Temporomandibular Disorders

Park Ridge DentistOUR JAWS DO A LOT of work throughout the day, opening and closing over and over so that we can do ordinary things like talk, eat, and yawn. Ideally, all of the anatomy involved functions as it should and we can perform these tasks without trouble, but many people struggle with temporomandibular joint (TMJ) disorders because something has gone wrong.

The Anatomy Of The Temporomandibular Joints

The joints on both sides of our jaw, located between the ear and the cheekbone, consists of three parts: the socket (part of the temporal bone), the ball (the top part of the jawbone), and a small, fibrous disk that acts as a cushion between the two. The ball and socket are covered in cartilage to help keep movement smooth and comfortable.

If the disk erodes or moves out of its proper alignment, if the cartilage on the bone is worn away by arthritis, or if there is a traumatic injury to the joint, a TMJ disorder may be the result.

Symptoms Of TMJ Disorders

Common symptoms of a TMJ disorder include:

  • Clicking or popping sounds in the joint when chewing, or a grating sensation
  • Pain or tenderness of the jaw
  • Pain in one or both of the temporomandibular joints
  • Difficult or painful chewing
  • Aching pain around the face
  • Aching pain in and around the ear
  • Difficulty opening or closing the jaw due to locking of the joint

Tips For Relieving TMJ Pain

If you’re dealing with TMJ pain, there are a few things you can do to reduce it on your own:

  • Keep yawning and chewing to a minimum.
  • When possible, avoid extreme jaw movements like from singing or yelling.
  • If you have to yawn, control it by pressing a fist beneath your chin.
  • When resting, hold your teeth slightly apart rather than fully closed. This is the natural resting position for the jaw, even when the lips are closed.
  • Eat soft foods that require little to no chewing.

Treatment For TMJ Disorders

In most cases, TMJ pain is temporary and goes away on its own after a week or two, but not always. If it doesn’t, and especially if it gets worse, then it likely needs treatment, which varies depending on the cause.

These treatments include ice packs, exercise, and moist heat, medication, and splints, but if none of them are enough, then measures like transcutaneous electrical nerve stimulation (TENS), ultrasound treatment, or trigger-point injections may be necessary. If all else fails, jaw surgery may be recommended.

Talk To Us About Your Jaw Pain

If you’ve been experiencing persistent pain or tenderness in your jaw or difficulty opening and closing it completely, give us a call or stop by so that we can look for the cause and get you on the path to being pain-free.

Together, we can defeat TMJ pain!

The content on this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.

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Defeating Bad Breath

Park RIdge DentistWE’VE ALL BEEN THERE BEFORE — sitting in the middle of a job interview or a first date and realizing that our breath is far from minty fresh. Even when everything else is going perfectly, bad breath can be enough to ruin your confidence and turn a good experience sour. Why do we get bad breath, and what can we do to stop it?

Oral Bacteria And The Food We Eat

In order to effectively fight bad breath, it’s important to figure out what’s causing it. The simplest and most common cause is leftover food particles stuck between our teeth after a meal. The bacteria in our mouths break down these particles, and the end result doesn’t smell good. We can combat this with a good daily hygiene routine, including daily flossing, twice-daily brushing, scraping our tongues clean, and chewing sugar-free gum.

Causes Of Chronic Bad Breath

Chronic cases of bad breath (also called halitosis) might not be solved by good oral hygiene practices alone. Halitosis may be caused by:

  • Chronic conditions. Sometimes, bad breath is linked to conditions that you wouldn’t think are connected to oral hygiene, such as diabetes, liver or kidney disease, and acid reflux.
  • Medications. A common side-effect of medications is dry mouth. Without saliva to wash away food particles and neutralize acid, the mouth is vulnerable to problems like bad breath.
  • Mouth-breathing. Whether it happens by habit or because breathing through the nose is difficult, mouth-breathing tends to dry out the mouth, leading to the same problems as described above.
  • Mouth, nose, and throat infections. Bad breath can be the result of increased mucous when we have a cold or a sinus infection.
  • Pregnancy. Symptoms such as morning sickness and nausea can cause bad breath, because of the extra acid in the mouth. This is also a problem for people struggling with bulimia.
  • Tobacco products. Tobacco in any form leaves smelly chemicals in the mouth and can also dry it out. In addition, it increases the risk of oral cancer and gum disease, which negatively impact breath as well.
  • Tooth decay and gum disease. Poor dental health often goes hand-in-hand with chronic bad breath because cavities and periodontitis are caused by the same bacteria that produces those nasty-smelling chemicals.

