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frostgears · 3 months ago

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nose goes

you rubbed the scar on the underside of your columella for the hundredth time that evening and the millionth time in the last three weeks. fucker still itched. some tiny splinter of a dissolvable suture slowly working its way out of your nose, and you'd know no peace until it was ejected. though afterward wasn't looking great either.

---

"hey, newbie," Emerald had said. "we have pretty good health care. get your nose unfucked. i'm tired of looking at it."

"oh," you'd said, dumbfounded, "i can get that fixed? regimental medics said not to bother." it had been bent since you bashed it against the inside of a miniframe with a bad jump booster. they'd said there was a line for operationally necessary care and your nose wasn't messed up enough to even get in it.

the director's raptor of an assistant had cocked her head to the side. you were still learning the specialized biology vocabulary you weren't sure if you'd live long enough to need, but "raptor" seemed right: skinny, sharp features, unclear if she blinked, probably ate lizards.

"military healthcare is shit. don't exceed three gees while healing, don't shove anything up there, don't miss work," she'd said, and flicked a net address to your handheld. a civilian medical appointment.

you should have known that it had been too easy. you'd woken up in a room that hadn't been the one you'd gone to sleep in. more blinking lights and display screens than a frame maintenance bay. and your boss was there. sharp suit, curly hair, looked like she was in a hurry.

"good news, everything went well," she said. "and volunteering saved me a bit of time, so thanks for that. here."

you were still incredibly out of it, but you accepted the vase of mixed flowers. the smell almost put you under again. you'd never smelled anything like this. or maybe you had, but you were suddenly smelling a hundred things on top of it. an incredibly rich roiling blend of scent. grassy, floral, faintly acrid, notes of emergency sealant, hangar moonshine, the smell of the taste of the filler in shipping containers…

"bwuh?" you managed. she'd put something up your damn nose. had to be.

"olfactory and recall augment. it'll adapt with you, to some extent, but it's also pre-biased with hundreds of thousands of Terran and CEZ biochemical presets. one of these flowers doesn't belong. show me."

you'd taken a big sniff, which was stupid and hurt. then you took a few smaller, more careful sniffs. one of the yellow-orange ones was off. not bad. off. like you'd tasted a dozen red Nebula Chews in a row and the last one was supposed to be purple but the factory fucked up the dye.

you plucked the flower from the vase and showed it to her.

"you're probably right," she said. "one of the marigolds is infected with a hybrid xenopathogen. doesn't have a name. something that evolved on one of the CEZ DNA worlds after Terran life was introduced, and that doesn't really get along with our soil bacteria — the CEZ nearly lost that planet. its metabolism produces a volatile compound that'd be useful for detection, except that i can't smell it, nobody else on staff can smell it, and more importantly, our current generation of mass-production biochips can't either. but now you can."

she turned to go, heels clicking on the floor. then she looked back over her shoulder.

"you look a little spooked. you shouldn't be. it's a knockout, can't reproduce without an excess of a dextral amino acid that nothing outside of our labs makes," she said. "keep the flowers."

---

"stop rubbing your fucking nose, newbie," Emerald said from across your restaurant table.

"i have a name," you groused, putting your hands back in your lap, where you could fidget with the edge of the expensive-looking tablecloth instead of decking the barely field-competent backup posing as your dinner date.

"i don't care. people are looking. or they might. so quit it. you find anything yet?"

"not yet." you'd noticed a few unusual scents on the air, but so far they'd all been strictly known compounds and the most noticeable one at this table wasn't exactly mission-related.

the waiter turned up, finally, and presented the next course. you lifted a spoon to your lips. rice. you'd had that plenty of times. several different mushrooms. a rare treat, but just because you couldn't really afford them. and an accent of… cassia, cheap shampoo, hot paint? your new nose wasn't sure what to make of it. but you'd smelled it before.

there was a sample terrarium running Celeq Corporation's proprietary synthetic biology in one of the library labs. Celeq, the Director had said, like many synthetic biologies, was fine. perfectly stable. if your planet didn't have seasons. or weather. or humans. worked fine on her parents' homeworld, because they could never leave the domes.

