My Smile Is Disappearing

Posted on by .

I would love some advice. It is almost impossible to see my teeth, even when I smile. I don’t know what is causing this but I am so embarrassed by my smile. My dentist said that porcelain veneers might help. That is a pretty expensive procedure to get a might. Here is some more information and maybe you can tell me if that maybe leans more toward a yes or no. When my lips are in repose, you cannot see my teeth at all. When I force my smile as big as possible, you can see a bit of my teeth. I have jaw pain and wear my night guard. When the night guard is in, you can see my teeth a bit better. What do you think?

Caroline

Dear Caroline,

A chart showing the connection between muscles, jaw joints, and teeth

I am going to right off the bat tell you that porcelain veneers are NOT the solution for this. In fact, it is so much not the solution to this that I think when you get the actually procedures you need, it will be important to find another dentist to do it. While porcelain veneers might help your appearance, if he is a skilled cosmetic dentist, it could potentially make your pain significantly worse.

Based on your description, it sounds like you have ground your teeth down, which has caused them to be overclosed. That kind of positioning could lead to TMJ Disorder. The fact that you’ve been having jaw pain makes me think this is what is happening. I’m glad you have a nightguard because that could help prevent further damage. However, the damage already done needs to be dealt with. This will require a dentist who has training and understands TMJ Disorder and the different type of treatments.

I believe you are going to need a full mouth reconstruction which means crowning each of the ground down teeth. It needs someone with training far above what most general dentists have.

I would suggest doing an internet search for “TMJ Dentist.” Then, check that they have post-doctoral training in TMJ. It’s not a recognized specialty, but general dental school is not enough. Ideally, they would have gained additional training at one of these institutions:

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

Then, take the additional precaution of checking out their smile gallery to see if they have some artistic skill with cosmetic dentistry and can create beautiful smiles. You do not have to choose between form and function. Find a dentist who can do both.

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

Treatment for TMJ Disorder

Posted on by .

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.