Archives for May 2019

Treatment for TMJ Disorder

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My doctor has been unable to find a cause for my headaches. They are debilitating, especially in the morning. It’s kept me from being the mom I want to be. At my last visit, my doc suggested I see a dentist and ask about TMJ Disorder. He called it a “Hail Mary”, because he doesn’t know what else to do for me. I did see my dentist and mentioned what my doc said. He told me if I have headaches in the morning it is because of TMJ and I’ll need to have a full-mouth reconstruction. He had the business office write me up an estimate. It will cost me a fortune. Before I invest in this, I just want to make sure this is the correct course of action. Should I move forward or get a second opinion first?

Ellen

Dear Ellen,

An illustration with a close up of a TMJ Joint

There are many causes and solutions to TMJ Disorder

While a full-mouth reconstruction is a legitimate treatment for certain cases of TMJ Disorder, there are other treatments. Treatments which are much less invasive. Which treatment is used, depends on what the underlying cause is. You need the right treatment for the right cause. If that is the right treatment, it requires a dentist with exceptional training in both restorative and neuromuscular dentistry that is not gained in dental school. Because of that, I am going to suggest you get a second opinion by someone with the right training.

Sometimes, those headaches in the morning are caused by your clenching or grinding your teeth. Many patients don’t even realize they are doing it because they only do it at night. It is hard to know what you are doing in your sleep. A full-mouth reconstruction wouldn’t even help that issue. Instead, all you would need for this is to wear a night guard while you slept. It’s a simple and comfortable mouthpiece that is worn over your teeth.

Finding a Qualified Dentist to Evaluate Your TMJ

What you want is a dentist who invested time in post-graduate training. There are several schools which have great TMJ training. Here are a few of the best:

  • The Dawson Academy for Advanced Dental Study
  • The Las Vegas Center for Advanced Dental Studies
  • The Pankey Institute
  • The Kois Center

A dentist who has studied at one of these institutes will be qualified to both diagnose and treat you. It may be something simple, such as I mentioned earlier. If it turns out that you do need a full-mouth reconstruction and it requires putting a dental crown on every tooth, you will need a dentist with an additional qualification. Because this treatment is a combination of fixing your bite and creating a new one, you’ll need someone who is also skilled in cosmetic dentistry. I’d look for someone who has reached accreditation with the American Academy of Cosmetic Dentistry.

This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

Solution for a Gigantic Tooth Gap

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I have a rather large tooth gap. My dentist said it is about 9mm. I want to fix it and whiten my teeth at the same time. My dentist said he was just certified in Lumineers and can place those on my teeth to close the gap. Is this a good solution? I want to make sure for two reasons. One, it’s expensive. Two, he is new at it.

Joey

Dear Joey,

Invisalgin Aligner

Inviaslgin Aligner

I want you to run away from the recommendation your dentist gave you as fast as you can. Here are just a few reasons why. First, Lumineers are simply a brand of porcelain veneers. This particular brand is highly marketed to inexperienced cosmetic dentists as being easy to place because there is no prep. In all honesty, there is no such thing as no-prep veneers. Your teeth will have to be etched no matter what brand you use.

Second, certification in Lumineers simply means they have attended a seminar. It does nothing to develop their skill or teach them artistry.

Thirdly, your particular case would require a dentist who has tremendous skill, experience, and artistry in placing porcelain veneers. The size of your gap is enough to fit an entire tooth into. In order to make this look natural, it will take some technical expertise not available to your dentist.

Invisalign is a Much Better Solution

In your place, I would have Invisalign done. These use clear aligners to straighten and align your teeth. You can see a picture of one of the aligners above. These will close the gap without anyone even knowing you are wearing orthodontics. They are invisible even at a conversational distance. Additionally, they are much more comfortable than traditional braces and work in half the time.

Not only will using Invisalign cost significantly less than getting porcelain veneers, but the aligners can double as teeth whitening trays, saving you even more money. Your dentist can just provide you with the whitening gel, which you can wear in your aligners at a convenient time for you. This allows you to straighten and whiten your teeth at the same time.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Do You Have to Quit Smoking for Dental Implants?

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I want to get dental implants to replace some missing teeth. My dentist said he won’t place them unless I quit smoking. Is this really necessary or is he trying to force his own agenda on me?

Kevin

Dear Kevin,

An image of a dental implant crown being placed in three stages

I don’t think your dentist is trying to force an agenda on you. Instead, he’s trying to give your dental implants procedure the best chance at success.

The Risks of Nicotine with Dental Implants

  • The Reduction of Blood Flow

Any form of tobacco, including cigarettes, vaping, smokeless tobacco, or dipping restricts your blood vessels. In some cases, it cuts off the blood flow completely.

  • Poor Osseointegration


    • One of the keys to a successful dental implant procedure is when the implants fully integrate with the bone. With reduced blood flow, this hinders healing which slows down the integration. This will lead to a loose implant which will fall out.

    • Increased Risk of Infection

    Because your reduced blood flow hinders healing, it increases your risk for infection at the implant location. The leading cause of dental implant failure is an infection.

    Options for Dental Implants When You Smoke

    Obviously, you can accept the risk and move forward. You will be able to find a dentist willing to provide the procedure even while you smoke.

    On the other end of that spectrum is to quit smoking. You can talk to your doctor about options to aid you in that process. There are options to help with the withdrawal symptoms.

    Another possibility is to meet somewhere in the middle. You can quite for several weeks before the surgery and during the healing time. Then, when everything is secure, you can smoke again. However, you may find during that time period that you don’t really need that tobacco as much as you thought you did.

    A Cosmetic Consideration with Dental Implants

    Smoking causes serious tooth stains. Often, patients want to get a whiter smile when they’re replacing their teeth. You may want to consider getting your teeth whitened before having your implant crowns made. This way they can match the porcelain crowns to your new, whiter tooth color. Giving you a youthful, healthy looking smile.

    This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.