"i think we're going to want to talk to the chef," you said.

"damn. can i at least finish dinner first?"

"probably. but you can have my risotto. smells like Celeq."

she shrugged and reached over the table to pull your plate over to her side. "not toxic, then, just unsustainably high maintenance. and better you than me with that augment. i already have my nose the way i like it."

"thanks for volunteering me, by the way. all these wonderful things i can never unsmell." you paused, smirked. "you ever read the specs? you know the breadth of the Terran biochem recall?"

"do you have a point."

"yeah. you can relax with the bitch act. i can smell how hot you are for me."

she dropped the fork.

"as if!"

you scratched your nose again. "doesn't lie."

"fuck you," she said. "i'm not hungry any more. let's do this." she stood up and pulled a badge from her slacks, screamed at the waiter: "Directorate of Planetary Ecology! take me to your chef!"

you pulled your pistol. wasn't a frame, but the enzyme pellets were a lot safer inside a hab. "god. you really are out of practice. gun first, threats second…" □

#microfiction #mech pilot #DPE #mechposting

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naivepets · 3 years ago

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How Much Does It Cost to Spay or Neuter a Dog? 2022 Price Guide | Pet Keen

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Spaying or neutering your frump is a big decisiveness because it ’ s a surgical routine, which always comes with its own fit of risks. Another character of the big decision is the price of the surgical routine. Price shopping for spaying or neutering can be beneficial to you, specially if your chase doesn ’ t have any bad aesculapian conditions. For bad pets, it ’ sulfur best to stick with your convention veterinarian or whoever they refer you to since they are most conversant with your frump. here are the things you should know about the cost of getting your dog spayed or neutered .

What ’ s the Difference between Spaying and Neutering ?

Spaying is equivalent to a hysterectomy in a human and is performed on female dogs or dogs with internal female anatomy. Neutering is besides called castration and is performed on male dogs. neutering can be performed on male dogs before or after the testes have dropped .

How a lot Does Spaying a cad cost ?

Spaying your cad will vary significantly in monetary value based on where you live and the size of your dog. Your income may play into the price if you are using a low-cost service. other factors that impact the monetary value include your pawl ’ s health status and old age. Female dogs that are in season, pregnant, or corpulent will cost importantly more to spay than other female dogs. For a healthy pawl that is not in season, the average cost of a alter is going to cost between $200–400. Low-cost clinics will frequently spay a healthy, young chase for less than $200, with some spaying small dogs for vitamin a small as $40–50.

What Does a Spay Surgery Involve ?

Spaying a female chase involves the complete removal of the uterus, ovaries, and fallopian tubes. When a chase is in heat, these organs are swollen and prone to bleed, making the operating room higher risk. To spay your andiron, the surgeon will make an incision on the lower assign of the abdomen, allowing them to access these organs. Some surgeons will use inner sutures, which doesn ’ deoxythymidine monophosphate require the removal of stitches after operation. however, some surgeons do use non-dissolvable sutures, which will need to be removed approximately 10–14 days after the surgery.

Reading: How Much Does It Cost to Spay or Neuter a Dog? 2022 Price Guide | Pet Keen

Some bruise around the incision web site can occur with alter surgeries, but the incision typically heals with minimal scarring. In fact, it can be difficult to tell if a female andiron has been spayed or not if she is found as a isolated since the scar can be so balmy. Your frump may need to wear an e-collar, colloquially known as the “ cone of shame ”, after operation to keep her from licking or chewing at her incision .

What Does the Cost Typically Include ?

The cost of your frump ’ south alter will vary depending on where your frump is spayed and what additions you agree to or decay. broadly, the cost of the alter will involve more than merely the surgery itself. The cost will besides include the price of surgical supplies, anesthesia, and the prison term of the veterinarian and their staff. It may besides include IV fluids and extra medications needed earlier, during, and after the procedure . Your vet may besides want to perform a pre-op blood panel on your dog to ensure there is not an underlie medical condition. Some vets will allow you to opt out of this choice. early expenses frequently included in the price include pain medications and antibiotics for home, deoxyadenosine monophosphate well as an e-collar . You might also be interested in: 9 Reasons Why Dogs Get Eye Boogers (And How to Deal With It)

How a lot Does Neutering a pawl price ?

