Tag Archives: Bruxism

Dentist Destroyed My Smile

I have some abrasion lesions that my dentist decided to help me repair after much begging. Now I think I may have made a mistake. I had a beautiful smile with the exception of the lesions– emphasis on had.

We did dental bonding on the teeth at the gumline and nothing matches. The color my dentist put on there is way too dark and opaque compared to the rest of my teeth. My friends that have seen it have all been quietly polite, but I have noticed the double takes. Is it safe to remove this and have it done by someone else?

Candace

Dear Candace,

I’m sorry you are in this position. This is just one example of why I always tell people who write to not pressure their dentist into a procedure, even a procedure like this one, which should be within their skill set.

Image of a tooth with abrasion lesions

The image directly above is for the benefit of those who may not know what abrasion lesions are. A dentist can simply remove the dental bonding that was done and put new bonding on. I don’t think your dentist is going to be able to do this.

Though technically, with this procedure, any dentist should be able to do it, in most cases of real cosmetic dentistry work, like a smile makeover, you’d need a dentist who has invested in a lot of post-doctral training. As you are going to need another dentist to fix this anyway, I suggest you get the best cosmetic dentist you can. This way you won’t have to worry about another disaster. AACD accredited dentists are in the top 1% of their field. I’d start there.

If you don’t have one in a reasonably close proximity to you, my next stop would be mynewsmile.com. A retired accredited dentist pre-screens every practicioner who wants to be listed. They can’t just pay to get on. Instead, they have to prove their technical knowledge and skill as well as show their artistry. Anyone listed on that site will do a phenomenal job for you.

A Word about Your Dental Bonding

We used to think the reason for abrasion lesions was brushing too aggressively. The latest research, however, seems to indicate it is more the result of someone who clenches their teeth a lot. Clenching makes the teeth flex somewhat at the gumline, this in turn weakens the tooth there and leads to the abrasions.

Because of the flexing, I’m going to recommend you ask your dentist to use a softer, flexible composite bonding material. Otherwise, with a hard material, it could lead to your bonding popping out.

You may also consider having your dentist offer you a custom nightguard. This will help protect your teeth from clenching and grinding, though the night when you are least likely to notice it.

This blog is brought to you by Salem, MA Dentist Dr. Randall Burba .

My Dental Bonding Turned Yellow

I had dental bonding placed on four front teeth. I was happy with finally having front teeth which didn’t looked so damaged and chipped. I tend to grind my teeth so that was a problem. I wanted to take care of them and started brushing with baking soda. I’ve only had them for less than a week and they’re already turning yellow. Did the baking soda have a chemical reaction with the bonding? Will teeth whitening fix them?

Kelly

Dear Kelly,

before and after dental bonding

There are a couple of things going on here which are setting off warning bells in my head. First, is the care of your dental bonding. I’m concerned that your dentist didn’t seem to give you any post-operative care instructions for your bonded teeth. This could have prevented this issue.

While you had good intentions in trying to take good care of your bonded teeth, you weren’t instructed on how to do that. Unfortunately, baking soda is quite abrasive and will eventually wear off the protective polish on your bonded teeth. If you really want to take good care of them, I am going to suggest you switch to Supersmile Toothpaste after this is fixed. This is specifically designed to clean and protect cosmetic dental work. It’s perfect for natural teeth as well.

As for teeth whitening, it will not work on your dental bonding. It only works on natural tooth structure, which means your natural teeth will get whiter, but the bonded teeth will be unaffected. This will make them look worse, not better.

Because you’ve had them for such a short period of time and your dentist didn’t instruct you in their care, I suggest going back to your dentist and asking him to fix them at no charge. If he knows the polishing technique, he can do it that way. Otherwise, he’ll need to just re-do them.

A second possibility is that your dentist used inferior materials when he placed your bonding. I hope that is not true. The only way to know with certainty is after you have them fixed. If you are caring for them properly and they turn yellow again, it is his material.

I’m also providing a link here, which gives you a lot of information on dental bonding. If you scroll toward the bottom, it will tell you how to care for them.

