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     The temporomandibular joint (TMJ) and the three trigeminal nerves work together as very important structures in the head.  When the TMJ is injured or jarred out of alignment, it affects the head and the neck because the trigeminal nerves innervate the TMJ and much of the rest of the head and the neck.  Therefore, head and facial pain may result with any disorder in the TMJ.  A Coeur d'Alene dentist can help.

     The TMJ is the most active joint in the human body.  It is involved in 2,000 to 3,000 swallowing actions daily.  That’s 60,000 to 90,000 actions per month; that’s about 1 million actions per year.  And then there is chewing at meals, snacks, gum, etc.  And then there is speaking and breathing!

     The TMJ is the only joint in the body that is one side of the jaw is knocked out of its alignment that the other side is also knocked out.  This causes numerous problems in the head and face.  A Coeur d'Alene dentist may be the only one who can help.

     80% of the input to the brain comes from the 12 cranial nerves.  These nerves control almost everything from taste to blood vessels.  Nearly 60% of the total input to the brain comes from the trigeminal nerve.  This input comes from teeth, periodontal ligaments, muscles that move the jaw, muscles that tighten the ear drum, muscles that control the eustachian tubes, the sinus linings, parts of the tongue and the TMJ.  It even controls the blood flow to over 60% of the front of the brain.

     TMJ pain moves through nerve structures and the resultant pain is referred elsewhere in the head, neck, and face.  Temporomandibular joint disorder (TMD) has symptoms which include grinding, clicking, or popping in the joint.  A Coeur d'Alene dentist can easily recognize this.  Also headaches (including migraines) may also be from TMD as is tinnitus (ringing in the ear), dizziness (vertigo), and severe neck pain.

     Most people do not suspect that their pain is in any way associated with their TMJ.  They suffer from the problem of TMD and some are able to control it, adapting in their own way.  But when the adaptation fails, which it usually does, what do they do next?  Usually they just put up with it for the rest of their lives.  As TMD gets worse, pain can become unbearable.  Since TMD is difficult to diagnose, many patients are ignored when they consult a dentist.  They just do not know how to treat it because they do not know how to find the cause of the pain.  It is important to find a Coeur d'Alene dentist who is trained in treating head, neck, and facial pain.  

February 18, 2017
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     A patient’s tooth can become uncomfortable after the dentist cements a crown onto it.  The patient may think that root canal treatment is needed; and if something is not done, that may be the treatment needed.  After a short exam by another dentist, the patient is found to be biting on the new crown too heavily.  After adjusting the bite on the crown, the pain is gone.  And the tooth remains pain free for years afterward.

     A bad bite can cause problems, pain, and the need for further dental treatment.  This bad bite is called malocclusion.  Your occlusion is the way your teeth come together and they do that about 2,000 to 3,000 times a day when you swallow!  Malocclusion means that the teeth do not come together correctly each time you close.  Thank goodness that this condition is treatable.

     Most dental procedures including orthodontics, tooth replacement with implants or bridges, placement of fillings for cavities, denture placement, and crowns placed for damaged teeth may cause bad changes in the occlusion.  This is called malocclusion and may cause uneven wear in teeth or even cause the teeth to fracture or need root canal treatment.  This malocclusion can even cause problems with the TMJ (jaw joint).

     Temporomandibular dysfunction (TMD) and facial pain are conditions in which the TMJ and its muscles do not work properly.  One could experience mild pain, clicking, and popping noises all the way to severe jaw and muscle pain, headache, migraine, and jaw locking open.  Frequently, malocclusion causes these TMJ symptoms.

     These are just a few examples of problems with the dental bite.  The way one’s teeth come together causes other problems and symptoms.  Remember, your teeth have to come together every time you swallow and that is 2,000 to 3,000 times a day.  That’s about a million times a year.  If you think you have a problem with your bite, call and make a consultation appointment.  There is no charge for consultation appointments in our office.

