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Really Confused about TMJ Treatment?

I’ve been recently diagnosed with TMJ dysfunction was told I would need to be fitted for a splint that I would wear for 69 months until my symptoms went away and then I would need to look at more permanent option like orthodontics. This doesn’t seem to reflect a lot of the research I’ve been doing. Most of what I’ve been reading seems to say that TMJ is very poorly understood and they aren’t really sure how to treat it. I’ve read that splints can be effective but it varies from person to person and they shouldn’t be worn over an extended period of time. I also read that irreversible options such as braces should be avoided. Doing less seems to be the preferred method of treatment. So now I’m really confused. Do I go ahead with what the doctor recommended or do I try lifestyle changes such as correcting my posture, minimizing stress, etc which seems to be supported my credible institutions and organizations.

Thanks, Ashley

Dear Ashley,

We are glad to know that you have been doing some of your own research on TMJ Dysfunction. The cause of temporomandibular dysfunction is unclear and can be difficult to treat at times however some things that can contribute to this disorder are grinding and clenching of the teeth, stress, a bad bite, and arthritis. Wearing a splint can relieve a lot of symptoms like a popping and clicking jaw, headaches and earaches, as well as in the prevention of grinding and clenching of ones teeth. This disorder can last for a short time and go away on its own or last for years. At times orthodontics is recommended especially if your bite if off. Having braces may eliminate your TMJ dysfunction but not a guarantee. If patients experience severe symptoms and a split is not working for them surgery is recommended however this is very rare. Making some lifestyle changes is not a bad idea and may help relieve some pain therefore reducing stress, eating soft foods, exercise, and not chewing gum to name a few. Placing ice or heat packs on the side of your face may also help in relieving some discomfort.

Post courtesy of Dr. Malone, Lafayette Louisiana Cosmetic Dentist

 

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Is there a way to floss between a bridge and the gum?

Is it necessary to floss under a bridge? I have read that these are tight-fitting against the gum to prevent food from getting trapped between the bridge and gum. I had gum disease over a year ago, had teeth extracted, and a bridge placed after everything was cleaned up. Now I am having problems with a swollen gum under the front bottom of the bridge. It’s swollen to the point of bleeding around the bridge even when the bottom lip is simply pulled back.

Thanks, Gary

Dear Gary,

Yes, it is necessary to floss under a dental bridge daily, even more so if you were previously treated for gum disease. Flossing daily will help in the prevention of further bone loss around the teeth. There could be two reasons why your gums are swollen and bleeding around your bridge. Due to the fact that you have not been flossing under it, there is a big possibility that your teeth anchoring your bridge are reinfected with gum disease and may need to be retreated. Another problem could be that your dental bridge was placed right after the teeth were extracted therefore the extraction site may have not had the proper time to heal which can cause a similar affect on the tissue under the bridge.

There are different types of bridge floss threaders available in the toothpaste isle at your local store to help you clean under your bridge. Ask your dental hygienist at your next cleaning appointment to show you how to floss properly around your bridge. We recommend you discuss this matter with your dentist to find the root of the problem with your bleeding gums.

Post courtesy of Dr. Malone, Lafayette Louisiana Cosmetic Dentist

 

 

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Am I Grinding My Teeth?

For the past of couple nights when I’m a sleep I feel like my jaw keeps going to the side and I can’t move it…like it locks up on me and I don’t know if it’s actually doing it or if it’s just me dreaming. Technically it feels like it goes to the right side and no matter how bad I try to move it I can’t and then I wake up. So I don’t know if it’s a dream or if it’s really happening while I’m asleep. It’s not painful just real annoying. Happened about 5 times already. Any information on this?

Thanks Derek

Dear Derek,

It sounds like your grinding your teeth at night while you’re sleeping. It is common for this to happen especially if you have some stress or anxiety, an improper alignment of the teeth, or even some missing teeth. Grinding over time can chip and break your teeth, cause them to become worn down, and even cause bone loss around your teeth. If you notice that you are continually doing this in your sleep we recommend you let your dentist know about your grinding and have them do an exam to see if there are signs of grinding. If so, a custom made mouth appliance will probably be recommended for you to wear at night while you are sleeping to prevent you from causing damage to your teeth and help in the prevention of future grinding. Try to avoid caffeine and alcohol and relax your jaw muscles at night by putting a warm washcloth on your jaw by your earlobe.

Post courtesy of Dr. Malone, Lafayette Louisiana Cosmetic Dentist

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I have 2 temp crowns on front teeth, how long should they last?

