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Dentistry/Tooth 13&15--Junction of L nostril and top jaw


Hello. Thank you for your time and expertise. I have always had dental issues, but I keep trying to keep my teeth. I have worn a nightguard (hard plastic, made by a dentist) for YEARS but I still grind my teeth, despite taking Xanax PM to relax. I awoke the other day with TMJ-like tenderness in L upper jaw, but investigating, it seems to involve an inner-mouth "tendon"?? above the canine molar...General dentist referred me to endodontist, appt on Tuesday. I am CONCERNED b/c I have TWICE had apicoectomy on the front upper teeth(right under/AT the nostril area) and wonder HOW this can be treated orally, or topically if it involves STAPH or bacteria, or a predisposition to these types of problems, ie what role might tea tree oil play in avoiding or curing? I am a woman, age 54, floss daily, brush twice or more daily (properly, and what is your opinion of best toothbrush (I prefer manual). I am not a smoker or drinker, but I do enjoy sweets. I have dental work to nearly ALL my teeth. Besides this, I worry about the 4 front bottom teeth--they are ALL NATURAL but I see small cracks and receding gums...I hope you can address all the parts of this question--I am very interested in your expertise and opinion. THANK YOU! God bless!

Nan -  You seem to be uninformed of what is actually occurring in your mouth.  The dentist does not seem to be vocal as to the reasons for a continuation of your jaw tenderness.  Let just say, that a nightguard can definitely be beneficial and assisting in the relaxation of the jaw muscles to reduce grinding, but the dentist needs to be more so interested as to your bite.  Most grinding occurs when the bite is not balanced.  The dentist should not just place you in an appliance, but at the same time balance your bite and make adjustments to the appliance to coordinate with bite changes made.  

If you do have a staph infection of a tooth, the cause of the infection needs removal and then removing any associated infected tissues.  An apicoectomy is a safe procedure in the hands of a skilled surgeon, but in those doctors who only worry about the tooth and not the effects of the infection on the surrounding bone, a recurrence or continuation of infections can occur. This cannot be treated topically or with medication alone if bacteria are contained within the bone.  

The best toothbrushes are by the company Oral-B  


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Joel S. Teig, DMD, Diplomate ABOMS, retired


I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.


Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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