      Dr. Donald Johnson founded Heartfelt Dental Excellence in Coeur d’Alene to help patients improve their dental health and LIVE FREE WITH NO LIMITS!  His office is at 114 W. Neider Ave. in Coeur d’Alene, near Costco.  The website for more information is and the office phone is 208-667-4551.  SCHEDULE A FREE CONSULTATION APPOINTMENT TODAY!

February 07, 2017
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     Our practice uses the advanced T-Scan III system to help us see your dental occlusion (your bite) to increase detail and efficiency.  We employ many state-of-art technologies in our practice to increase patient comfort, shorten the length of patient visits, and improve the results of our treatment.  Dentistry is full of advancements that make the claim that they improve a dentist’s practice and give advanced solutions that are new for patients.  We carefully investigate each new innovation and new technology before introducing them into our practice to guarantee that everything is right for our practice and for our patients, no matter what their age is.  One recent technology we have added to our practice is T-Scan III system.

     The T-Scan III system gives us a better analysis of our patients’ bite and better detailed results when we are determining how to adjust any one of our patient’s bite once there are symptoms of problems such as chronic headaches, TMJ (jaw joint) dysfunction, tooth pain, or facial pain.  T-Scan III records the real-time contact of teeth in 3 dimensions.  It records as the patient bites down (occludes) and moves the jaw side to side and front to back.  We can view the data in intervals as small as .01 seconds for the whole recording.  Altogether, the T-Scan III system helps the treatment of chronic headaches, TMJ problems, and other symptoms of a “bad” bite. 

     Call to schedule a free consultation at our office to see if a test with our T-Scan III system may be of help in determining the cause of your headaches, TMJ problems, toothaches, etc.

     As parents, we absolutely want what is best for our children in every way.  We are well aware of the specific milestones that our children should reach during the first eighteen months of life.   But there are several important growth and development factors that must be evaluated during the first decade of each child’s life.  It may surprise you that your child’s dentist should be the guardian of normal facial growth for your child, not just taking care of your child’s teeth.  The goal of your child’s dentist should be to monitor and guide the growth and development of young child’s face and teeth.       

     Many parents are unaware that 60% of their child’s facial development is completed by age 6, and that 90% is completed by age 12.  This means that the earlier your child sees a dentist that understands this, the better the opportunity to detect and correct developmental problems that are present.

     Facial growth involves the individual growth of each bone in the face.  Several things can cause an unequal growth of these bones and this imbalance may affect a child’s health and appearance. A normal balanced face is the result of more than just bone growth.  It is the balance of normally functioning muscles and teeth, proper nutrition, and the ability to breathe through the nose properly.  Studies show that when the proper balances are altered, changes in health and appearance occur.

     The most common abnormalities in facial growth and development are caused by a compromised airway--the inability to breathe properly through the nose.  These children breath through their mouth which sets up a chain of events which will severely impact not only the health of the child throughout his life, but also will impact the facial features.  The most common cause of this altered mouth breathing is enlarged adenoids and tonsils.

     The effects of a compromised airway on the growth of a child are revealed in many ways. The tongue positions itself between the lower teeth to allow a child to breathe through the mouth, changing the growth of the lower jaw so that it grows more vertically and makes the child’s face look longer. At the same time, the upper jaw and midface (the nasal bones, cheek bones, and bones supporting the tissue of the face) fail to develop outward because the tongue is not on the roof of the mouth 12-15 times per minute (the rate of breathing).  This would have pushed the roof of the mouth wider, counteracting the inward pressure from the cheek muscles.  The result of mouth breathing is a deficiency of growth of the upper jaw and midface which, added to the long facial growth from the lower jaw, directly impacts the facial balance and beauty of the child and later the adult.

     Children are born with small adenoids and tonsils.  They reach their maximum size between the ages of 3-6, and reduce in size during the teen years.  But they can become infected and block a child’s nasal passages resulting in nasal congestion, mouth breathing, and increased snoring.  In severe cases where the adenoids and tonsils block the nasal passages completely, they can cause sleep disturbances such as sleep apnea where breathing is stopped altogether.  A child may be tired all the time as a result of interrupted sleep related to the nasal blockage.  This may also result in a mis-diagnosis of ADHD when it is really sleep apnea.  But, of course, enlarged adenoids and tonsils are not only the cause of mouth breathing in children.  Other causes must be investigated by your physician.