Keeping Your Breath Fresh

Even if strict oral hygiene isn’t enough to keep the bad breath completely at bay, it will help to manage it, and treating the underlying cause may be able to eliminate it. If you are a habitual mouth-breather, try breathing through your nose more. Quitting smoking will eliminate a major cause of bad breath. If dry mouth is the problem, chew sugar-free gum and mints to stimulate saliva production, sip water, and use a humidifier to help keep up the moisture.

Your Dentist Can Help

Discovering the underlying cause of bad breath is a crucial step in fighting back, and the dentist is your best ally here. Schedule an appointment so that you can get the answers you need to fight bad breath the best way.

We want all our patients to feel confident about their breath!

The content on this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.

Top image used under CC0 Public Domain license. Image cropped and modified from original.

Nitrous Oxide: Having A Gas At The Dentist

Park Ridge Dentist

MOST OF US HAVE at least heard of laughing gas, the whimsically-nicknamed sedation method used by dentists, even if we haven’t had it ourselves. But what exactly is laughing gas, and why is it so closely associated with dentistry?

Nitrous Oxide From Discovery To Dentistry

Laughing gas is a colorless, odorless gas. It consists of two nitrogen atoms and one oxygen atom bonded together. The way it works is not entirely clear, but studies do indicate that it reduces a patient’s perception of pain and increases the release of dopamine.

In 1772, Joseph Priestly first isolated the compound nitrous oxide. It wasn’t until 1799 that Humphry Davy discovered the relaxing, euphoria-inducing effects that earned it the name laughing gas. Several decades later, in the 1860s in Germany, nitrous oxide found its place in dentistry, and we still use it today.

Is Laughing Gas Safe?

The nitrous oxide used in a medical setting is very safe, because exposure is carefully controlled. The masks dentists use to administer the gas first delivers pure oxygen, followed by a mixture of oxygen and nitrous oxide. The limited exposure produces temporary effects that reduce pain and help the patient relax during a procedure. In rare cases, it may cause side effects like headaches, shivering, sweating, nausea, or fatigue.

Recreational use of nitrous oxide, on the other hand, is no laughing matter because few to none of the factors that make it safe in a medical context are present. The gas is kept cold enough to cause frostbite to the mouth, nose, and throat if inhaled directly, and it is stored at such high pressure that it can damage the lungs. Outside of a medical professional’s hands, laughing gas can also cause asphyxiation because it isn’t properly mixed with oxygen.

Laughing Gas Versus Dental Anxiety

For patients who suffer from dental anxiety, laughing gas can be especially helpful. Foregoing dental treatment because of anxiety and fear will only give the problem time to become worse. Laughing gas is one option to help anxious patients relax and feel comfortable during a dental procedure, or even during a routine dental appointment.

Still Have Questions About Laughing Gas? Just Ask!

If you’d like to know more about the effects of laughing gas and its uses in dentistry, we are happy to answer your questions! Give us a call or schedule an appointment so that we can discuss this and any other dental health concerns you may have.

Our patients’ comfort is one of our highest priorities!

The content on this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.

Top image used under CC0 Public Domain license. Image cropped and modified from original.

An Intro To Veneers

Cosmetic Dentist Park Ridge IL

MANY OF US ARE unhappy with the way our smiles look. Maybe our teeth aren’t as white as we’d like, they have unusual shapes, or they’ve suffered some damage like chipping or fractures. Veneers are a great, long-lasting solution we can use to fix these problems and get the smiles of our dreams.

How Do Veneers Work?

