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A superior mouth is a mouth that opens upward, with the lower jaw more anterior than the upper jaw. This is an effect typically seen in fish. Some humans are born with this defect, often making their face resemble a shark's. This usually means that the fish feeds from the surface of the body of water in which it dwells.
Also called myofunctional therapy, the basic treatment aims of orofacial myofunctional therapist is to reeducate the movement of muscles, restore correct swallowing patterns, and establish adequate labial-lingual postures. An interdisciplinary nature of treatment is always desirable to reach functional goals in terms of swallowing, speech, and other esthetic factors. A team approach has been shown to be effective in correcting orofacial myofunctional disorders. The teams include an orthodontist, dental hygienist, certified orofacial myologist, general dentist, otorhinolaryngologist, and a speech-language pathologist.
Meth mouth is very difficult to treat unless the patient stops using methamphetamine; persistent drug use makes changes in hygiene or nutrition practices unlikely. Many drug users lack access to dental treatment, and few are willing to participate in such a course of action, often because of poverty. Those who are willing to seek dental treatment often resist discussing their drug use. Providing dental treatment to individuals who use methamphetamine can also be dangerous, because the potential combination of local anesthetic and methamphetamine can cause serious heart problems. There is also an increased risk of serious side effects if opioid medications are used in the patient's treatment.
Treatment of meth mouth usually attempts to increase salivary flow, halt tooth decay, and encourage behavioral changes. Toothpaste with fluoride is very important to the restoration of dental health. Only prescription fluoride rinses can adequately treat the condition. Sialogogues, drugs that increase the amount of saliva in the mouth, can be used to treat dry mouth and protect against dental health problems. Pilocarpine and cevimeline are sialogogues approved by the Food and Drug Administration (FDA) to treat low salivation caused by Sjogren's syndrome and may have the potential to effectively treat dry mouth caused by methamphetamine use.
Education about oral hygiene for long-term methamphetamine users is sometimes required. Changes in diet are often necessary for recovering drug users that are receiving dental treatment, and the use of sugar-free gum may be beneficial. The consumption of water and the avoidance of beverages with a diuretic (dehydrating) effect can also help patients with meth mouth.
The adaptation from nasal to mouth breathing takes pace when changes such as chronic middle ear infections, sinusitis, allergic rhinitis, upper airway infections, and sleep disturbances (e.g., snoring) take place. In addition, mouth breathing is often associated with a decrease in oxygen intake into the lungs. Mouth breathing can particularly affect the growing face, as the abnormal pull of these muscle groups on facial bones slowly deforms these bones, causing misalignment. The earlier in life these changes take place, the greater the alterations in facial growth, and ultimately an open mouth posture is created where the upper lip is raised and the lower jaw is maintained in an open posture. The tongue, which is normally tucked under the roof of the mouth, drops to the floor of the mouth and protrudes to allow a greater volume of air intake. Consequently, an open mouth posture can lead to malocclusions and problems in swallowing. Other causes of open-mouth posture are weakness of lip muscles, overall lack of tone in the body or hypotonia, and prolonged/chronic allergies of the respiratory tract. A.union
The most common treatment, which is cheap and widely available, is to apply a clear, bitter-tasting nail polish to the nails. Normally denatonium benzoate is used, the most bitter chemical compound known. The bitter flavor discourages the nail-biting habit.
Behavioral therapy is beneficial when simpler measures are not effective. Habit Reversal Training (HRT), which seeks to unlearn the habit of nail biting and possibly replace it with a more constructive habit, has shown its effectiveness versus placebo in children and adults. A study in children showed that results with HRT were superior to either no treatment at all or the manipulation of objects as an alternative behavior, which is another possible approach to treatment. In addition to HRT, stimulus control therapy is used to both identify and then eliminate the stimulus that frequently triggers biting urges. Other behavioral techniques that have been investigated with preliminary positive results are self-help techniques, and the use of wristbands as non-removable reminders. More recently, technology companies have begun producing wearable devices and smart watch applications that track the position of users' hands.
Another treatment for chronic nail biters is the usage of a dental deterrent device that prevents the front teeth from damaging the nails and the surrounding cuticles. After about two months, the device leads to a full oppression of the nail biting urge.
Evidence on the efficacy of drugs is very limited and they are not routinely used. A small double-blind randomized clinical trial in children and adolescents indicated that N-acetylcysteine, a glutathione and glutamate modulator, could, in the short term only, be more effective than placebo in decreasing the nail-biting behavior.
