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Temporomandibular dysfunction (TMD) refers to a diverse range of disorders that relate to muscular function in the jaw and face — the temporomandibular joint (TMJ). That could mean difficulty opening your mouth, pain in the jaw or face, or any sort of problem with the jaw joint.

TMD can be difficult to diagnose because of the varied causes. Whatever the case, an accurate diagnosis from Dr. Bradley Hoppens and Dr. Mary Beth Meier helps make treatment as successful as possible.

Most often, jaw problems will resolve themselves within several weeks or months. Surgeries like arthrocentesis, arthroscopy, and open-joint surgery should be a last resort. More conservative and reversible treatments should come first and are in fact the most critical step in the treatment of TMD.

Less invasive treatments like acupuncture and splints can be helpful, but that will depend on your particular case. It’s worth your while to speak with Dr. Bradley Hoppens and Dr. Mary Beth Meier at our McCook, North Platte, or Ogallala office to learn about solutions that could work for you.

A combination of treatments will most often produce the greatest relief for TMJ patients. It’s a good idea to avoid activities that overuse the jaws, such as chewing gum or clenching your jaws.

You can be proactive in finding relief for TMD by trying the following remedies at home:

• Eat soft food: When you eat soft and/or blended food, your jaw gets an opportunity to rest. Avoid chewy and crunchy food, and food that requires you to open your mouth wide, like apples or corn on the cob.
• Apply moist heat: A hot water bottle wrapped in a moist towel can help reduce symptoms.
• Apply ice: Applying an ice pack wrapped in a cloth or towel for no longer than 15 minutes may also reduce pain and promote healing.
• Do jaw exercises: A physical therapist can help identify the exercises that will work for you. Jaw exercises have been shown to be an effective treatment method that can be performed at home.
• Relaxation: Actively try to relax the muscles of the face and lips, and let your teeth come apart. Many find meditation, yoga, and slow, deep breathing to be helpful for reducing stress and tension.
• Avoid wide yawns: Keep your fist under your jaw when you feel a yawn coming on, to keep your jaw from opening too widely.

When you get your braces, Dr. Bradley Hoppens and Dr. Mary Beth Meier and our staff will also give you a list of foods you should not eat and things you should not do. Pay particular attention to these items to keep your teeth and braces safe.

Charms belong on bracelets. While you can decorate your braces with colored bands, hanging a charm off them is a bad idea. If you bite down on the charm, you could damage your braces or your teeth. You could also swallow your jewelry.

Never use your teeth as a bottle opener. This is just as important when you are wearing braces. While braces straighten your teeth, your teeth are moving in the process. That makes them weaker, and the metal in the braces does not make them invincible. Invest in a bottle opener; you can buy one for a few dollars, which is much less expensive than having to replace your braces.

Contrary to what you might think, your braces are not designed to work as a radio. There are tales of people who have picked up radio signals from dental fillings or braces. While this is remotely possible, attaching an antenna to your mouth is just not a good idea. You will get better quality music from a radio.

On the other hand, you can still kiss someone while wearing braces. In fact, even if both of you wear braces, the chances of your getting locked together are almost negligible. However, to avoid cutting your partner’s lips, kiss with caution.

If you have any questions about taking care of your braces, please ask Dr. Bradley Hoppens and Dr. Mary Beth Meier and our staff. We want you to get the best results from your treatment without needless delays.

You’re in the band and you’re getting braces. Now what? If you are a member of the string or percussion sections, you can go back to rehearsal. You’re good to go. When your talents have seated you in the reed or brass sections, though, a little adjustment might be necessary to keep your instrument and your braces working in harmony.

If you play a wind instrument, you know the term embouchure—the way you position and use your lips, tongue, facial muscles, and teeth to produce the sound you want. Depending on the instrument you play, you might be completely unaffected when you get your braces, or you might need to develop a more comfortable embouchure to accommodate them.

Wires and Woodwinds?

If you play a wind instrument such as the flute or piccolo, you might find that your normal lip positioning or blowing angle is affected by your braces, but usually the adjustment time is fairly short. Reed instruments such as the saxophone, clarinet, oboe, and bassoon are considered some of the easiest to adjust to when you have braces, but even though the single and double reed mouthpieces don’t require as much pressure as brass instruments, there can still be an adjustment period. One thing you should look out for is more condensation in your mouthpiece or instrument—be sure to keep your instrument clean to keep your sound pure.

Brackets and Brass?

Brass instruments require mouthpiece pressure. This leaves your lips pressed between the mouthpiece and your braces. For this reason, many brass players have a more challenging adjustment when wearing braces. Smaller mouthpieces (trumpet, French horn) usually require more pressure than larger ones (tuba, trombone). It’s important to learn how to use technique to avoid cuts, irritation, and other injuries caused by the pressure of your braces against your lips. Learning to play with less pressure on the lips and more air control and breath support will help you to recover your tone and range of notes while protecting your lips and mouth.

How Can We Help?