I am going to Amsterdam for a couple of weeks and am afraid that my temp crowns may come off of my two front teeth. I will not be able to get the permanent ones in until I come back! How long will they last?

Thanks, Jim

Dear Jim,

There are different types of temporary cement used in dentistry however most temporary cements can last several weeks. Due to the fact that these crowns are on your front teeth your dentist may have used a type of cement that has more retention to hold your temporary crowns in place better, however call your dental office and ask them.

We recommend that you take some precautions to help prevent you from having a problem with your temporary crowns. Keep away from hard foods like carrots or apples because these types of foods could cause your temporaries to break or shift and try to avoid sticky foods like gum which could pull the crowns off. When you floss around your temporary crowns do not lift the floss out like you normally would. Instead slide the floss out otherwise you could pull the crowns off.

If one of your temporaries comes off, all is not loss. There are several types of temporary cements found in local stores in either the toothpaste isle or pharmacy area that you could purchase if needed. It’s important that you clean out your temporary crown so no old cement is in there. Afterwards try it in and make sure it fits well and that you can seat it all the way. Before you add cement to your temporary it’s very important to dry your crown as well as your tooth otherwise the cement with not adhere. Follow the instructions thoroughly on the printed package and you should not have a problem. If you have difficulty with this you always have the option to see a dentist on your vacation and they can recement it for you.

Post courtesy of Dr. Malone, Lafayette Louisiana Cosmetic Dentist

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Do your gums grow back after quitting chewing tobacco?

I chewed tobacco for about 10 years and recently quit. I noticed that my gums had receded quite a bit. Will they grow back?

Thanks, Steve

Dear Steve,

It’s great that you were able to quit such an addicting habit that affects the entire mouth as well as your general health. Studies have shown that 10% to 30% of regular chew tobacco users have gum recession and develop some bone loss around the teeth. Besides gum recession other risk factors for tobacco use are sores in the mouth, oral cancer, tooth decay and sensitivity.

Unfortunately our gums do not grow back. Gum recession is usually permanent and difficult to repair. Stopping your tobacco use will prevent further gum recession; however you also have to make sure you have good dental hygiene by brushing and flossing daily as well as visiting your dentist every six months for your dental cleanings.

We advise you to address your gum recession concerns with your dentist who may recommend surgery of a more cosmetic or restorative nature to make your smile look more aesthetically pleasing.

Post courtesy of Dr. Malone, Lafayette Louisiana Cosmetic Dentist

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I chipped a front tooth, can it be grow back?

I chipped one of my front teeth, but it still has the root and is a minor chip. I was wondering if adult teeth can be re-grown.

Thanks Aaron

Dear Aaron,

Unfortunately teeth that become chipped or broken do not grow back. If the chip is small your dentist will most likely place a white colored filling best known as dental bonding where the chip was and make your tooth look natural again. Sometimes when chips are so small cosmetic contouring is a good option. This is accomplished by taking a drill or laser and reshaping your chipped tooth. Usually when this procedure is done minor reshaping on your other front teeth is required as well to make your smile look more uniform. This is a very inexpensive quick procedure that requires no anesthetic.

The longer you let your chipped tooth go untreated the more prone you are to chipping the tooth even more with the possibility of having to have a porcelain veneer or porcelain crown placed. These two types of permanent restorations are more expensive than dental bonding and cosmetic contouring as well as take a longer time in the chair and more trips to the dental office. We recommend you consult your dentist to see what treatment option is best for you.

Post courtesy of Dr. Malone, Lafayette Louisiana Cosmetic Dentist

 

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Why do my teeth have small holes at the gum line?

I was eating chips and thought I cut my gum. When I looked in the mirror I noticed that a couple of my bottom front teeth had holes in them. I changed my toothpaste, been brushing three times a day, and am using Listerine twice a day however after a month my teeth seem to be getting more holes. I have not been to the dentist for two years, are these holes cavities?

Thanks, Skylar

Dear Skylar,

It sounds like your teeth are developing cavities at the gum line and that its time for you to make a dental appointment. Tooth decay at the gum line is usually caused from a diet high in citric or ascorbic acid. These types of acids are common in sodas including diet soda, energy drinks, and fruit juices. Drinking these types of liquids on a daily basis erodes the enamel making our teeth highly weak and very susceptible to tooth decay.

There is no special toothpaste or mouthwash over the counter that is going to prevent these areas of erosion from getting worse, however improving your hygiene and greatly decreasing your intake of acidic drinks will help prevent further complications. If you have a lot of erosion of the enamel your dentist may recommend you to use a prescription toothpaste that contains a higher amount of fluoride to prevent further tooth decay.  It is recommended that if you are using Listerine make sure it contains no alcohol. Mouthwashes that have alcohol tend to make the mouth dryer, therefore causing more plaque buildup, a possibility of more tooth decay, and make ones breath not so fresh.