Bruxism and Dental Bonding

Another thing which has me concerned is your teeth grinding. When you clench or grind your teeth it will lead to damage. You’ve experienced this yourself and it is why you had the bonding done in the first place. However, without addressing the cause of the damage, the bonding won’t hold up any better than your natural teeth did.

It doesn’t sound like your dentist has addressed this. There is a simple solution too. Have him fit you for a nightguard and your dental bonding, as well as the remainder of your teeth, will be protected. Without it, they’ll end up ground down to nubs and you’ll eventually need a full-mouth reconstruction.

This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.

Her Dentist Isn’t Helping Her

I have a puzzle I’m hoping you can help me with. I had a check-up just a couple of months ago. They said everything was good to go. Yet lately, I’ve been having this weird pain on one of my back teeth. It feels like someone is pulling at the tooth briefly and then letting go. It is sort of hard to describe. I haven’t had a cavity before so I don’t know what they feel like. The only other thing I can think of is my husband says I grind my teeth at night. Could that be it? What do I do? I don’t want to go back to the dentist unnecessarily.

Paula

Dear Paula,

Woman grabbing her jaw from pain.

I know you said your dentist gave you the all-clear, but I am quite concerned you’re not getting the proper care from your dentist. Some “bread and butter” dentists, especially those from discount clinics will check your teeth for cavities, but ignore all the peripheral issues, such as gum disease and teeth grinding. Both of those issues are extremely important to deal with.

Bear in mind I haven’t examined you and am going just on the pain as you described it. It could be either from your grinding (known as bruxism) or from gum disease. Usually, by the time you feel pain from gum disease, there has been some bone loss and that is dangerous for you. It could lead you to losing your teeth.

The grinding should have visible evidence at this point. Not only will it lead to TMJ Disorder, but eventually your teeth will be ground down to nubs requiring a full-mouth reconstruction. This means putting a dental crown on each one of your teeth that are worn down. I can pretty much guarantee your current dentist isn’t qualified to do that procedure. It takes advanced training.

You Need a Second Opinion by a TMJ Dentist

I’d like you to see another dentist. Almost all dentists should know how to recognize and treat gum disease. That won’t be the tricky part. I want you to see a dentist with advanced TMJ training. This isn’t a recognized specialty. Instead, a dentist has to take the initiative and decide it is something he or she wants to treat and get the training to enable them to do it well.

Some of the more reputable post-doctoral centers that do great training in TMJ are The Las Vegas Institute for Advanced Dental Studies (often called LVI), The Dawson Center, The Kois Center, and the Spear Institute. Look for someone with training from at least one of these schools.

This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.

Do I Have Oral Cancer

Lately, every morning when I wake up my jaw and teeth hurt like mad. I can’t see anything wrong with the teeth or gums. Is this a symptom of oral cancer? Cancer runs in my family, not this kind in particular but a variety of others. I’m trying not to panic. Would this be a dental emergency?

Macy

Dear Macy,

Woman holding her jaw in pain from TMJ

Don’t panic. If you see a dentist regularly, they should be doing checks for oral cancer. I wouldn’t consider this a dental emergency necessarily and I would be surprised if it was any type of oral cancer. In fact, I think you are dealing with bruxism. You need to bear in mind that I haven’t seen you and am going purely on the symptoms you mentioned above.

Pain in the jaw and teeth is often caused because we grind or clench our teeth in our sleep without realizing it. Your dentist would normally notice signs of this because it wears down the surfaces of your teeth. This could be a fairly new habit for you which would explain why your dentist hadn’t mentioned it yet. Maybe there is new stress in your life which can be causing it.

Bruxism Can Lead to a Dental Emergency

When you are grinding or clenching your teeth it damages them. This can lead to you cracking a tooth or causing it to come loose. Putting off treatment for this can even lead to an extreme procedure known as a full-mouth reconstruction where all your teeth have to be crowned to fix the bite.

Truthfully, it is much easier and affordable to deal with this now. This is especially true because the solution is so easy. Your dentist can fit you with a night guard. This is a simple custom-fitted mouthpiece which you will wear while you sleep. It takes the pressure off of your teeth, protecting them from the damage they would normally incur. Because your dentist fits it to your particular bite, they are very comfortable.

