Tag Archives: TMJ

Surgeon Won’t Take OUt Both My Teeth

I am very frustrated. I had a root canal treatment that I think has failed and the tooth needs to be removed. Near that, I have an impacted wisdom tooth that my dentist says is infected and he thinks needs to be removed. I am fine with that, but he refuses to remove the tooth on which I had the root canal treatment. Shouldn’t I be the one to decide that? I’m refusing the procedure because I do not want to do them separately and I am certain the other needs to be removed. What do you recommend I say to convince him to do both teeth?

Linda

Dear Linda,

I want you to be very careful here. An infected tooth is nothing to mess around with. It appears your dentist feels very strongly that this wisdom tooth IS, in fact, infected. If you think about how close your jaw is to your throat (which could swell up and close), heart, and brain, you definitely do not want this infection to spread. This is one of the reasons we consider tooth infection a dental emergency.

So, if your dentist is trying to get you to remove one tooth, why not two? He’d certainly make more money if he did. The only reason I can think of is that your dentist does not believe the tooth with the root canal treatment is infected and he has too much integrity to take your money on a tooth that is saveable.

I am sure if you searched you would find a dentist willing to remove both. While you do not have to replace an extracted wisdom tooth. The other tooth will need to be replaced. This will give the dentist even more money, especially if you choose to get the best tooth replacement option, a dental implant.

If you choose not to replace it, the other adjacent teeth will either shift or tip into the tooth’s empty space. This will throw your bite off and can lead to painful TMJ Disorder.

The fact that your dentist is not wanting to remove this tooth and gain all this extra money tells me your tooth is healthy and you have a dentist of great integrity. I’d stick with him.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Botox and Migraines

My wife has been having jaw pain and migraines. We took her to the dentist because we’ve heard that can be TMJ disorder. The dentist checked her over and suggested Botox. That sort of threw me because I thought that was a cosmetic procedure. Will that actually help her?

Karl

Dear Karl,

I am glad you wrote and believe I can help clear some things up here. If you look at the image above, you can see in the top (before) image, the woman looks angry. In truth, it was the constant tension in her forehead muscles that were causing her muscles to cramp up like that.

Using Botox relaxes those muscles and gives her a less angry appearance, as you can see in the after image. This is the principle behind using Botox for TMJ disorder.

The same medication used for cosmetic purposes can serve a three-fold purpose. The smoothing out of the face is a side benefit for your wife. What she is really after is the way it releases the tense muscles. This will relieve the pressure on her jaw joint, which will help with her TMJ disorder. TMJ disorder can cause migraines. So, three birds with one stone. There is another use your wife probably doesn’t need, but I will mention it here for other readers. It can also help with gummy smiles.

You will still want to get to the bottom of what is causing her TMJ. Many times if it is a tension issue, you may find that your wife grinds or clenches her teeth. She may not even realize she does it because those types of habits are often done during sleep.

One thing that can help with that is a nightguard. It is like a sports guard but custom-fitted to her jaw so it will be very comfortable. The Botox will give her immediate relief. The night guard will help protect her teeth, at night, from any grinding and absorb some pressure from any clenching.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

CEREC Crown is Too Bulky

I had a dental crown break after three years. I needed to replace it but have been quite busy lately. Because of that, I went to a different dentist who advertised same day crowns using a CEREC machine. However, the tooth with the CEREC crown is way too bulky. It’s uncomfortable, doesn’t line up with my other teeth, and I find myself biting my tongue unintentionally because the crown is “in the way”. The dentist has tried filing it a couple of times, but it hasn’t really improved much. Where do I go from here?

Madeline

Dear Madeline,

porcelain block for CEREC crown
CEREC restoration

This must be so frustrating for you. Here you were trying to save time and it has ended up even more of a hassle. I have two concerns here, beginning with your original crown. It should not have broken after a few years. These are designed to protect the tooth underneath and keep them from breaking. As a result, they should last you many years. Your dentist should have recognized that and offered to replace it. Hopefully, it was a matter of flawed material, which can happen to the best of dentists, and not that he was incompetent in how he placed it.