Like spaying a cad, the cost of neutering a andiron will vary based on the size and age of your dog, ampere well as the sphere you live in. however, neutering a chase is typically importantly less expensive than spaying a cad ascribable to the less invasive nature of the operating room. The exception to this is if your dog has cryptorchid testes, which means the testes are however inside the body and have not by rights dropped. This surgery is more invasive than a normal alter and often costs close to what a alter would cost. To have your dog neutered, the average monetary value is going to be around $75–250. If your andiron is neutered in a low-cost clinic, a alter will probable cost you less than $75, with some low-cost clinics entirely charging $20–40 on a neuter.

Read more: How Long Does a Dog Stay in Heat?

What Does a Neuter Surgery Involve ?

A alter is a batch more straightforward than a alter surgery. Neutering a dog involves making an incision at the base of the scrotum and removing the testes through the incision. This incision is much closed with inner sutures, although some surgeons use external sutures. sometimes, surgical glue is used in little dogs . If your dog has one or two cryptorchid testes, then the surgeon will have to make an incision in your frank ’ sulfur abdomen to remove the retain testis. It is less involved than a alter operating room but is still quite invasive. A cryptorchid neuter is much higher risk than the average normal alter surgery. It ’ south important to understand, though, that a cryptorchid testis can still be amply functional, so your pawl would however be able to produce pups if left intact .

What Does the Cost Typically Include ?

The monetary value of a neuter involves many of the same things as a alter. The cost covers the surgery, the surgeon and staff ’ s fourth dimension, surgical supplies, anesthesia, and medications needed ahead, during, and after the surgery. It will besides probable cover the monetary value of medications you might need to take home, like trouble medications, and an e-collar. Pre-op rake tests are recommended for any animal that undergoes anesthesia, thus even with a low-risk surgery like a convention dog neuter, a blood gore is even recommended. This will help rule out underlying conditions you may not be mindful of .

In Conclusion

Getting your frank spayed or neutered can be a big expense, but it is worth it. There are medical benefits associated with alter and alter, and an animal that has been spayed or neutered can not make puppies. In many areas, there is an overabundance of dogs and puppies that need homes. many animals are euthanized annually because of this exit, so alter and alter can help reduce the risk of undesirable or unexpected litters of puppies.

Read more: Benadryl for Dogs – American Kennel Club

If you are uncertain about neutering or spaying your frump, talk to your frump ’ sulfur veterinarian. They can help guide you and help you understand the pros and cons of having these procedures done. When it comes down to it, the final decision falls to you, so you have to weigh the pros and cons carefully to ensure you are doing the best thing for your andiron . Looking for more information of dog costs? Try: Featured Image Credit : Eduard Goricev, Shutterstock

reference : https://blog.naivepets.com Category : Dog

source https://blog.naivepets.com/how-much-does-it-cost-to-get-a-dog-neutered-1645252450

#Pets

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jenniferjlearnv · 5 years ago

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Top Treatments to Tighten and Rejuvenate Saggy Neck Skin

Sagging skin is one of the many downsides of aging. It’s a small thing to worry about, but many people find it hard to maintain a positive attitude about gaining fine lines and wrinkles – and that’s okay, too. If you want to reverse the clock a bit, several treatments – non-invasive or surgical – are effective when it comes to skin tightening around the neck area.

So what are the top treatments that can rejuvenate and tighten saggy neck skin? Many patients choose between surgical neck lift, neck botox, or radiofrequency treatment for noticeable results. Creams and serums as well as certain exercises can also help with skin tightening, but they are mostly used as complementary steps for a more permanent solution.

Sagging Neck Skin: How it Happens and What to do About it

The skin has a certain elasticity that allows it to stretch up to an extent before snapping back in place. If the skin can’t do this anymore, it starts to sag. It happens to almost any part of the body, but it is more noticeable on the face and neck.

