which we go to extremes to deprive lab animals of one mineral or another.  Companies extract those minerals from rocks and sell them to you; which seems foolish; because it's easier and very likely healthier to simply consume minerals in their natural balance, directly from the rocks, in the form of clay.  Such a balanced source of minerals, in about the same concentration as they can be found in the earth, gives you the trace minerals for which we understand the need as well as those for which we don't yet understand the need.  Also, we know that some minerals (like calcium) cannot be absorbed without the presence of other minerals, and the earth provides all the minerals in a balance that makes them easily absorbed.  Bentonite clay is a good sample of all the trace minerals from the earth ground up into powder.  The minerals in a typical sample of bentonite clay are listed below:
 
Photo_jpeg_3.jpg

Some toothpastes contain clay, usually mixed with herbs and/or essential oils.  However, bentonite clay can be most easily used in powder form.  Just dip a wet brush into a bowl of powdered clay, and brush.  Afterwards, you can just swallow it.  Even if you spit it out, you'll still get all your needed trace minerals.  After all, they're TRACE minerals.  A lifetime supply of clay is cheap and requires no packaging.

KEEPING YOUR ORAL APPLIANCE CLEAN

 If you wear an oral appliance every night, you should leave it soaking in clean water all day to prevent it from building up the white hard crust that you can see on most old appliances.  This white crust, called tartar or calculus, is made of minerals from your saliva; and it is the same material that dentist scrapes off your teeth during a cleaning.  One way to prevent it from accumulating on your appliance is to keep the appliance wet. 
 

DISINFECTING - your appliance by soaking it in something that kills bacteria should be done daily or at least weekly.  Denture cleaners, which include bleach, baking soda, and citric acid to remove stains, are available at all drug stores.  Alternatively, you can soak your appliance in any type of mouthwash, vinegar, hydrogen peroxide, or even vodka.  To your health!