Let Dr. Bradley Hoppens and Dr. Mary Beth Meier know if you play, or plan to play, a wind instrument. We might be able to offer some suggestions. For regular metal and ceramic braces, some musicians find extra wax is helpful in preventing lip and cheek injuries. There are brace guards available that can be applied over the braces to protect your lips and mouth if wax doesn’t do the trick.

There are also alternatives to regular bracket-and-wire braces, depending on your orthodontic needs, cost factors, and length of treatment. Invisalign® devices fit smoothly over your teeth and can even be removed when it is time to practice or play, as long as you get the necessary hours of wear in per day. In some cases, lingual braces, where the brackets and wires are placed behind the teeth, might be the best choice for you.

Finally, don’t forget to talk to your music instructor. Don’t be dismayed if you find the quality of your playing has been affected. Your teacher might have valuable suggestions for adjusting your embouchure, playing with less pressure on the lips, and developing better air and breath support. You might need to shorten your practice time at first, and there might be another period of adjustment after your braces come off.

Above all, take care of yourself! If something is poking your lip or cheek, call our McCook, North Platte, or Ogallala office immediately before it causes injury. It might be difficult at first, but finding an embouchure that works for your comfort and technique is worth it. And remember, these temporary fine-tunings will lead to a wonderful coda: skilled musicianship and a beautiful, healthy smile. Bravo!

If there’s one meal that can claim the title of “Sweetest Meal of the Day,” it’s almost certainly breakfast. Sugary cereals, syrup-covered waffles, oatmeal with honey, cinnamon toast (which is literally sugar poured on toast)—it’s hard to imagine another menu even coming close. But you’re trying to keep your diet as healthy as possible. What to do?

First, no need to deprive yourself of the occasional pastry or stack of pancakes. The real problem with breakfast isn’t so much sugar as it is added sugar.

• Just a Spoonful of Sugar? What’s So Bad About That?

Nothing! Many healthy foods have natural sugars. Milk contains lactose sugar, and it also contains calcium and is enriched with vitamin D—both of which are essential for strong bones and teeth. Fruits get their sweetness from a sugar called fructose, and deliciously provide vitamins, minerals, antioxidants, and fiber to our diets.

Even processed sugar is surprisingly low in calories. In fact, a teaspoon of white sugar has only about 15 calories. But this teaspoon is also rich in nutrients for cavity-causing bacteria. The oral bacteria in plaque use sugars and carbohydrates from food particles as a fuel source to produce acids. These acids erode enamel and lead to cavities.

Choosing breakfast foods without additional sugars, then, is an easy way to reduce the number of empty calories in your diet while safeguarding the health of your teeth. We have a few suggestions.

• Be Selective with Cereals

If the word “sugar” or “honey” or appears on the box, that’s a hint that your favorite cereal is heavy on the sugar. But there’s a more scientific way to tell just how much sugar is in that spoonful.

While the colorful packaging and playful mascots are eye-catching, check the black-and-white panel with nutritional facts found on every box. If one serving equals 27 grams, and the sugar in that serving equals 15 grams, you know you have a problem. And cereals marketed to children are especially “rich” in added sugar.

But luckily, you don’t need to give up your morning bowl. Many cold cereals are available that offer whole grains, protein, and fiber without a lot of added sugar. Spend some time in the cereal aisle comparing, or, to make life easier, there are many online sites which recommend the best (and worst) cereals in terms of sugar content.

• Use Your Judgment with Juices

Fruits are packed with important nutrients. Not only do they provide essential vitamins and minerals, they’re a great source of water and fiber. If you drink 100% fruit juice, you are getting the benefit of most of the vitamins and minerals found in fruit. (You’re also getting less of the fruit’s natural fiber, and more of the fruit’s natural sugar, so consider fresh fruit as an option occasionally.)

But when fruit juice comes with “cocktail,” or “punch,” or “ade” attached to the end of it, there’s often something else attached—added sugar. For natural fruit flavor and the least amount of sugar, stay with 100% unsweetened fruit juice.

• Search Out “Surprise” Sugars

Remember the childhood excitement of searching through your cereal box for the prize inside? Fun! What’s not so much fun? The surprises you might find when you search through the labels on your favorite breakfast items—because added sugars make their stealthy way into many of our morning favorites.

When you compare plain, Greek, and low-fat yogurts, for example, the low-fat options are often higher in added sugar. A container of low-fat yogurt can provide 19 grams of sugar—that’s a tablespoon and a half!

And while you’re at it, be sure to compare the sugar content in granola bars. Some are full of nuts and grains, and some are full of added sugar.

Going out for a breakfast smoothie? Those can contain 70 grams of sugar and more. Making your own at home might be a little more time-consuming, but if you use fresh fruit as your sweetener, you can make sure that what you’re not consuming is added sugar. If you’re on the go, check out all-fruit options at your favorite smoothie shop.

Dr. Bradley Hoppens and Dr. Mary Beth Meier and our team aren’t asking you to eliminate sugar from your breakfast diet altogether. (Everyone loves a doughnut now and again.) But substituting some alternatives for your regular menu choices can reduce the amount of added sugars by tablespoons every meal. That’s another great reason to greet the morning with a smile!