Tag Archives: Dr. Richard M. Nadler

Is It Really A Migraine??

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Last week in the course of a routine examination, I asked a standard question of our young woman patient: “Do you have any problem with headaches?” She replied that she does have “migraines”. So I asked a few relevant questions about the headaches, and as is often the case, this patient’s answers led me to believe that her headaches are, in fact, not migraines.

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In our office, we often treat patients with head and neck pain who have been diagnosed by their doctors as having temporomandibular joint dysfunction. Oftentimes, such patients visit their doctors because they assume that the headaches from which they suffer must be migraines.

What are the typical signs and symptoms of a migraine headache? A typical migraine may last several hours to as many as three days. The pain is moderate to severe, pulsating, and usually on one side of the head. Typical associated signs of migraines include nausea and/or vomiting, as well as sensitivity to light and noise. Many migraine patients describe an “aura” just before the migraine begins. Auras are exhibited as a change in vision or hearing. Episodic migraines occur fewer than fifteen times per month with only some of these headaches being actual migraines. Such headaches occurring more than fifteen days per month with pain lasting four hours or more over a three-month period are considered to be “chronic migraines”.

Migraines may be triggered by various factors, and three out of four migraine sufferers describe specific triggers. Common examples of these triggers are physical exertion, stress, hormonal changes, weather changes, and others.

Tension headaches are the most common primary headaches. Such headaches may be misdiagnosed as migraines and vice versa.

Cluster headaches are severe attacks of pain on one side of the head lasting between fifteen minutes and three hours. These headaches may occur every other day or as often as eight times each day. Cluster headaches may be associated with facial sweating, restlessness, agitation or nasal congestion.

Other types of headaches include those brought on by exertion or coughing.  They may be described as feeling like stabbing pain or other equally unpleasant feelings.

If you or someone that you know suffers from headaches, we can generally help determine whether or not migraine headache is a proper diagnosis. The determination is made based upon the patient’s history and description of the pain as well as a screening examination to rule out the possibility of TMJ-type pain. We even have a computerized evaluation system to diagnose which muscle or muscles may be causing the problem. Patients often find it hard to believe that their headaches may be related to their jaw joints or their bite. The truth is, the connection between head and neck pain and the muscles involved in moving the jaw as well as those holding the head erect are commonly the source of such pain.

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If you have a question about headaches or would like additional information please feel free to contact us via our website www.DesignsForDentalHealth.com or by calling our office at 908.359.6655.

Cracked Tooth Syndrome – What You Need To Know

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We have had several patients recently who have had problems related to cracked teeth. The symptoms of which these patients complain can be difficult for both the patient and the dentist.  Both can become frustrated because the underlying cause of symptoms is frequently difficult to pinpoint.  Often, patients will complain about pain which is caused by biting pressure and sometimes temperature.  It is frustrating for both parties because the described symptoms are often difficult to duplicate in the dental office.  It’s kind of like bringing your car to the dealer with a specific problem which suddenly vanishes as soon as you arrive at the dealership.

Cracked teeth generally occur for two reasons.  First, silver or amalgam fillings expand and contract as we consume hot and cold foods and beverages. The expansion and contraction of the filling is slightly greater than the tooth itself.  So, after years of such cycling in temperature-associated expansion and contraction, cracks frequently develop in the teeth.  Second, cracks may occur while chewing foods.  Commonly patients will describe a sharp pain in a tooth while they had been chewing, and the tooth will remain sensitive to biting pressure and/or temperature.

Cracked teeth are addressed in stages depending upon symptoms.  First, a bonded filling may be placed in an attempt to prevent the cracks from propagating further.  Depending on the depth and severity of the crack, an onlay or crown may be necessary to prevent the tooth from breaking.  An onlay covers any thin walls of the tooth which may be at risk for fracture and is considered a conservative, aesthetic and long-term restoration.  If the tooth has an extensive existing restoration or a more severe crack, then a crown which covers the entire tooth will be required to prevent the tooth from breaking.