Veneers are thin, tooth-colored porcelain or composite resin shells that cover the natural teeth. Because they are as resilient as tooth enamel, they protect the teeth from damage and can last many years. Veneers are custom-made to the contour of the patient’s teeth and bonded to the enamel over the course of one or two in-office procedures.

The Veneer Placement Process

Veneer placement follows these steps:

  1. If the patient’s teeth are particularly sensitive, local anesthetic may be used, but it usually isn’t necessary. The dentist cleans the tooth and determines the ideal shade, then removes a thin layer of enamel to make room for the veneer.
  2. The dentist takes an impression of the tooth and places a temporary veneer.
  3. Once the custom veneer has been delivered, the tooth is cleaned and the veneer is etched, rinsed, and dried, and finally cemented onto the tooth.
  4. A curing light helps harden the adhesive to attach the veneer to the tooth. The dentist polishes the veneer and removes any excess material.

Are Veneers Right For You?

Veneers are a fantastic option to address certain esthetic issues with one or more teeth, but they are not the best solution for every dental problem, as they can be pricey and some amount of natural enamel must be scraped away to make room for them. The best candidates for veneers are patients with chipped, broken, badly discolored, or worn teeth.For patients with alignment issues or less severe discoloration, orthodontic and whitening treatment will usually be preferable to veneers.


Taking Care Of Your Veneers

It’s important to take good care of your veneers once you have them so that they will last as long as they should before they need replacement. This mainly consists of the same good brushing and flossing habits you maintain for your natural teeth, and you can minimize the risk of the veneers becoming stained by avoiding foods and drinks that stain, such as coffee and red wine.

Bring Us Your Questions About Veneers!

If you’re considering veneers, we’re sure you have plenty of questions. Just give us a call or stop by to set up an appointment. We can tell you everything you need to know and make a plan to get you the smile you’ve always wanted!

We love when our patients love their smiles!

The content on this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.

Top image used under CC0 Public Domain license. Image cropped and modified from original.

Bad Oral Health Fads

Park Ridge Family Dentist

FADS AREN’T ALWAYS ABOUT hairstyles and slang; they can also be about the way we take care of our bodies, including our teeth. It’s important to be able to tell the difference between something that is popular and something that has the support of the dental health community. That’s why we’re going to take a critical look at a few of the recent oral health fads.

Charcoal Toothpaste

You might’ve seen this seemingly paradoxical product in the store: activated charcoal toothpaste, which will turn your teeth black when you brush but supposedly whiten them in the long run. If you haven’t seen it in the store, you’ve probably seen people using and singing its praises on social media.

The problem with these products and home-made pastes is that there is no scientific support for the claims that they are safe to scrub against our teeth, let alone effective at whitening them. On the contrary, there is actually significant concern that they could do more harm than good. Charcoal is highly abrasive, so it could be eroding away tooth enamel. Loss of enamel exposes the more yellow dentin beneath and leaves the tooth much more vulnerable to decay.

Non-Fluoride Toothpastes

Fluoride is the active ingredient in ADA-approved toothpastes, but in recent years, we’ve seen a lot of claims and conspiracy theories about the evils of fluoride, which have given rise to an array of fluoride-free toothpastes. This mistrust of fluoride is not supported by science, and there is a wealth of scientific data on the oral health benefits of fluoride when used in small amounts.

When fluoride was first added to the public water supply in Grand Rapids, Michigan, it reduced childhood dental caries by a whopping 60 percent, with no adverse effects except for occasional cases of mild fluorosis (harmless white patches on the enamel). Avoiding fluoride won’t do anything except put your teeth at greater risk of cavities.


Bring Us Your Questions About Dental Fads

These are just two of the fads out there. If you encounter another one, make sure you let us know about it before you try it out. We’d love to hear about these trends so that we can offer patients our professional opinions and advice. In the meantime, stick to tried and true dental health practices like brushing twice a day with fluoride toothpaste, flossing daily, and scheduling regular checkups!

When it comes to your dental health, always trust the science!

The content on this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.

Top image used under CC0 Public Domain license. Image cropped and modified from original.