Nail cosmetics can help to ameliorate nail biting social effects.
Independently of the method used, parental education is useful in the case of young nail biters to maximize the efficacy of the treatment programs, as some behaviors by the parents or other family members may be helping to perpetuate the problem. For example, punishments have been shown to be not better than placebo, and in some cases may even increase the nail biting frequency.
There have not been any controlled studies on meth mouth, and several of its aspects are unclear. Although the condition has been popularized by media coverage and case reports, no systematic studies have been conducted to conclusively tie methamphetamine use to symptoms that are commonly described as meth mouth. There are few ties between dental scholars and those who study drug use, and it can be difficult for dental researchers to find methamphetamine users to study.
Whether the drug has a unique effect on dental health has been questioned by a few academics, who note that the long-term use of several other drugs sometimes causes dental problems. Several academic reviews have contradicted this perspective, affirming meth mouth's status as a discrete condition. In favor of its unique status, these reviews cite the differences between methamphetamine-caused caries and those that occur for other reasons, such as cocaine use, as well as the scope of the tooth decay found in some long-term methamphetamine users.
If a cause can be identified for a burning sensation in the mouth, then treatment of this underlying factor is recommended. If symptom persist despite treatment a diagnosis of BMS is confirmed. BMS has been traditionally treated by reassurance and with antidepressants, anxiolytics or anticonvulsants. A 2016 Cochrane review of treatment for burning mouth syndrome concluded that strong evidence of an effective treatment was not available. Other treatments which have been used include atypical antipsychotics, histamine receptor antagonists, and dopamine agonists.
Burning mouth syndrome (BMS) is a burning sensation in the mouth with no underlying dental or medical cause. No related signs of disease are found in the mouth. People with burning mouth syndrome may also have a dry mouth sensation where no cause can be found such as reduced salivary flow, tingling in the mouth, or an altered taste or smell.
A burning sensation in the mouth can be a symptom of another disease when local or systemic factors are found to be implicated, and this is not considered to be burning mouth syndrome, which is a syndrome of medically unexplained symptoms. The International Association for the Study of Pain defines burning mouth syndrome as "a distinctive nosological entity characterized by unremitting oral burning or similar pain in the absence of detectable mucosal changes", and "burning pain in the tongue or other oral mucous membranes", and the International Headache Society defines it as "an intra-oral burning sensation for which no medical or dental cause can be found".
Due to insufficient evidence it is unclear if effective treatments exist.
While it is rare before the age of 3, about 30 percent of children between 7 and 10 years of age and 45 percent of teenagers engage in nail biting. Finally, prevalence decreases in adults. Figures may vary between studies, and could be related to geographic and cultural differences. The proportion of subjects that have ever had the habit (lifetime prevalence) may be much higher than the proportion of current nail-biters (time-point prevalence). Although it does not seem to be more common in either sex, results of epidemiological studies on this issue are not fully consistent. It may be underrecognized since individuals tend to deny or be ignorant of its negative consequences, complicating its diagnosis. Having a parent with a mental disorder is also a risk factor.
Treatment is cause-related, but also symptomatic if the underlying cause is unknown or not correctable. It is also important to note that most ulcers will heal completely without any intervention. Treatment can range from simply smoothing or removing a local cause of trauma, to addressing underlying factors such as dry mouth or substituting a problem medication. Maintaining good oral hygiene and use of an antiseptic mouthwash or spray (e.g. chlorhexidine) can prevent secondary infection and therefore hasten healing. A topical analgesic (e.g. benzydamine mouthwash) may reduce pain. Topical (gels, creams or inhalers) or systemic steroids may be used to reduce inflammation. An antifungal drug may be used to prevent oral candidiasis developing in those who use prolonged steroids. People with mouth ulcers may prefer to avoid hot or spicy foods, which can increase the pain. Self-inflicted ulceration can be difficult to manage, and psychiatric input may be required in some people.
Oral ulceration is a common reason for people to seek medical or dental advice. A breach of the oral mucosa probably affects most people at various times during life. For a discussion of the epidemiology of aphthous stomatitis, see Aphthous stomatitis#Epidemiology.
To relieve pain, some doctors suggest pressing the tongue against the roof of the mouth to warm the area, tilting the head back for 20 seconds, or drinking something warmer than whatever caused the headache. Some people report relief from breathing in through the mouth and out through the nose, thus passing warm air through the nasal passages.