In either case, the problem needs to be addressed as quickly as possible to prevent the crack from propagating further into the tooth leading to more severe dental problems.  For example, if the crack reaches the pulp of the tooth, then root canal therapy will be required as well.  The most severe complication would be the vertical tooth fracture which includes the root thereby making the tooth non-restorable.  In such cases removal of the tooth and replacement in some fashion will be required.

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The important points to remember are as follows:

1. Determine the exact source of discomfort first

2. Address the symptoms as quickly as possible

3. Begin with the most conservative treatment and progress as needed to eliminate all symptoms

Such teeth need to be followed on a regular basis to ensure that damage to the pulp has not occurred.  Appropriate x-rays at routine intervals will be helpful for this.  Keeping your dentist apprised of precise symptoms will also go a long way to help in diagnosis.

If you have any questions about cracked tooth syndrome please do not hesitate to contact our office by calling 908.359.6655 or on the web at www.DesignsForDentalHealth.com

Expressions Of Gratitude From Members Of Our Team

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The holiday season means different things to different people. For some, it may be that they look forward to celebrating and spending time with family and friends. For others, it may be a time for faith and devotion.

 We’re Reflecting On The Things We’re Most Grateful For…

Everyone on our team has taken some time to reflect on her (or his) life and to list some of the things we’re grateful for.  We want to share those thoughts with you!  FYI, there was no collusion amongst we participants…

 What we are thankful for:

 Dr. Nadler

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“I’m thankful for having found my wife, Elizabeth, thirty years ago!  And, for our many friends who provide our lives with so much joy and meaning.  And, finally, for my dental practice which has been my raison d’etre for three decades…”

Liz

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“I am most thankful to have found my best friend, my soul mate, my husband, Richard.”

April

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“This year I’m most thankful for my family. Having a baby changes your life and I’m so thankful to have the continuous support from my loved ones.”

Remi

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“I am thankful for my beautiful family and wonderful friends, also for our freedom, the Country that we live in and everyone that helps keep us healthy and safe.  I am thankful for my daughter Sara, she is my sunshine and she makes me smile every day!  I am grateful for learning new things every day and being able to find humor in the craziest places.  And Lastly, I am thankful for my Parents.  When I became a Mom I gained a priceless appreciation for all parents!  Wishing everyone a Great Thanksgiving!”

Maria

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“This year, I am most thankful for my family, friends and life. I’m thankful for my husband, the love of my life and my best friend. I am thankful for my beautiful daughter that I love unconditionally and am so proud of everyday.  I’m thankful for my supportive parents who sacrifice a lot in order to give me and my brother a better life.  But above all, I am most thankful to have a great job that I love, and work together with amazing colleagues that I respect and appreciate.”

Allison

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“I am thankful that I have the opportunity to spend this holiday with my loving family and reconnect with great friends that are visiting during this time of the year. I am also thankful for all of the wonderful opportunities I have had throughout my life including schooling, traveling, and being involved in my favorite sports and activities.”

We Would LOVE To Hear From You Too!

As the holiday season approaches, what are you grateful for? Please share your thoughts with us in the comments section below.

 One More Thing…

We’re so grateful for each of you—our wonderful patients and friends! Because of you, we love working here each day. We’re thankful for our relationships, and for the trust you place in us each time you visit and reach out with your health concerns and feedback.

We wish you a very happy holiday season!

What Are Loupes And Why Must Your Dentist Wear Them?

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Dr. Nadler and Zora Circa 2003

Dental loupes are the magnifying glasses that dentists wear to enlarge everything that they see in the mouth. There are two basic reasons why these glasses are worn. First and foremost, vision is improved simply because everything in the field of view is so much bigger. Secondly, loupes are worn to allow dentists to have a more “physiologic” posture while working, and thereby minimize the slouching which dentists are historically known to develop.