As for the CEREC crown, it sounds to me like your dentist is new with this software. Usually, the dentist would take images of your tooth that needs to be crowned and the CEREC software would build-up an excellently fitted tooth from there. However, you didn’t have the original tooth because your need was to replace a damaged crown.

There are ways to build up a tooth from scratch that will fit perfectly using the software, but it seems to have been beyond the scope of your dentist’s knowledge.

This crown does need to be replaced. The issues you listed can lead to serous problems, including tumors on your gum where you keep biting it, gum disease from a crown iritating the area, and even TMJ Disorder from your bit getting thrown off.

Have your dentist replace this crown at his or her expense. However, I don’t think they are going to be able to get the results you want with her understanding of the software. I think you are going to have to go the “traditional” route and have this porcelain crown made in a dental laboratory.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Having Pain With My Porcelain Veneers

I got porcelain veneers. When my dentist put in the temporaries they felt okay. But, now that the real ones are in they’re giving me some pain. My dentist looked at them and said the bite is off just a bit. He adjusted them a few times, but it’s still hurting when I bite down. Do I keep going back or have them removed?

Sandy – Georgia

Sandy,

I don’t think what you have is porcelain veneers. If you had temporaries, and your dentist has adjusted them, and he’s saying your bite is off, that sounds more like porcelain crowns.

Your dentist needs to fix this or it will cause severe problems, including TMJ. If adjusting them doesn’t improve things, you may have an infection and that is what is causing the pain.  Have the dentist do the x-ray.

I’m a little concerned that you thought you had porcelain veneers. Was that what your dentist told you? Maybe have another dentist look at your bill and the work you had done.

This blog is brought to you by Dr. Mike Malone.

Problems with my smile makeover

I just spend an unbelievable amount of money on my smile makeover. I got ten porcelain veneers. I know most people get six or eight, but I have a really wide smile, so I wanted to make sure that everything visible was covered. We talked for a long time about what kind of smile I wanted. But, when he put it in, I thought it looked ridiculous. It seems too cloudy. I had some stains on my teeth from some medicine I took when I was a child. My dentist said he had to make it that way to cover the stains and insists it looks better than I think, but I just don’t like it. Plus, my jaw hurts and the veneers feel loose so I’m afraid to bite down too much. I don’t even smile anymore. Is there any way to fix this?

Cindy- Mississippi

Cindy,

I can’t tell you how often we hear these type of stories.  There are very few dentists that can do a beautiful smile makeover, especially in a situation like yours. I’m assuming the stains on your teeth are from tetracycline.  These take a very skilled cosmetic dentist to get right.  For the beginning cosmetic dentist there is generally one of two mistakes. Either they are made normally, which allows the tetracycline stains to show through, or they make them too opaque to cover the stains and they don’t look natural.

If you had gone to an expert cosmetic dentist he would be appalled to hear you don’t want to smile anymore. True cosmetic dentists take steps to insure their patient is thrilled with their new smile. First, they make an acrylic smile for them to try on and see how they like it.  If they don’t like it, then they would go right back to designing the smile. Then, after the smile arrives, your dentist will put it in with a try-in paste.  You would get to look at them in different lights. You could even have a friend or family member come in to look at them and give their opinion. Only when the dentist was sure that you were pleased would they be permanently bonded on. You would never be pressured into liking them.

Generally, if you received a bad smile makeover, there isn’t much recourse. The standard for judging cosmetic dentistry for refunds is whether or not it is functional. Now, here is where you are at an advantage. Your veneers are not loose. I know that because if the veneers were loose they would just fall off. I suspect, based on your jaw pain that your teeth are loose because your bite has been thrown off. This could cause some serious problems for you, including TMJ Disorder. That entitles you to to compensation for getting this repaired.

Here is what I suggest you do. First, go to the AACD (The American Academy of Cosmetic Dentistry) website to see if there is a dentist in your area that is AACD accredited. That is different than just being a member. Any one of them could give you an opinion on the work that has been done and help you get the compensation you need to repair the damage if the porcelain veneers are what threw off your bite.  Then, you can get the smile makeover you had dreamed of.

