General Dentist or TMJ Specialist?

I have really good teeth. Never had a cavity or any other problems, though I do grind my teeth. I had a checkup a month ago with an all clear. Yet, this week I keep getting an intermittent pain in my teeth. I can’t tell exactly where it’s from. I don’t know if it’s a cavity or not. My cubicle neighbor said she had a similar problem and it turned out to be TMJ. Should I see a general dentist or a TMJ Specialist?

Norma

Dear Norma,

Woman holding her jaw in pain from TMJ

I want to clear up a common misunderstanding. There isn’t a recognized specialty in TMJ Disorder. Any dentist who treats TMJ is just a general dentist who (hopefully) has done additional study and training in TMJ treatment.

We’ll get into how to find a qualified TMJ dentist in a moment. First, let’s address your pain. You don’t have localized pain, but generalized. That makes me think it’s not a cavity. However, if it’s referred pain, that could still make a cavity a possibility.

Your checkup wasn’t too long ago, so unless your dentist missed something a cavity wouldn’t generally pop up and suddenly hurt in that short period of time. Here’s what I’m going to recommend. Go back to see your dentist and get some x-rays done. If by chance it is decay, it’s much easier to get a simple filling than to put it off until it blows up into a dental emergency. So don’t be afraid to go to the dentist and get diagnosed. It’s better than waiting until things are dangerous.

Finding a Qualified Dentist to Treat TMJ

If it turns out there’s not decay or any other typical dental issue, then it will be time to see a TMJ Specialist. So how do you know who is qualified without that true specialty degree? You ask about their TMJ training.

It should be post-graduate and be at some place like one of the following:

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

These are just a few of the advanced training centers, but they’re among the most reputable. If they haven’t done significant post-graduate training, look elsewhere. Additionally, you should know that a good TMJ Dentist will start with the least invasive treatment. They wouldn’t start with a full-mouth reconstruction unless it was a serious and obvious problem where that was the only solution.

Best of luck to you! Hopefully, it’s a simple solution.

This blog is brought to you by Dr. Randall Burba.

What Can Keep My Dentures In?

I’ve had my dentures for a long time. Don’t ask my age. It’s rude. However, I do need advice. Regardless of how old I am, I don’t enjoy being humiliated by having my dentures fall out when I’m in public. So, be a nice young man and tell me how to fix this disaster. I’m almost scared to open my mouth. If you knew how much I loved talking you’d feel very sorry for me right now.

Eleanor

Dear Eleanor,

An image of a snap-on denture
Snap-on Dentures will keep them secure

What’s happening to you is a result of how long you’ve had your dentures. I certainly hope your dentist warned you about the problems with long-term dentures, but based on your question I don’t think he did.

When your teeth were removed, your body began reabsorbing the minerals in your jawbone to use elsewhere. After 10-20 years, there’s not enough jawbone to keep your dentures secure. This is known as facial collapse and the reason yours keep falling out.

Snap-On Dentures Could Be Your Solution

To solve this will take a couple of steps. The first thing you need is to build back up that lost jawbone. A simple outpatient bone grafting procedure can do that for you. Once you’re healed from that you have a few choices. I would never dare ask your age, but it will have an effect on which you choose.

The cheapest solution is to have new dentures made, but remember in a period of time, you’ll face the same issue of a shrunken jaw.

If you want the top-of-the-line tooth replacement option, then I’d get implant supported dentures. These attach your newly made dentures to dental implants. They will last a lifetime and prevent you from any further bone loss. The only drawback is the expense. They come with a hefty price tag.

In between those two treatments, is something called snap-on dentures. I’ve posted a picture of them right after your question. These use just two implants that will snap on to your dentures. They’re not as secure as a full set of implants would be, but they will keep your dentures in.

If you want to, you can add more implants as you’re able.

This blog is brought to you by Dr. Randall Burba.

Can Children Get Porcelain Veneers?

My son is almost nine and he fell and chipped his front tooth. It’s a permanent tooth so I want to repair it in a way that will both last and look natural. I had porcelain veneers done several years ago because of stained and chipped teeth and love them. Can children have veneers done? I think he’d only need one.

Carla T.

Dear Carla,

A chipped tooth
Can Porcelain Veneers Fixed Chipped Teeth?

It’s fantastic that you’re looking out for your son’s smile. I especially like that you’re thinking through a permanent solution for him. While porcelain veneers can repair chipped teeth, I don’t recommend them in children.

Their jaws are in almost constant development throughout their childhood. That keeps the way their bite relates to its surroundings in flux as well, making it nearly impossible to keep on without changing it often. While technically do-able, it’s an expensive way to repair his chipped tooth, especially when there are better options.

Repairing a Chipped Tooth Without Porcelain Veneers

There are three basic options for repairing a chipped tooth. I’ll list them from most expensive to most affordable. You can click on each link to learn more.

You’ll have the same problem with porcelain crowns that we discussed above regarding porcelain veneers. However, this also will require grinding down a great deal of healthy tooth structure. Rarely do I suggest that.

Additionally, your son has experienced tooth trauma. You need to schedule an emergency appointment with your dentist so he can check for nerve damage and can take steps to deal with that, if necessary.

Dental bonding is the standard treatment for chipped teeth and it is a lot more affordable. While it will have to be updated every once in a while, it will hold up much better on a growing jaw because of its design.

Because dental bonding is done freehand, you will want to make sure you have an artistic cosmetic dentist to do the procedure.

This blog is brought to you by Dr. Randall Burba.

Can Dentures Be Attractive?

Everyone I know who have dentures have an ugly smile. I’m losing my teeth and need to replace them. I am going to save up for dental implants, but in the meantime I need dentures. I don’t want an ugly smile. Is there a way to get attractive, normal looking dentures?

Kevin

Dear Kevin,

Mature couple smiling
You can have a gorgeous smile no matter what your age!

Yes, you can certainly have an attractive smile with dentures. It’s not the procedure which makes the difference in appearance, but the dentist. In order to have a natural and attractive smile, you need to see a cosmetic dentist with a lot of expertise.

There are different levels of artistry in cosmetic dentists, just like there are better and worse painters and sculptors. Any art is a skill which takes both technical skill, natural talent, and lots of practice. So, how do you find such a dentist?

I suggest you look for a dentist who has reached accreditation level with the American Academy of Cosmetic Dentistry. AACD accredited dentists are in the top 1% of expert cosmetic dentists in the world.

Transitioning from Dentures to Dental Implants

I’m sure your dentist has explained the dangers of dentures to you and that’s why you’re saving up for dental implants. One thing you could do starting out is to get snap-on dentures. This can be done with as few as two dental implants and will at least get you started.

Make sure that whoever you go to for your dentures also has some expertise in dental implants as well, especially because you’re going to be transitioning. They can do your snap-on dentures or even complete removable dentures in a way that will make the process easier.

The Danger of Dentures

In case your dentist didn’t explain why implants are the better option I’m going to put it here for you and for the benefit of others. Once you remove your teeth, your body will begin reabsorbing the minerals in your jawbone to use elsewhere throughout your body. This causes your jawbone to begin shrinking. Eventually, you won’t have enough jawbone left to even retain your dentures, making it nearly impossible for you to eat. This process is known as facial collapse.

Dental implants prevent facial collapse because the root form tricks your body into thinking you still have natural teeth there and it leaves the mineral in place, saving your jaw bone structure.

This blog is brought to you by Dr. Randall Burba.