 

Why is it important to have an enlarged view of the working area? The most obvious answer is that a better and enlarged view of the treatment site automatically results in more precise dental work. Dentists are better able to see the shapes that they are carving or preparing in the natural teeth as well as in the final restorations which they are providing for their patients. Perhaps even more importantly, dentists are better able to make more accurate and complete diagnoses of what is occurring in each patient’s mouth.

 

As an example, I was testing out a new product which was touted to assist in better diagnoses of oral cancer. This system required the wearing of colored lenses used in conjunction with a special light. Using this system, I would be unable to wear my loupes. I first examined a patient using this new system without magnification. And then, put on my loupes and re-examined the patient. There was no comparison between the two examinations. Without magnification, even with the special light effect, much more was visible and apparent with magnification.

 

I began wearing loupes back around 1990 while I was taking advanced classes at the L.D.  Pankey Institute in Florida. It was at this time when I truly feel that the quality of the treatment which our office provided moved to an entirely new and higher plateau. Not only was I learning some amazing skills, but also the use of the loupes alone allowed significant improvement in my ability to provide excellent treatment.  Since that time, the loupes that I use have gotten increasingly longer and provide more magnification. These glasses are simply addictive to any dentist who is serious about doing his or her absolute best work.

 

A few years after beginning to wear them, I decided to try a headlight mounted right on the  loupes. After the first patient to be seen with this light, and in spite of the discomfort of extra weight on my nose, there was no turning back. The benefits of the light are nearly as significant as those of the loupes themselves. As good as the overhead dental light is, there are still shadows as we lean in as well as from the lips and tongue, etc.  Whereas, wearing the loop-mounted headlight, the light shines exactly where I am looking.

 

I don’t see how any dentist can work without either magnification or head-mounted lights. I believe that dental schools should teach the use of this equipment as mandatory – at least in the final year of dental school. If you’ve ever seen the intraoral photographs that we take for our patients, you’ll know what it’s like to look through loupes with light. It’s just so easy to see!

 

If you have not had the opportunity to see an intraoral photo of your teeth, please ask us for a demonstration at your next appointment. It will only take a moment and can be quite eye opening. If you have any questions or concerns please visit us online at www.DesignsForDentalHealth.com or call us at 908-359-6655.

Free Sleep Apnea Screenings Offered in November

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Again this year, we are offering free Obstructive Sleep Apnea (OSA) screenings during the month of November. This is our way of giving thanks for all the blessings which we have received during the year, and it is our hope that we may potentially save a life by providing this service.

 Sleep apnea is a serious condition with potentially life-threatening side effects. Most people are not at all aware of this condition and certainly do not think that it affects them.  People who have Obstructive Sleep Apnea are at risk for various medical conditions including:

  •  Adult onset diabetes (the #1 growing disease currently in the US!)
  • High blood pressure (especially when resistant to treatment)
  • Anxiety and depression
  •   Daytime sleepiness
  •  Heart attacks and strokes
  •   Gastro-esophageal reflux disease (GERD)

In addition, OSA patients are prone to daytime sleepiness which places them at risk when driving. Also, these patients may struggle with diet-resistant weight gain.  Such patients frequently lose significant weight when treated for their sleep apnea condition.

If you have any of the above symptoms or conditions, or have been told that you snore or stop breathing while asleep – or you just sleep poorly – perhaps finding out if sleep apnea is the problem may be the prudent thing to do. The screening is very quick and easy. It involves a history form and a brief examination, after which a preliminary diagnosis can immediately be made.

This offer is available to all of our patients as well as their friends, family, and coworkers. Please take advantage of this service! The first step is to determine if you are at risk for sleep apnea.   Once a diagnosis is established, there are various ways to control the condition, allow you to sleep better, live healthier and feel great!

Call us at 908.359.6655 or visit our website at www.DesignsForDentalHealth.com to schedule your free screening.