What To Do When You Have A Toothache

Park Ridge IL Dentist

A TOOTHACHE IS never fun to deal with, and they can happen for a variety of reasons. Do you know what to do when one strikes, especially if it happens over the holidays or at the beginning of the weekend and you can’t get quick access to professional dental care?

Toothache Causes

The most common reason a tooth might initially feel painful is tooth decay, but it isn’t the only reason. Tooth pain can also be the result of pulp inflammation, an dental abscess, a cracked tooth, or even gum disease. Impacted teeth (teeth that are blocked from coming in where they should by bone, gum tissue, or other teeth) can also be painful. Tooth sensitivity can lead to discomfort as well, and sometimes the cause is merely a sinus infection or congestion.

Reducing Dental Pain Before Your Appointment

The best thing to do when you have a toothache is to come see us right away. If for some reason that isn’t possible, there are a few things you can do to manage your dental pain in the meantime.

  • Rinse and spit with warm saltwater to reduce inflammation
  • Apply a cold compress to the cheek near the sore area
  • Take anti-inflammatory medication
  • Use an over-the-counter topical medication

Preventing Future Toothaches

If you’ve had or currently have a toothache, you probably want it to be your last. Obviously some of the causes can’t be prevented, such as sinus infections and a tooth being damaged in an accident, but there’s a lot you can do to protect your teeth from the aches and pains that come from poor dental health.

Brushing twice a day for two minutes with a soft-bristled brush and fluoride toothpaste, flossing daily, and scheduling regular dental appointments will keep your teeth healthy. You can also help your teeth out by cutting down on sugary foods and drinks.

Bring That Tooth Pain To Us As Soon As You Can

Pain is the body’s alert system to let us know when there’s a problem, and it’s important not to ignore it. No matter what you think might be causing your toothache, schedule an appointment with us to get it taken care of before the underlying problem has a chance to get worse. We’ll be able to take a look and get your tooth the treatment it needs!

Let’s fight that toothache together!

The content on this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.

Top image used under CC0 Public Domain license. Image cropped and modified from original.

The Top 3 Worst Drinks For Your Teeth

Park Ridge Dentist

ONE OF LIFE’S CRUELEST ironies is that so many of the foods and drinks we enjoy the most aren’t good for us at all. Naturally, as dental professionals, we’re particularly concerned about the ones that are bad for our teeth. That’s why we’re giving our patients a heads up about the three drinks that have the worst impact on oral health.

1. Soda

Two of the most harmful things for our teeth are sugar and acid, and carbonated beverages are full of both. Sugar is harmful because the bad bacteria in our mouths eat it and excrete acid on our teeth, and when we drink something acidic, we’re essentially cutting out the middle man and applying the acid to our teeth ourselves. Tooth enamel begins to dissolve at a pH of 5.5, and soft drinks range in acidity from RC Cola at a pH of 2.32 to Canada Dry Club Soda at 5.24. Even diet soda isn’t much less acidic than its sugar-loaded counterpart.

2. Sports Drinks

We all enjoy a refreshing drink to go along with a hard workout, but those sports drinks we use to replenish our electrolytes have a down side. Like soda, they are often full of sugar and highly acidic. One study showed that lemon-lime Gatorade dissolved the most tooth enamel compared to any other drink, including Coke.


3. Fruit Juice

By this point, you probably already know what we’re going to say. Fruit is a very healthy snack and can even be good for your teeth, but when we drink the juice on its own, we’re bathing our teeth in the sugar and acid content of many servings of fruit, without the filter of whole fruit’s healthy fiber. In the end, it’s not much better for our teeth than soda.

Honorable Mentions: Coffee, Black Tea, And Alcohol

Soda, sports drinks, and fruit juice aren’t the only drinks that are bad for our teeth. Coffee, black tea, and alcohol are too, particularly the dark ones, which can leave stains. We also tend to add sugar to our coffee and tea, and alcohol can dry out the mouth, leaving it vulnerable to bacteria.

Keeping Our Teeth Healthy

While we aren’t going to insist that our patients give up these drinks forever, we definitely recommend cutting back and counteracting the negative effects by drinking more water, maintaining good oral hygiene habits, and scheduling regular dental appointments.