Although it is usually associated with aging, people of all ages can get loose skin. Those who experience dramatic weight loss are especially susceptible to this condition. Sagging skin can also be related to other medical conditions, like the Ehlers-Danlos Syndrome – a rare disorder that affects the collagen production of the body, causing several symptoms to show such as doughy skin on the face and near areas.

So what can you do to tighten skin on your neck? For slight sag, a lifestyle change, as well as some skin tightening creams and supplements might do the trick. But for moderate to significant sag, treatments like surgery, injectables, and radiofrequency therapy might be necessary.

Surgical Neck Lift

Lower rhytidectomy, or neck lift, is a surgical skin tightening procedure that targets the skin around the neck and jawline. If the patient has a great upper face skin but a loose skin in the neck, a neck lift is the better option instead of a full facelift procedure.

Costs

This average cost of a neck lift starts at $5110. The price might still increase if anesthesia fees, surgeon’s fees, facility costs, and prescriptions are to be included. To determine the final fee, consult a doctor first.

Patient Qualifications

Almost all patients are qualified for a surgical neck lift, with a few exceptions:

Individuals who smoke

Patients with medical conditions that might impair the healing process

How it Works

Neck lift treats sagging neck skin in three steps:

Anesthesia – For the patient’s comfort during the surgery, the doctor will administer the anesthesia as the procedure starts. It can be general anesthesia or intravenous sedation.

Creating the Incision – The size of the incision will depend on the change that the patient wants to see. A traditional incision will run from the hairline at sideburn level and down around the ear up to the posterior hair. A limited incision is shorter and only ends around the ear. Once the incision has been made, the fat deposits are redistributed and the neck tissues are repositioned. The neck skin is then lifted and any excess skin is trimmed.

Closing the Incision – Once the procedure is done, incisions are closed using skin glue or suture. The sutures might dissolve or be removed a couple of days after the procedure.

Results and Risks

Neck lift is a one-time procedure that produces visible results. The patient might experience swelling and bruising at the treated area and it will take several weeks before it dissipates. After the procedure, you might need to change your lifestyle to prolong the results of the neck lift.

But like any other surgical skin tightening, lower rhytidectomy includes the following risks:

Anesthesia risks

Facial asymmetry

Hematoma

Infection

Scarring

Skin Discoloration

Neck Botox

Neck botox, or sometimes called Nefertiti lift, is a non-surgical procedure that involves the injection of botulinum toxin type A into the patient’s neck. The skin tightening treatment is meant to paralyze neck muscles, leading to reduced lines and wrinkles. Botox effectively tightens the face, neck skin and changes the jaw’s shape.

Costs

The average cost of neck botox is usually more expensive than normal botox treatments. It is priced at around $800 while facial botox treatments only cost around $397. The price difference is caused by the number of injections needed to complete the neck treatment.

Patient Qualifications

Since it is a non-surgical treatment, anyone can opt for neck botox treatments. However, there are a few exceptions for this procedure, including patients:

Who are breastfeeding or pregnant

Diagnosed with psychological conditions

Who are taking medications that might react with botulinum toxin

How it Works

The procedure is completed in a doctor’s office for at least 15 minutes. A small needle will be used to inject botulinum toxin into the platysma muscles along the neck and jaw. The toxin will block all muscle nerves in the neck, preventing the contraction that causes sagging, wrinkles, and lines.

Results and Risks

The results will start appearing two weeks after the procedure. The effects will last for up to 3-4 months before needing a touch-up session.

Like other treatments that involve the injection of botulinum toxin into the muscles, neck botox patients may also experience the following side effects:

Injection in the wrong place

Bruising and redness

Weakness in the neck

Headache

Radiofrequency Therapy

Radiofrequency therapy, or Thermalift, is another non-surgical skin tightening treatment. It utilizes energy waves that heat the deep layers of the skin, triggering collagen production. This therapy is known to tighten skin and fight signs of aging since 2001.

Costs

The non-surgical skin tightening treatment costs around $2000 per round, which needs to be repeated every few years to maintain the neck’s improved appearance and restore collagen levels.