If there is not an AACD accredited dentist in your area, then you can also find an expert cosmetic dentist by going to the mynewsmile.com website. They recommend expert cosmetic dentists by state. Anyone on their list will be safe. It will be worth it to travel if you have to.

This blog is brought to you by Lafayette Lousiana Cosmetic dentist Dr. Mike Malone.

TMJ and Neuromuscular Dentistry

I’ve got quite a story to tell. I hope that maybe other people can avoid making some the of mistakes I made, and save themselves a lot of pain and A LOT of money.

I have a long standing teeth grinding habit that caused me to have porcelain crowns placed on all of my teeth about 10 years ago. At the time, I went with the dentist who quoted me the best price, and I’ve paid for it ever since. The crowns were not placed like they should have been, and they have worn down over time. I also have a lot of pain when I chew, and have been told I have a “posterior crossbite”. I’ve been struggling with gum disease off and on for years because of the placement of the crowns, and they are just plain ugly.

I’ve determined that my biggest mistake was in not choosing the right professional to help me the first time around. Because of the pain in my jaw and the complexity of my case, I have consulted with a neuromuscular dentist who also has a lot of experience in cosmetic dentistry. I asked for his credentials in both, and he directed me to his website where I read about the extensive coursework he has had in treating TMJ, and saw pictures of his cosmetic work in his Smile Gallery. His prices are a little higher than those of the general dentists I have talked to, but looking at those pictures and reading about his education and awards really made me realize that he is worth every penny and then some.

We are currently working on addressing the TMJ issues that are likely at the cause of all my issues, and he has given me a phased treatment plan that I can afford. We’ll eventually replace the old crowns with new porcelain crowns, and if his Smile Gallery photos are anything to go by, my new smile is going to be stunning.

I just wanted to share my story, so that other people don’t make the same mistake I did and then pay for it for years to come. Don’t price shop for a dentist!

Lucy in Chicago

Dear Lucy,

We hear stories like yours every day, and it really speaks for itself. We hope to hear soon that your smile has joined all the others in your dentist’s smile gallery!

Lafayette Louisiana cosmetic dentist Dr. Malone’s office sponsored this blog post.

For more information about CEREC crowns, which are dental crowns that can be done in a fraction of the time of standard porcelain crowns, see our website.

Is there a specific time wisdom teeth should be removed?

Even though I am well into my forties, up until last week I still had all my wisdom teeth. A broken filling in one of the wisdom teeth prompted my dentist to advise me to have both the upper ones out, which I did. She said that replacing a filling in a wisdom tooth would be extremely challenging to do properly, and that a poorly placed filling could lead to an infection, which would likely end with the tooth coming out anyway, so we just cut to the chase.

She is more ambiguous about whether or not I should have the lower wisdom teeth removed. I’ve never had any problems with them, but would it be better to just get it over with if they will cause problems like these down the road. I have good dental coverage right now, and would almost have it all over and done with rather than waiting for a problem to develop.

Thanks,

Paul in Las Vegas

Dear Paul,

There should always be some reason for removing wisdom teeth, beyond them just being wisdom teeth. It sounds as if yours erupted normally, or they would have been causing you problems long before now. I am sure you have heard of wisdom teeth that are impacted. Impacted wisdom teeth can cause a lot of problems with the alignment of your other teeth, and they are best removed as soon as possible, preferably before the age of 25.

However, as you have experienced, even wisdom teeth that have erupted normally can cause problems. Your dentist was wise to recognize the challenge in placing white fillings in wisdom teeth.

In your case, it could happen that the wisdom teeth will super-erupt, which is when missing teeth cause the corresponding teeth in the opposite jaw to grow to try and reach the now absent teeth. This could create alignment problems that could ultimately lead to TMJ issues.

Ultimately, you and your dentist must decide together. In time, it may become obvious that the best course of action is to have them out.

 

For more information about white fillings, dental bridges, dental implants and other restorative services, see our website.