Prostheses are used for nonsurgical closure in a situation of velopharyngeal dysfunction. There are two types of prosthesis: the speech bulb and the palatal lift prosthesis. The speech bulb is an acrylic body that can be placed in the velopharyngeal port and can achieve obstruction. The palatal lift prosthesis is comparable with the speech bulb, but with a metal skeleton attached to the acrylic body. This will also obstruct the velopharyngeal port. It is a good option for patients that have enough tissue but a poor control of the coordination and timing of velopharyngeal movement. It is also used in patients with contraindications for surgery. It has also been used as a reversible test to confirm whether a surgical intervention would help.
Pharyngeal flap and sphincter pharyngoplasty seem to be safe and reliable procedures for treating velopharyngeal dysfunction. Although not in all patients complete closure will be achieved after the surgical procedures, they do show a reduction of the size of the velopharyngeal defect. The planning of the surgical procedure seems to be the most important aspect of the surgery for correcting velopharyngeal dysfunction. To clarify the problems of each individual patient, diagnosis will be confirmed by hearing (speech analysis) and imaging (videofluoroscopy and nasoendoscopy) the defect. It is important to think about that these different diagnostic procedures can give a various result, because of the fact that what you hear does not necessarily correlate with what is seen.
The preoperative planning will give you important information about the movement of the soft palate, the lateral pharyngeal walls and posterior pharyngeal wall. The part of the soft palate with the maximal movement, gives you the precise level where tissue has to be attached. This information decides the length of the pharyngeal flap or lateral flaps. Likewise, the size and shape of the gap is considered for determining the width of the pharyngeal flap or lateral flaps. The dissymmetry will be corrected by placing an asymmetric flap or creating unilateral a wider flap in the sphincteroplasty procedure. This is why diagnostic tools contribute immensely in the approach of the problem, and consequently decide if the operation can be called a success.
Moreover, it is concluded that the diagnostic tool that should be used has to be chosen on the aspect of the velopharyngeal defect of the individual.
A recent meta-analysis which used two RCT's (Randomised Controlled Trial), currently provides the highest quality data in comparing pharyngeal flap with sphincter pharyngoplasty. This study suggests a possible trend favouring the pharyngeal flap. However, in this meta-analysis only one out of two RCT’s shows a better outcome for the pharyngeal flap, the other RCT doesn’t show any difference. What’s needed next is more research to be done, so that the result of the meta-analysis can be supported.
Treatment is surgical, and usually is able to be performed once life-threatening injuries are stabilized, to allow the patient to survive the general anesthesia needed for invasive orthopedic restructuring. First a "frontal bar" is used, which refers to the thickened frontal bone above the frontonasal sutures and the superior orbital rim. The facial bones are suspended from the bar by open reduction and internal fixation with titanium plates and screws, and each fracture is fixed, first at its superior attachment to the bar, then at the inferior attachment to the displaced bone. For stability, the zygomaticofrontal suture is usually replaced first, and the palate and alveolar ridge are usually fixed last. Finally, after the horizontal and vertical maxillary buttresses are stabilized, the orbital fractures are fixed last.
The phenomenon is common enough to have been the subject of research published in the "British Medical Journal" and "Scientific American". A study conducted by Maya Kaczorowski demonstrated a higher incidence of sphenopalatine ganglioneuralgia in subjects consuming the ice cream sample in less than 30 seconds vs. those who consumed slowly, with no time limit (27.3% and 12.5% respectively). However, Kaczorowski was ultimately not able to draw a clear connection between the speed of consumption and incidence of sphenopalatine ganglioneuralgia.
According to research by Nigel Bird, Anne MacGregor, and Marcia I. Wilkinson published in the journal "Headache", in their study "17% of the migraine patients and 46% of the students developed headache following palatal application or a swallow of ice cream."
If small and asymptomatic, no treatment is necessary. Larger, symptomatic cases of Zenker's diverticulum have been traditionally treated by neck surgery to resect the diverticulum and incise the cricopharyngeus muscle. However, in recent times non-surgical endoscopic techniques have gained more importance (as they allow for much faster recovery), and the currently preferred treatment is endoscopic stapling (i.e. diverticulotomy with staples ). This may be performed through a diverticuloscope. Other methods include fibreoptic diverticular repair.
Other non-surgical treatment modalities also exist, such as endoscopic laser, which recent evidence suggests is less effective than stapling.
