Published on October 31st, 2017 | by Michael J. Goldberg


Why Good Oral Health is Important

by Michael Goldberg

“Snap, crackle, pop!” is the sound Rice Krispies are supposed to make when milk is poured over the popular breakfast cereal. It’s not what we should hear when our mouths open or close. Creaky, crackling and noisy joints might be symptoms of problems that lead to limitations of jaw movement such as lockjaw. Try to imagine not being able to open wide enough to eat a sandwich.

The jaw joint, or temporomandibular joint (TMJ), is unique in the body. The lower jaw is attached at both ends to the head via two TMJs. The lower jaw position is controlled by these joints and by the muscles, tendons and ligaments that attach to the head, jaws and neck. Most often, joint sounds are innocuous. Many people don’t know they have any. Your dentist should include an examination of the TMJs as part of a comprehensive examination.

Sometimes, joint sounds are problematic. They can be indicative of a misalignment in the joint, arthritis or inflammation. In a car, such a misalignment will cause the tires to wear out unevenly. The same thing happens in the mouth, as teeth can also wear out. The usual reasons are wear and tear, clenching/grinding, muscle imbalances, sleep position, sleep disturbances, stress, mineral deficiencies/overload and even medications.

Every drug has some unintended consequence. Some of the more common ones that can affect muscles are:

  • Diuretics (like Lasix and hydrochlorthiazide),
  • Procardia (for angina and hepertension)
  • Proventil, Ventolin, Brethine (for asthma)
  • Statins like Lipitor and Crestor(for cholesterol)
  • Evista (used for osteoporosis)
  • Antidepressants (Paxil, Zoloft, Prozac, Celexa, Lexapro and other Selective serotonin reuptake inhibitor (SSRI), which can also be used to treat ADHD)

Millions of Americans take one or more of these medications, yet, most people and even most doctors don’t associate the symptoms of muscle issues with them. The most common muscle complaints involve painful leg cramps which might never be associated with medication use. But such cramps and spasms can happen in any muscle. Treatment involves making the proper diagnosis and appropriate recommendations for treatment, which might include self-care, medication modification, bite guards, physical therapy, orthodontics, bite adjustments and sleep appliances.

To prevent trouble, pay attention to joint sounds or changes, bring such changes to the attention of the dentist or hygienist and give them a list of all current medications.

Dr. Michael Goldberg practices biorational dentistry at Manhattan Dental Health, with offices on Madison Ave., NYC, and River Edge, NJ. For more information, call 201-881-0660 or visit


About the Author

Dr. Michael J. Goldberg, DMD, FAGD, FIADFE, FACD, FNYAD, practices BioRational Dentistry at Manhattan Dental Health NJ, 117 Kinderkamack Rd., River Edge, NJ, and Manhattan Dental Health: 635 Madison Ave., NY. He can be reached at 201-881-0660 or 212-928-1000 and at

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