How it Works

When the body maintains a temperature over 115-degree Fahrenheit for 3 minutes or more, it releases heat-shock proteins, which are responsible for triggering the creation of new collagen fibers. Radiofrequency waves that penetrate the skin layers for this therapy have a temperature of 122 to 167-degree Fahrenheit.

Patient Qualifications

Radiofrequency therapy is a safe procedure that almost anyone can opt for. However, there are a few exceptions:

People with broken blood vessels or capillaries

Pregnant or breastfeeding women

Patients diagnosed with rosacea

Results and Risks

The procedure is completed in an hour or less inside a doctor’s office. The results are not instant, since it might take a few weeks for the collagen to start repairing tissues in the body.

While it is a safe procedure, patients are still at risk of the following:

Burns

Swelling

Redness

Tingling

People with dark complexion have higher risks of acquiring the side effects of this treatment.

Creams and Serums

Although they are not as effective as surgical treatments and non-invasive treatments, different anti-aging creams and serums are also effective in skin tightening, fine line, and wrinkles in the body.

Patient Qualifications

Creams and serums can be utilized by people of all ages. As long as the patient has no allergies or other skin conditions, creams and serums are safe to use.

How it Works

Most creams and serums include N-acetyl glucosamine in their ingredients list. It is an effective substance that improves the turkey neck by smoothing the skin and reducing hyperpigmentation of the body.

Results and Risks

Continuous use of anti-aging creams can help improve the appearance of the sagging neck up to some extent. But for more permanent results, other treatments might be the better option.

Exercises

Regular exercise can also help the neck muscle tighten, as it improves blood circulation in the area. It can tone the muscles, but the excess skin cannot be removed without surgery.

Currently, four recommended facial exercises help tighten the turkey neck:

Forehead Push

Place your hand against the forehead.

Push your head against the hand without allowing it to move forward.

Keep this position for 10 seconds.

Hold your hands behind the head and push backward with the neck

Keep this position for 10 seconds.

Chew

Sit back straight and lift your head so that the chin points up.

Seal the lips together while creating chewing motions with the mouth.

Repeat this exercise 20 times.

Kiss

Sit back straight and lift your head so that the chin points up.

Pout the lips as if you are kissing.

Repeat this exercise 20 times.

Neck Lift

Lie in the bed as your head hangs over the edge.

Slowly lift your head using the neck muscles.

Repeat this exercise five times.

If you experience neck pain, discontinue the exercise.

Picking the Right Treatment for You

ProsConsSurgical Neck LiftIt is a one-time treatment that repositions the muscles and trims excess skin.It leaves incision lines that are barely noticeable in the hairline up to the ear area.Neck BotoxThis non-surgical treatment is basically painless.The botox might be injected in the wrong place if performed by an inexperienced practitioner.Radiofrequency TherapyAnother non-surgical skin tightening procedure that triggers the collagen production of the skin for a more natural neck lift.It doesn’t work as well on darker complexions.Creams and SerumsSince it is readily available in the drugstore, you won’t have to pay for a doctor.The results are only minimal, so it is better off as a complementary procedure.ExerciseIt is free and can be added to your daily exercise regime.It can only tone the muscles, but it cannot remove excess skin.

If sagging skin is something that worries you, there are several effective treatments you can choose from. A surgical face & neck lift, neck botox, and radiofrequency therapy are some of the most effective treatments that can help in collagen production and skin tightening. On the other hand, creams and exercises are only helpful to some extent, so it would be better to just combine them with other treatments.

To know which treatment would suit your lifestyle the best, a consultation with a doctor is necessary.

Skin Tightening with Different Treatments at Ethos Spa

Want to get rid of the sagging neck skin? At Ethos Spa, we offer several treatments for skin tightening around your neck.

Our team of experts has years of experience when it comes to handling patients who want to try skin tightening treatments. Contact us now and let’s see what we can do about your turkey neck.