If dermatochalasis is severe enough to obstruct the peripheral or superior visual fields, then it may be treated with a surgical procedure called blepharoplasty. In blepharoplasty surgery, excess skin, muscle and fat are removed. While the improvement of vision is an indication for blepharoplasty on the superior eyelid, if the visual fields are not obstructed, it may be performed for cosmetic reasons. In general, blepharoplasty of the inferior eyelid is considered cosmetic, as dermatochalasis in the lower eyelid does not interfere with vision.
A Le Fort fracture of the skull is a classic transfacial fracture of the midface, involving the maxillary bone and surrounding structures in either a horizontal, pyramidal or transverse direction. The hallmark of Lefort fractures is traumatic "pterygomaxillary separation", which signifies fractures between the pterygoid plates, horseshoe shaped bony protuberances which extend from the inferior margin of the maxilla, and the maxillary sinuses. Continuity of this structure is a keystone for stability of the midface, involvement of which impacts surgical management of trauma victims, as it requires fixation to a horizontal bar of the frontal bone. The pterygoid plates lie posterior to the upper dental row, or alveolar ridge, when viewing the face from an anterior view. The fractures are named after French surgeon René Le Fort (1869–1951), who discovered the fracture patterns by examining crush injuries in cadavers.
Once diagnosed, the gap in the temporal bone can be repaired by surgical resurfacing of the affected bone or plugging of the superior semicircular canal. These techniques are performed by accessing the site of the dehiscence either via a middle fossa craniotomy or via a canal drilled through the transmastoid bone behind the affected ear. Bone cement has been the material most often used, in spite of its tendency to slippage and resorption, and a consequent high failure rate; recently, soft tissue grafts have been substituted.
Dermatochalasis commonly affects the elderly, although sometimes it is congenitally acquired. The elderly version may begin to develop as early as 40 years of age, and it continues to progress with age. The congenital version may begin around 20 years of age. There is no racial predisposition towards developing dermatochalasis, and men and women are equally affected.
A Zenker's diverticulum, also pharyngoesophageal diverticulum, also pharyngeal pouch, also hypopharyngeal diverticulum, is a diverticulum of the mucosa of the pharynx, just above the cricopharyngeal muscle (i.e. above the upper sphincter of the esophagus). It is a pseudo diverticulum (not involving all layers of the esophageal wall).
It was named in 1877 by German pathologist Friedrich Albert von Zenker.
Jaw dislocation is common for people who are in car, motorcycle or related accidents and also sports related activities. This injury does not pin point specific ages or genders because it could happen to anybody. People who dislocate their jaw do not usually seek emergency medical care. In most cases, jaw dislocations are acute and can be altered by minor manipulations. It was reported from one study that over a seven-year period at an emergency medical site, with 100,000 yearly visits, there were only 37 patients that were seen for a dislocated jaw.
Most temporomandibular disorders (TMDs) are self-limiting and do not get worse. Simple treatment, involving self-care practices, rehabilitation aimed at eliminating muscle spasms, and restoring correct coordination, is all that is required. Nonsteroidal anti inflammatory analgesics (NSAIDs) should be used on a short-term, regular basis and not on an as needed basis. On the other hand, treatment of chronic TMD can be difficult and the condition is best managed by a team approach; the team consists of a primary care physician, a dentist, a physiotherapist, a psychologist, a pharmacologist, and in small number of cases, a surgeon. The different modalities include patient education and self-care practices, medication, physical therapy, splints, psychological counseling, relaxation techniques, biofeedback, hypnotherapy, acupuncture, and arthrocentesis.
As with most dislocated joints, a dislocated jaw can usually be successfully positioned into its normal position by a trained medical professional. Attempts to readjust the jaw without the assistance of a medical professional could result in worsening of the injury. The health care provider may be able to set it back into the correct position by manipulating the area back into its proper position. Numbing medications such as general anesthetics, muscle relaxants, or in some cases sedation, may be needed to relax the strong jaw muscle. In more severe cases, surgery may be needed to reposition the jaw, particularly if repeated jaw dislocations have occurred.
An imperforate lacrimal punctum is a congenital disorder of dogs involving the lack of an opening to the nasolacrimal duct (tear duct) in the conjunctiva. Dogs normally have two lacrimal puncta, the superior and inferior. This condition can affect either or both. Symptoms include excessive tearing and tear staining of the hair around the eye. Affected breeds include the American Cocker Spaniel, Bedlington Terrier, Golden Retriever, Poodle, and Samoyed. Imperforate lacrimal puncta can be corrected by surgical opening of the punctum.