We love our patients’ smiles!

The content on this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.

Top image used under CC0 Public Domain license. Image cropped and modified from original.

Oral Piercings: Self-Expression With Risks

Park Ridge, IL Dentist

WE ALL LIKE to show off our personality and sense of style in the way we present ourselves, from clothing to hairstyle to cosmetics. Piercings are often an important component of personal image, but unlike clothing and hairstyles, piercings come with health risks — particularly oral piercings.

Common Oral Piercing Risks

There will always be risks associated with piercings, even the most basic earlobe piercings, such as infection or an allergic reaction to the metal. Oral piercings share those risks, and they also have a few unique ones.

  • Infection. The human mouth is home to numerous species of bacteria. Good oral hygiene is crucial to keep it in check, but a piercing can put that bacteria in closer contact with the bloodstream, leading to infection, pain, and swelling.
  • Damage and injury. It’s easy to develop a habit of fidgeting with a tongue or lip piercing, but this can lead to chipped or cracked teeth, damaged fillings, and injury to the gum tissue, lips, or tongue.
  • Gum recession. When the gum tissue is constantly in contact with a piercing, it can wear it away, exposing the roots of the teeth and leaving them vulnerable to decay.
  • Numbness. Tongue piercings can leave the tongue temporarily or permanently numb due to nerve damage. This can affect taste and mouth movements.
  • Drooling. Our salivary glands are activated by the presence of foreign objects in the mouth. Usually this means food, but a piercing can trick your salivary glands into working overtime.
  • X-ray interference. A piercing can obscure important areas in a dental X-ray, making it easier for cavities to slip under the dentist’s radar.
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Oral Piercings And Orthodontics

For orthodontic patients, oral piercings are even riskier. It’s very easy for a piercing to become tangled up in braces, and this can damage the appliance and cause injuries if the piercing tears free. Even if you’re willing to accept the dangers of an oral piercing, we strongly urge you to wait until your orthodontic treatment is over.

Taking Care Of Piercings

Whether you already have an oral piercing or you’re willing to accept the risks of getting one in the future, there are ways you can minimize those risks, aside from being diligent with your oral hygiene habits. These aren’t as effective as not getting piercings or removing them, but they do help.

  • Keep the piercing site clean. Don’t let bacteria and food particles build up around the piercing site; make sure to rinse after every meal or snack.
  • Avoid clicking it against your teeth. Try to be gentle in how you move the piercing around your teeth so they don’t chip.
  • Make sure the piercing is secure. This will prevent it from coming loose and becoming a choking hazard.
  • Remove all piercings while playing sports. Any piercing becomes a hazard during intense physical activity, so make sure to take it out before workouts, practices, and games!
  • Signs of infection? Go to the dentist. Any symptoms like swelling, pain, or unusual redness around the piercing, as well as fever, chills, or shaking could mean infection, so go to the dentist or the doctor right away!

Let’s Keep That Mouth Healthy!

As dental professionals, our top priority will always be helping our patients maintain healthy teeth and gums for life, and oral piercings introduce a lot of unnecessary risks. If you’d like to know more about how a piercing can impact your oral health, drop by or give us a call!

We encourage you to make good oral health a lifelong goal!

The content on this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.

Top image used under CC0 Public Domain license. Image cropped and modified from original.

Teeth, Gums, And Diabetes

Park Ridge IL Dentist

IT MIGHT SEEM LIKE diabetes and oral health have little to do with each other, but this is unfortunately not the case. One of the most common effects of diabetes is, in fact, gum disease, and the two conditions can actually make each other harder to deal with. This is why we want to make sure all of our patients have the information they need about the relationship between diabetes and oral health problems.

The Basics Of Diabetes

Diabetes is a chronic disease that affects how the body makes and uses insulin, a crucial hormone that regulates blood glucose levels. When the pancreas can’t produce insulin (type 1 diabetes) or the body can’t use it properly (type 2 and gestational diabetes), this leads to hyperglycemia. What does this mean for the teeth and gums? Well, high blood sugar both weakens the immune system and feeds bad oral bacteria, leaving diabetics vulnerable to oral inflammation and decay. 