The post Top Treatments to Tighten and Rejuvenate Saggy Neck Skin appeared first on Ethos Spa.

source https://www.myethosspa.com/saggy-neck-skin-rejuvenation/ from Ethos Spa, Skin and Laser Center https://myethosspa1.blogspot.com/2020/09/top-treatments-to-tighten-and.html

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melissahail · 5 years ago

Text

Top Treatments to Tighten and Rejuvenate Saggy Neck Skin

Sagging Neck Skin: How it Happens and What to do About it

Surgical Neck Lift

Costs

Patient Qualifications

Almost all patients are qualified for a surgical neck lift, with a few exceptions:

Individuals who smoke

Patients with medical conditions that might impair the healing process

How it Works

Neck lift treats sagging neck skin in three steps:

Anesthesia – For the patient’s comfort during the surgery, the doctor will administer the anesthesia as the procedure starts. It can be general anesthesia or intravenous sedation.

Closing the Incision – Once the procedure is done, incisions are closed using skin glue or suture. The sutures might dissolve or be removed a couple of days after the procedure.

Results and Risks

But like any other surgical skin tightening, lower rhytidectomy includes the following risks:

Anesthesia risks

Facial asymmetry

Hematoma

Infection

Scarring

Skin Discoloration

Neck Botox

Costs

Patient Qualifications

Since it is a non-surgical treatment, anyone can opt for neck botox treatments. However, there are a few exceptions for this procedure, including patients:

Who are breastfeeding or pregnant

Diagnosed with psychological conditions

Who are taking medications that might react with botulinum toxin

How it Works

Results and Risks

The results will start appearing two weeks after the procedure. The effects will last for up to 3-4 months before needing a touch-up session.

Like other treatments that involve the injection of botulinum toxin into the muscles, neck botox patients may also experience the following side effects:

Injection in the wrong place

Bruising and redness

Weakness in the neck

Headache

Radiofrequency Therapy

Costs

The non-surgical skin tightening treatment costs around $2000 per round, which needs to be repeated every few years to maintain the neck’s improved appearance and restore collagen levels.

How it Works

Patient Qualifications

Radiofrequency therapy is a safe procedure that almost anyone can opt for. However, there are a few exceptions:

People with broken blood vessels or capillaries

Pregnant or breastfeeding women

Patients diagnosed with rosacea

Results and Risks

The procedure is completed in an hour or less inside a doctor’s office. The results are not instant, since it might take a few weeks for the collagen to start repairing tissues in the body.

While it is a safe procedure, patients are still at risk of the following:

Burns

Swelling

Redness

Tingling

People with dark complexion have higher risks of acquiring the side effects of this treatment.

Creams and Serums

Patient Qualifications

Creams and serums can be utilized by people of all ages. As long as the patient has no allergies or other skin conditions, creams and serums are safe to use.

How it Works

Results and Risks

Continuous use of anti-aging creams can help improve the appearance of the sagging neck up to some extent. But for more permanent results, other treatments might be the better option.

Exercises

Regular exercise can also help the neck muscle tighten, as it improves blood circulation in the area. It can tone the muscles, but the excess skin cannot be removed without surgery.

Currently, four recommended facial exercises help tighten the turkey neck:

Forehead Push

Place your hand against the forehead.

Push your head against the hand without allowing it to move forward.

Keep this position for 10 seconds.

Hold your hands behind the head and push backward with the neck

Keep this position for 10 seconds.

Chew

Sit back straight and lift your head so that the chin points up.

Seal the lips together while creating chewing motions with the mouth.

Repeat this exercise 20 times.

Kiss

Sit back straight and lift your head so that the chin points up.

Pout the lips as if you are kissing.

Repeat this exercise 20 times.

Neck Lift

Lie in the bed as your head hangs over the edge.

Slowly lift your head using the neck muscles.

Repeat this exercise five times.

If you experience neck pain, discontinue the exercise.

Picking the Right Treatment for You

To know which treatment would suit your lifestyle the best, a consultation with a doctor is necessary.

Skin Tightening with Different Treatments at Ethos Spa

Want to get rid of the sagging neck skin? At Ethos Spa, we offer several treatments for skin tightening around your neck.