     The ideal treatment for chronically enlarged, obstructing adenoids and tonsils is to have them surgically remove by a qualified surgeon.  The child’s dentist, working closely with an ENT (Ear, Nose, and Throat) Specialist, can help to eliminate these things which are causing abnormal facial growth.  In the cases where negative facial growth changes are already significant and facial harmony is already disrupted, the dentist may intervene and use various appliances to modify the abnormal growth pattern and restore the balance to growth.  Taking your child to the dentist as early as possible, yes even before age 3, is very important.

     It is important to bear in mind that no matter what your child’s rate of development and growth, a loving and supportive environment are crucial to his or her happiness and self-esteem.  If you have a concern about your child’s ability to breathe or rate of growth or development of the face or teeth, call our office for a free consultation to discuss the concern and see if anything can be done.

     If you’re 50 or older, chances are you’ve noticed a few grey hairs and maybe a wrinkle or two --- but you probably haven’t noticed the fact that your teeth may be changing, too. In fact, the enamel on their surface may have started to wear away -- putting your smile in serious danger.  And it may be an important symptom of a dangerous condition known as sleep apnea.

      You see, even though tooth enamel is the hardest substance in our bodies, it can wear down, exposing the softer dentin inside the tooth and leading to some very serious problems.   When you think about how hard we ask our teeth to work, that’s really no surprise.

     For starters there’s all the biting and chewing we do every day. And there are lots of other factors too, like drinking too many soft drinks, chewing on things like ice, and grinding our teeth – not to mention various medical conditions, drugs and supplements.  Clenching and grinding are main symptoms of sleep apnea.

     All those factors pile up, with the result that by the time you’re 50 or so the enamel on your teeth – particularly the teeth in the front of your mouth – can be so worn that the dentin begins to show through as yellow spots at the middle or edge of a tooth. The dentin can “cup” as well, causing what some dentists refer to as “potholes” in your teeth.  It may be that your teeth are ground down to a straight line across the tooth and the edges are sharp 90 degree angles rather than rounded corners.

Potential Tooth Damage or Loss

     What’s worse, the thinning edges of these “potholes” then begin to develop chips and micro-fractures, setting the stage for a downward spiral that can lead to the need for expensive and time-consuming dental work like root canals and crowns or even the loss of teeth.

     That’s a shame – and totally unnecessary – because there are simple and effective ways to repair worn enamel and prevent future problems, if the condition is caught promptly.  Unfortunately, this potentially devastating condition is not something you’re likely to notice on your own – at least not in its earliest stages.  Most often there’s no pain associated with enamel loss, although some people do notice increased sensitivity to hot and cold.

     As for appearance, you might possibly see areas of yellow dentin if you examined your teeth very carefully using a good magnifying mirror and an extremely bright light. Even using these tools, though, you’d only be able to detect the problem AFTER you had already lost a considerable amount of enamel.

     The good news is that our office looks for signs of enamel wear every time you visit. And, if we see a problem, we have the tools to fix it.

­­High tech repair

     Basically, what we do when we see a problem is very gently reshape the affected area, then flow in an ultra high tech composite resin that matches your enamel in both color and strength.  This resin is bonded to the existing tooth.

     The process is simple, quick and so comfortable it rarely requires anesthetic. And we can reinforce and protect as many teeth as needed in just one visit.  What’s more, this simple repair should last for many, many years – and, if needed, we can touch the resin up or redo it quickly and easily.

     When you consider that this simple procedure can help you keep your teeth – and avoid all the time, drilling, anesthetic and expense of root canals and crowns – it’s hard to think of a more effective way to preserve your smile.  If you’d like to know more, just ask. We’ll be happy to fill you in on all the details about this important treatment.