How Diabetes Affects Oral Health

By this point, it shouldn’t come as a surprise that 22 percent of diabeticssuffer from gum disease, ranging from gingivitis (inflammation) to periodontitis (advanced gum disease), which threatens the health of the teeth, gums, and even the underlying bone. Bacteria from gum disease can also endanger overall health if it reaches the bloodstream, making blood sugar even harder to regulate.

Some of the symptoms to watch out for include red, swollen, or bleeding gums, gum recession, bad breath, and loosened teethAnother diabetic symptom that increases the risk of developing gum disease is dry mouth, because saliva is crucial for regulating the mouth’s pH and washing away bacteria and food particles.

While we’re focusing on gum disease, uncontrolled diabetes can also lead to a variety of other oral health problems, including dry mouth, impaired or slower healing, burning mouth syndrome, salivary gland enlargement, more frequent and severe infections, and fungal infections.

Fighting Back Against Diabetes

The good news for our patients who struggle with diabetes is that good oral health is still within your grasp, and keeping your mouth healthy will also make your diabetes easier to control! By brushing twice a day for two minutes with a soft-bristled brush and fluoride toothpaste, flossing daily, avoiding smoking, and being careful with your sugar intake, you can keep your teeth and gums healthy.


The Role Of The Dentist

Just as crucial as your brushing and flossing routine is making regular trips to the dentist, and that might mean more than the standard two appointments a year. To play it safe, we recommend three or four yearly visits for diabetic patients. It is also essential that your doctor and your dental health care provider have the right information to be able to work as a team to keep you, your teeth, and your gums healthy.

We’re here to help you in your fight for good oral health!

The content on this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.

Top image used under CC0 Public Domain license. Image cropped and modified from original.

What To Look For In A Toothbrush

park ridge dentist

ON THE SURFACE, a toothbrush seems like just another item on the grocery list, but choosing the best one for you can be tricky. There are several factors to take into account, such as bristle softness, grip feel, head size, and whether to stick with manual or go electric. That’s why we’re here to help make your selection process easier!

Toothbrush Qualities To Look For

Have you ever noticed that the toothbrushes you bring home from dentist appointments have very soft bristles? This is no accident. Hard bristles might seem like they’re better equipped to clean away plaque, but they could be damaging your teeth and gums while they’re at it. We recommend choosing a toothbrush with soft bristles. This is particularly important for anyone with sensitive teeth or gums.

The next thing to look for is the size of the brush head. Mouths and teeth come in different sizes depending on age and genetics, which is why toothbrush heads have a range of sizes available. Find the toothbrush that matches the size of your mouth. Just like bristle hardness isn’t an indication of effectiveness, having more bristles doesn’t make the brush better if it won’t fit easily around your teeth.

You might think that a toothbrush’s handle is its least important part, but a toothbrush with the wrong kind of handle is a difficult toothbrush to use. Is your toothbrush comfortable to hold and easy to maneuver, or does it slip in your hand? The better you are able to hold your toothbrush, the better it can clean your teeth. This is a particularly crucial consideration for people with arthritis or other conditions that make it difficult to grip objects.


Manual Or Electric?

This is one of the biggest debates when it comes to choosing a new toothbrush. A lot of people swear by their electric brushes while others claim manual ones are better. Some electric toothbrushes can do a better job of removing plaque, but it’s up to you to decide if that is worth the greatly increased price tag. Electric toothbrushes can be particularly beneficial to orthodontic patients who have to brush around braces, people with dexterity problems, and even children!

Out With The Old Toothbrush, In With The New

Regardless of what type of toothbrush you have, remember to always replace it between three and six months, and store it upright somewhere it can fully dry between uses. If you still have questions about what to look for in a toothbrush, just ask us! We want to make sure all our patients have the best tools for keeping their teeth healthy and clean.

Put that new toothbrush to good use!

The content on this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.

Top image used under CC0 Public Domain license. Image cropped and modified from original.