Our team of experts has years of experience when it comes to handling patients who want to try skin tightening treatments. Contact us now and let’s see what we can do about your turkey neck.

The post Top Treatments to Tighten and Rejuvenate Saggy Neck Skin appeared first on Ethos Spa.

source https://www.myethosspa.com/saggy-neck-skin-rejuvenation/ from Ethos Spa Skin and Laser Center http://myethosspacom.blogspot.com/2020/09/top-treatments-to-tighten-and.html

0 notes

greencitydental · 6 years ago

Text

All About Orthotics for TMJ/TMD: Frequently Asked Questions

By Rebecca Taylor, DDS

Last week, we took at look at how orthotics can help bring relief from jaw joint dysfunction. Other benefits include

Spinal and cranial stability.

Reduced gum recession and tooth sensitivity.

Increased lymph drainage in the head and neck.

Reduced neck, shoulder, and jaw tension and pain.

More room in the mouth for the tongue.

Cosmetic improvement and wrinkle/line reduction from a more supported lower face.

Still, you might have some questions, just as our patients often do when we first recommend orthotic treatment to them or as they begin treatment. So we thought we’d follow up with some of the most common ones we hear.

I’m wearing my orthotic and feeling great! Now what?

Yay!!! That’s awesome!

Another feature of orthotics is that they can be a diagnostic tool, helping us determine if your bite and muscle position is linked to any of your underlying symptoms. Before we start moving teeth around, we want to stabilize the joint. Once it’s feeling good and stable, we can change the bite as needed.

It’s important that the orthotic is first worn for several months with symptom improvement before we move forward with any orthodontics. We can change the height and shape of the orthotic easily, so fine tuning the bite at this stage - and creating long-term stability and symptom relief - is crucial for creating good orthodontic outcomes.

Once we determine how much growth in the jaw is needed, we can then place expanders as necessary and then use orthodontics to move and align the teeth. This can take time - up to 2 years for some patients - and requires a financial commitment, as well. However, the result is a more stable bite that aligns with a more relaxed muscle position.

A quicker option for some patients who have several crowns in their mouths already is to replace them with taller ones, thus changing the bite and aligning the jaw with the orthotic position. (Expansion prior to crown placement is sometimes recommended.) We don’t recommend this, though, if you don’t already have a significant number of crowns. We try to avoid doing such aggressive dentistry whenever possible.

What if I don’t want to change my bite?

That’s perfectly fine. However, it’s important to remember that your regular bite is different from the one the orthotic creates. The orthotic works only when it’s in place. If it’s not worn regularly, symptoms can come back. If worn too much, though, the jaw can remodel and cause permanent changes to your bite. So if you decide not to change your bite, make sure you continue to wear your orthotic every night and during the day if needed, removing it only for meals and oral hygiene.

Can’t I just start changing my bite with orthodontics or placing crowns now? This orthotic step is annoying.

Creating jaw stability before any kind of treatment that changes the bite is essential! Read more about why here.

What about my tongue? I was told I might have a tongue-tie.

The tongue plays a big role in cranial, spinal, and muscle stability. If the tongue isn’t properly positioned (if it rests on the floor of the mouth instead of against the palate), if it doesn’t have good muscle tone or swallow correctly, this is dysfunction and can result in jaw and muscle instability. It will affect the muscles in the head and neck and can often result in pain and tightness. (Check out this video to learn more.)

This is why it’s so important to address tongue and related oromyofacial disorders. Doing so can significantly improve symptoms and clinical outcomes. We recommend that you work with a myofunctional therapist (think physical therapy for the tongue) to help retrain the brain and muscles to function correctly. If you work with a myofunctional therapist for 8-12 weeks and are having difficulty with the exercises, then a tongue-tie release may be necessary.

Do I really need to work with a myofunctional therapist?

Yes, you do. Here’s why:

Why you MUST work with a myofunctional therapist BEFORE AND AFTER tongue tie release!!! I get this question ALL THE TIME FROM PATIENTS... so I made you all a video about it. 😉👅💪

Posted by Green City Dental on Thursday, May 16, 2019

I don’t like TENS. Do I really need to do it?