Have a wonderful holiday!

Richard M Nadler DMD, FAGD and the Designs For Dental Health Team

Need a Dose of Commitment?

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Need A Dose Of Commitment?

If you had plans to change or improve or evolve in some way this year, I would love to know how you are doing!

Year after year, all of us who are regulars at the gym witness the “January Phenomenon.”  For about six weeks beginning at the end of December, there are too few parking spaces near the gym entrance.  It seems like long walks in the cold wearing only gym clothes is the norm until mid February.  Similarly, those of us who like to take classes – and I do love spin class – must arrive very early to claim an available bike as classes are generally full during that same time period.  Those that arrive in the nick of time are often bikeless and very disappointed.

Maintaining my commitment to exercise has never been an issue for me – I enjoy both working out as well as the people I’ve come to know at the gym.  As reported to you earlier this month, I began the “Clean” nutritional program again this year for the second time.  I felt great and had lost most of the holiday pounds which had been gained.  Then, came my birthday last week!  My wife loves to travel that week, so we went away for five days to “celebrate.”  Boy did we celebrate!  We traveled with two of our closest friends and played golf, ate great food, drank some nice wine, and forgot the cold weather – and our commitments.  Actually, for the first few days, except for some really nice wine, I ate only foods which were on the program and did not overindulge even a tiny bit.  On my birthday, fuggettaboutit!  What the heck, it was my birthday!
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That one day turned into a four-day food fest, and I felt like the prior two and a half weeks were wasted.  But, not true!  On Monday I started the program in earnest all over again without any signs of withdrawal!   So, I’m back on track with goals in tact and a plan to succeed.  The discomfort in my arthritic knees and the mirror in my bedroom are all I need to stay on track.  In the back of my mind is always the thought that a little compromise grows into a big one resulting in a loss of focus and the end of commitment.  Rewarding one’s self is another story and can help us meet our obligations to ourselves for the long haul.  That’s my view.

So, I wonder.  What can you share about your commitments?  What helps you to meet your goals or resolutions?  What experience can you share to help others?  I’d love to hear from you!  You may add a comment on this blog, send me an email via our website at www.DesignsForDentalHealth.com , or post a comment on our Facebook page.  May you all enjoy smooth sailing in the direction you have chosen for your lives!  All the best in 2013!

Improve Your Workouts And Lessen TMJ Pain With Six Exercises

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Mariano Rocabado, DPT is a physical therapist who specializes in problems with the head, neck and spines. His work with Temporomandibular Joint Disorders (TMJ or TMD) is very extensive, and he developed an exercise program that is taught to all over the world to address postural relationships with the head to neck, neck to shoulders and lower jaw to upper jaw. The objective of this home exercise program is for patients to learn a new postural position, fight the soft tissue memory of the old position, restore the original muscle length-tension relationships, restore normal joint mobility and restore normal body balance.

Temporomandibular joint (TMJ) disorder is a term which encompasses inflammatory disorders of the jaw. Symptoms of TMJ may include headache, earache, neck pain, jaw tenderness and clicking or aching facial muscles. TMJ usually occurs when the muscles used for chewing and your jaw joint are out of balance.  The cause of TMJ is most commonly improper alignment of your teeth, and is exacerbated by stress and tooth grinding.

What is most interesting is that when the body’s posture is corrected, amazing things happen with regard to strength, flexibility and balance.  Similarly, there are bite appliances which place the jaw in its “physiologic” neuromuscular position.  Such appliances are used not only to treat TMJ but are also worn by athletes of all kinds to improve their performance – golfers, basketball players, football players, etc.  I have seen demonstrations of such “instant” improvements and they are amazing.  Feel free to ask me for a demonstration the next time that you visit the office.

I began using one of these exercises during my workouts in cycle classes which I have grown to love.  These spin classes have been the core of my cardiovascular exercise for many years now.  Proper posture improves performance while exercising and playing sports, and I find that that there is a simple maneuver to help ensure good body position to allow me to get the most of my workouts.  It’s the last exercise in the series described below.