If the areas of tooth decay are small your dentist will most likely be able to place a tooth colored filling in the area. It the decay wraps around the tooth a more permanent restoration like a porcelain crown may be recommended.

Post courtesy of Dr. Malone, Lafayette Louisiana Cosmetic Dentist

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What to expect with a tooth implant surgery?

I’m getting a tooth implant surgery tomorrow in the front and I was wondering exactly what to expect.  I’m getting IV sedation so I know during the procedure it won’t be too bad, but how bad of pain will I experience in the days after? Do people swell or bruise with this surgery? And are you able to go back to school quickly? And one more question… A little later after the surgery do you think I could go shopping? I’m getting the surgery done in a city so it would be kind of nice if I could.

Thanks, Haley

Dear Haley,

A dental implant is a great choice especially for an anterior tooth because it will feel and look natural. You may have some discomfort however your dentist will probably prescribe some medication to help ease the pain. Make sure you take your medicine on a full stomach since pain medications can cause nausea and you will want to take it within a couple hours after your surgery.

Due to the fact that you’re being sedated during the procedure, we recommend that you go home and rest afterward. IV sedation can make one drowsy and you may experience some nausea therefore you should put off shopping for the day. Most patients feel back to normal after about 8 hours following the procedure however you should resume your normal routine when you feel comfortable. You should be able to return to school the next day, however that all depends on your pain tolerance and comfort level. There will be some pain but with each passing day the pain subsides.

Swelling is somewhat common to the mouth and cheeks however the severity depends on the surgery. If you are having bone grafting as well you may notice more swelling along with some bruising however usually 2 or 3 days after your surgery. Its best after surgery to put ice packs on your face where the implant was placed to help reduce any swelling that might occur at least for the first 24 hours.

Post courtesy of Dr. Malone, Lafayette Louisiana Cosmetic Dentist

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A sedation dentist can help with treatment during addiction recovery

I need a lot of dental treatment, and I have a problem. I am in treatment for drug addiction, and when I told my regular dentist this, she refused to give me any pain medication during treatment. We were supposed to do two root canal treatments, and I couldn’t even make it through one whole procedure. I had to have her stop, and though she seemed sincerely sorry, she refused to give me any kind of medication.

What should I do? I have to get these root canals done, and I am pretty sure I also need to decide if I want dental implants, but for sure that is off the table if I can’t find a dentist who will sedate me. I’ve read about the procedure, and no way can I have those root forms implanted without meds.

I appreciate any pointers you can give me. I am trying to turn my life around, and this needs to be done.

Marcus from New England

Dear Marcus,

You need to find a sedation dentist, a dentist who is trained in how to treat pain and anxiety during dental treatment. A dentist who has undergone training in sedation dentistry will understand how to best work with your treatment plan. The dentist who is overseeing your treatment plan might be an excellent resource to point you toward a dentist that will work with you.

Post courtesy of Dr. Malone, Lafayette Louisiana cosmetic dentist.

For more information about Cerec crowns, see our website.

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Fosamax and tooth replacement – special considerations

I recently had to have one of my teeth taken out (the left incisor). The dentist that did the extraction is leery of a dental implant to replace the tooth because I have been taking Fosamax for a decade. As a temporary fix, I’ve been wearing a dental flipper, which is extremely annoying and leaves a bad taste in my mouth all the time.

I’ve been reading about different kinds of dental bridges, like an Encore bridge or a Maryland bridge. Couldn’t either one of those work for me? My dentist seems hesitant because he would have to anchor it to one of my front teeth, but this flipper is not going to work forever. What would be my best course of action?

Carson in Topeka, KS

Dear Carson,

Several things should be considered. Getting a dental implant is not out of the question when you are taking Fosamax, though there is a slightly increased risk of local bone problems of a serious nature. The the likelihood of problems is small, those potential problems can be severe, so you need to carefully consider this. It might also be possible to have your oral surgeon and your doctor coordinate so that you temporarily stop taking the Fosamax so that you can have the dental implant root form surgery done.

If that all sounds too risky, certainly a dental bridge would be a perfectly feasible option. You should, in this case, definitely let your dentist chose the type of bridge that would best serve your particular situation.

Talk all of this over carefully with both your doctor and oral surgeon or dentist.

The office of Lafayette Louisiana cosmetic dentist Dr. Malone has authorized this blog post.