The simple answer is YES. It makes our treatment more reproducible and makes sure your muscles have oxygen and are relaxed. For more on why TENS is so awesome, check out this video and this.

How do I clean my orthotic?

Because you should be wearing it most of the day (and night) every day, your orthotic will get dirty. The best way to clean it is by brushing it with a soft toothbrush and hand soap. You can also soak it in white vinegar once a week for 20 to 30 minutes to help dissolve some of the mineral build up. When you come to the office for your appointments we will clean it in our ultrasonic cleaner.

What is the risk if I don’t do orthotic treatment?

Disease and dysfunction is always easier to treat when it’s caught early instead of late. If you don’t treat the problem now, your joints will continue to wear down, which can result in a locked jaw; pain; limited opening and range of motion; tooth wear; cracking teeth; receding gums; tooth sensitivity to cold, hot, brushing, and biting; increased risk for root canal therapy; and worsening head, neck, and jaw tightness.

Isn’t this the same thing as a nightguard?

A nightguard just puts plastic between your teeth, providing some cushion and protection from clenching and grinding. They aren’t designed to relieve symptoms (although sometimes we’re lucky and they do). Rather, the focus is on limiting wear on your teeth.

In some ways, nightguards can even be detrimental. Some studies have shown that upper nightguards push the jaw backward, causing an increase in clenching and grinding, making snoring and sleep apnea worse! Many osteopaths hate upper nightguards because the keep the palatal suture from moving, which is needed for proper lymphatic draining of the brain and cranial rhythm.

This is why it’s so important to position the jaw in an ideal position that helps support the rest of the body. An orthotic takes into consideration where your muscles are the most comfortable and helps support your cranial bones and spine position. It also helps keep the jaw forward, which for some people can help improve breathing. Symptom relief is expected.

Can this help my airway?

An orthotic can change posture and hold the jaw in a more forward position. Although an orthotic is not a treatment for airway issues, both posture changes and a more forward jaw position can help breathing and increase the volume of the airway. So the simple answer is, in theory, yes.

How often do I need to see my chiropractor, PT, osteopath, or other bodyworker during this process?

Ideally, you would see them for a few sessions before we take the bite for the orthotic and then again on the day of delivery. Depending on your symptoms, you may need to see them every month or as much as once a week. Everyone is SO different. In general, and in my own experience, the more bodywork you get, the faster you adapt and the more successful the treatment. Intraoral massage is highly recommended if muscles are very tight and painful to palpation.

A Few Final Words of Wisdom

You can do it. This is a process. You won’t know if the treatment will work unless you wear the appliance. The more you wear it, the faster you will adapt and the faster symptoms will subside.

You will be sore or experience discomfort when you first start wearing the appliance. Most of these symptoms resolve after 2 to 3 weeks.

Some patients have found it helpful to wear their orthotic for 24 hours right after they get it and stick to soft foods (soups, yogurt, etc). This makes it easier to transition.

Keep orthotics away from pets. They love to chew on these things!

Make sure to keep your teeth clean. Brushing and flossing is very important when wearing an orthotic. Don’t forget to come in for regular cleanings.

When you’re not wearing your orthotic, make sure to put it in a case or your pocket. If you lose your orthotic, making you a new one will take several weeks, so be careful with where you put it.

Stay positive. A positive mindset has been shown to increase healthcare procedure outcomes. If you go in with a positive attitude, you’re more likely to have a positive outcome. If you go in thinking negative thoughts or doubting, you won’t have results nearly so good. Don’t believe me?? Check out this article from JAMA.

Keep us posted! We love to hear about how you are doing (good or bad). Your feedback is important because it helps us know if we need to be more aggressive with treatment or if more or less adjusting is needed.

Ready to learn more about TMJ therapy, sleep apnea, and orthodontics? Here’s one great place to start.

The article All About Orthotics for TMJ/TMD: Frequently Asked Questions is courtesy of: https://greencitydental.com/

#oral health #laser dentistry #tooth remineralization

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