Rocabado advocates that the program be performed by the patient at home, and it consists of six different exercises and six repetitions of each exercise, performed six times per day until symptoms subside. The Rocabado exercises emphasize correct postural position and help to combat the soft tissue memory of your old posture. Perform the exercises one after the other until your session is complete. It will take about one minute.

The six exercises:

  1. Place your tongue on the roof of your mouth. Position the tip just behind your teeth and take six deep breaths.
  2. Keep your tongue on the roof of your mouth and open and close your mouth six times.
  3. Your tongue remains on the roof of your mouth and two fingers are placed on the chin to open your mouth against gentle resistance. Following that, place your fingers on both sides of your jaw and move the jaw sideways six times.
  4. Place your hands behind your neck and bend your chin down as if nodding your head.
  5. Move your chin down and back as if making a double chin.
  6. Finally, correct your posture by lifting your ribs and chest upward while squeezing your shoulder blades together.

Perform six repetitions of these exercises six times a day.

Give these exercises a try.  If you feel pain while performing these exercises, stop doing them and consider calling us to arrange a TMJ screening or consultation about your symptoms.  If you have questions, feel free to call us at 908.359.6655 or send us an email via our website at www.DesignsForDentalHealth.com

New Year ~ Old Resolution: How Dr. Nadler eats “Clean”

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On January 2, I began my annual nutritional cleansing program as I have done for the past decade and a half.  After a solid month of holiday and party food, I usually have a few pounds to shed and just don’t feel 100 percent.

This year, just like last year, I began the twenty-one day “Clean” program, which I had heard about from another dentist who attends the Las Vegas Institute for Advanced Dental Studies, where I also studied.  Not only does this cleanse help me to lose weight – eight pounds so far – but, it also has changed the way I eat entirely.  And, most importantly, this program introduced an awareness of the quality and healthiness of the foods that my family and I eat.

I had never before heard of GMO’s – Genetically Modified Organisms.  These are foods which have been engineered for a variety of reasons to produce more crops, be more insect resistant, be bigger and so forth.  And, there are a growing number of consumers, health professionals and producers who feel that GMO’s can be hazardous to our health.  I guess this is why we see an ever-increasing assortment of organic and gluten-free products and dairy substitutes like almond milk in our grocery stores.

To get a better sense of what has been happening to our food supply, I recommend that you watch a 2008 movie called “Food, Inc.”  This 90-minute documentary created quite a stir in the agribusiness community and was highly rated by critics.  You may also wish to read a short article (read here) entitled “GMO alert:  top 10 genetically modified foods to avoid eating.”

As for the cleanse, the program is rather rigorous as there is only one solid meal per day for three weeks.  Only fresh, non-processed, preferably organic foods are consumed.  After the initial cleanse, different foods are reintroduced to the diet.  This way, you can easily see which foods may be having a negative effect on your health and well-being.  After last year’s cleanse, I learned that dairy (except eggs) were out for me.  I have also eliminated gluten and starches like potatoes.  The result?  More energy, excellent health, much less flab.

So, if this is of interest to you, check out the book CLEAN by AlejandroJunger, M.D.  If you have any questions about this program or my experiences with it, feel free to call me in the office at 908.359.6655 or send an email via our website at www. DesignsForDentalHealth.com

BREAKING NEWS! It’s official!

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BREAKING NEWS! It’s official! We received the call this morning that Dr. Nadler has won the title of BEST Dentist in Central New Jersey! Our entire team Thanks You for voting and showing your support. We are committed to continuing our hard work to bring all of our patients the BEST that modern dental care has to offer:
*Personalized attention and a wonderful and friendly team
*State-of-the-art technology, techniques, and materials
*The best American Dental Labs
*A beautiful and clean office
THANK YOU , AGAIN!