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

Dentist Blamed my Bite for Broken Teeth

I kept breaking teeth when I ate. My dentist said it was because of my bite and suggested I crown every tooth so he could fix it. That was 50K+ so I expected decent results. Instead, I have several broken crowns. Now, my dentist is blaming my habits for breaking my teeth. He said I’m grinding my teeth at night and need to wear a night guard and something else during the day. I’m having trouble buying this for two reasons. First, because he originally said the cause was something else but when his repair didn’t work he’s now suddenly coming up with a bad habit that’s my fault. And this is the first time I’ve heard of this so-called habit. Second, because I break my teeth when I eat and not when I sleep. Do you have a recommendation?

Kyle

Dear Kyle,

Chart of TMJ and Neuromuscular Dentistry

I understand why you’re concerned. It doesn’t sound like your dentist really knows what he’s doing with this. After spending over $50,000 dollars, you have a right to be frustrated. I have two suggestions for you. First, I want you to get a second opinion. However, I don’t want you to get it from any dentist. Instead, I want you to find a TMJ Dentist.

While there isn’t a TMJ Specialty, there are dentists who’ve invested more time in studying the causes and treatments. You want a dentist who’s invested the time doing that post-doctoral. For instance, Dr. Burba studied at both the Dawson Academy and Spear Institute. Both are well known for their TMJ and neuromuscular training. Another great school for that is the Las Vegas Institute (LVI).

The reason I want you to see a TMJ dentist is due to the crowns you’ve had placed. What your dentist did is known as a full-mouth reconstruction. It takes expert level knowledge in occlusion to do this correctly or you could end up with serious problems with your bite. I don’t have the confidence your dentist has done this training.

TMJ and Night Guards

The second thing I’m going to recommend is you follow through with his suggestion of a mouth guard. While he didn’t run any tests or talk about evidence of teeth grinding before this problem, a night guard is not a bad idea. Though, I doubt you’ll need one during the day. The reason I say that is because people who grind their teeth at night don’t realize they’re doing it.

Teeth grinding causes a bunch of problems. Not only can it lead to TMJ Disorder, but it can also cause you to crack or break your teeth. I realize when your teeth break is during meals, however, that doesn’t mean they’re not being weakened by the habit.

One other thing. If you do grind your teeth and there was evidence of that, but your dentist didn’t mention it until now, that is severe negligence on his part. If that’s the case, I think you need a new dentist.

This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.

How Do I Know if I Have TMJ or TMD?

I’m at a loss. I’ve been doing some research and have narrowed it down to two conditions, but I can’t tell the difference between them so don’t know who to see.
Here are my symptoms:

  • Jawpain
  • Headaches
  • Clicking in jaw
  • Teeth have shifted

Do I have TMJ or TMD? Who do I see for it?

Marilyn

Dear Marilyn,

A Chart showing how joints muscles and teeth all work together in TMJ

I understand why you’re confused. These two acronyms are used interchangeably. TMD stands for Temporomandibular Disorder. TMJ stands for Temporomandibular Joint. When the joint is out of alignment, which can happen for several reasons as seen in the chart above, it causes TMD.

Your symptoms are pointing to this disorder, whether you call it TMJ or TMD. You’ll want to see a dentist, but not just any dentist. First, not all dentists treat it because it is so complex. Secondly, some do treat it who shouldn’t. You really want a dentist who’s invested significant training in diagnosing and treating this disorder. As an example, look at Dr. Burba’s TMJ Dentist credentials. This is the type of dentist you want to find in your area.

What to Look for in TMJ Treatment

Because TMJ is so complex, it is imperative your dentist finds the underlying cause of your TMJ in order to begin proper treatment. You also want to start with the least invasive treatment possible. For instance, if it turns out your problem has stemmed from nighttime grinding, the first thing to do is protect your teeth from any further damage.

From there, you can take up repairing the damage. Maybe your teeth are ground down to nubs and you need dental crowns. Or possibly, your teeth have been pushed out of place and you need Invisalign to realign your bite. Maybe you need a combination. The key is a dentist who knows what to look for.

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