Tag Archives: teeth grinding

Collapsing Mouth

My dentist is suggesting I get porcelain veneers for an issue I’ve been having. My mouth seems to be collapsing. It is getting harder and harder to see my teeth when I smile and I’ve even been having trouble saying certain letters such as P and T. I want to make sure that porcelain veneers are the right solution before I move forward. It’s a rather expensive procedure.

Elizabeth

Dear Elizabeth,

If your dentist suggested that porcelain veneers would fix your problem, he is mistaken. The only thing it will improve is the appearance of your teeth. Even that will depend on his or her skill as a cosmetic dentist.

You have a bigger issue than just the appearance. Based on your description, it sounds like your teeth are worn down. It’s likely you are grinding your teeth without realizing it. Most patients who grind their teeth do so while they are sleeping.

This grinding wears the teeth down to little nubs and causes your mouth to over close. This can lead to TMJ disorder and will give you a lifetime of jawpain and migraines.

You’ll need a dentist with extensive treatment in TMJ disorder in order to fix this properly. This is especially true with a case like yours which will be more advanced than most.

In your place, I’d look for a dentist who received training in one of the following institutions, which are all highly reputable.

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

A dentist with this type of training will be qualified to provide you with the solution to fix your bite and your appearance.

This blog is brought to you by Salem, MA Cosmetic 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.

Lumineers for Sensitive Teeth

I have very sensitive teeth and I can’t figure out why. It’s been causing me to lose a lot of weight. I can’t eat. It’s too painful. My dentist suggested we place Lumineers on my teeth to cover them. Will that help with the sensitivity?

Madison.

Dear Madison,

A single porcelain veneer being placed

Yes, getting a smile makeover can help with the sensitivity. However, before you do that, it is important you isolate the cause. Here are just a few things which could be giving you the problem:

  • Tooth decay. Though, if you’ve been having regular checkups, that should already have been eliminated.
  • Leaky fillings which need to be replaced.
  • You grind or clench your teeth. This can happen without you knowing it while you are sleeping.

There are other causes as well. The key is to evaluate why.

A Smile Makeover

I’m concerned your dentist immediately jumped to Lumineers. This is a brand of porcelain veneers often marketed to inexperienced dentists as being easy to place. That isn’t always the case. Plus, there is a lot more to a beautiful smile than the bonding procedure.

If you’re going to invest in a smile makeover, you’ll want to do it right with a dentist who has both the technical skill and artistry to do it well. There isn’t a recognized specialty in cosmetic dentistry. Any general dentist is allowed to do it. It’s also up to them how much training they get. Unfortunately, it is not a skill taught in dental school. Dentists have to take the initiative to get the training needed in a post-doctoral setting.

If I were investing in a new smile, I’d want the best dentist to do it. Dentists who’ve reached accreditation with the American Academy of Cosmetic Dentistry are the top of their field. They can provide a stunning smile for you. The kind you see the Hollywood celebrities get. I will tell you, they will likely suggest a completely different brand of porcelain veneers than what your family dentist suggested. Lumineers aren’t known for their beauty.

This blog is brought to you by Salem, MA Cosmetic 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.

Can a Dental Crown Cause TMJ

I’ve had a problem over the last month of my jaw aching, especially in the morning. I’ve been under some stress and have caught myself tensing my jaw some throughout the day. Then, I got a dental crown. It’s made the pain so much worse. I went back to the dentist…several times. He’s adjusted it several times, but the pain never seems to go away now, plus, it’s always hitting my other teeth before the others. Could this be causing TMJ?

Beatrice

Dear Beatrice,

Woman holding her jaw in pain

Yes, a poorly placed crown can certainly cause or exacerbate existing TMJ problems. There is a lot that goes into understanding how the bite should go together. Some dentists invest more time and training in that area than others. You may have a dentist who doesn’t invest much in it.

The fact that your teeth are not meeting uniformly is a cause of concern and he should know that. Some dentists who have trouble getting it right will just adjust and adjust until the patient is too embarrassed to keep complaining and drop it. This needs to be fixed.

The fact that your jaw had already had some minor pain and you’d noticed some clenching during the day worries me too. If you notice clenching during the day, you almost certainly are doing it at night as well. You should be wearing a nightguard. They’re custom fit to your bite and comfortable. Their function is to protect your teeth and jaw from the pressures of clenching and grinding.

Finding a TMJ Dentist

It doesn’t sound like your dentist is going to deal with this properly, so you need to see one who understands TMJ. While there isn’t a recognized TMJ Specialty, there are ways to know if a dentist has a good knowledge of the condition.

You’ll want to especially look at their post-graduate training. Don’t feel weird asking them about it. It’s important knowledge for you in choosing the right dentist. For instance, Dr. Stanley Burba invested significant training on TMJ Disorder. He’s studied at both the Spear Institute and the Dawson Academy.

Some other great centers are the Kois Center and the Las Vegas Institute for Advanced Dental Studies (LVI). If a dentist has trained at any of these institutes, they’re sure to be able to help you.

Additionally, if it turns out that your dental crown isn’t properly placed the new dentist can help you get a refund from your current dentist.

This blog is brought to you by 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.

Store Bought TMJ Treatment

I’m drowning in medical bills right now and don’t think I can afford a dentist. But, my jaw has locked up. My sister says TMJ does that and that I need an oral device to help. All I know is I can’t even eat. I’ve heard you can use an oral mouthguard to treat TMJ. I saw one at the pharmacy the other day and it was only about $20. I can afford that much. Is there anything I need to know about using it?

Drew A.

Dear Drew,

TMJ Treatment Dentist

Your sister is right on both points. Lock-jaw is often caused by TMJ Disorder. While, the orthotic anterior repositioning splint can be used to treat TMJ, that’s not what you saw at the store. A mouthguard is completely different. They’re used to protect people’s teeth from habitual tooth grinding. If that’s an issue you struggle with, you’ll want a mouthguard after you finish your TMJ treatment. However, the store bought ones aren’t custom fit. They just come in small, medium, or large. You can also find a one size fits all. They’re okay on a temporary basis, but you’ll grind through them rather quickly.

One made by your dentist will be more effective. I know your TMJ is the focus right now, but if you don’t protect your teeth from the grinding there are serious consequences. Not only does the grinding aggravate your TMJ, but it can lead to cracked teeth or even teeth coming loose and needing to be replaced. Best case scenario, they end up ground down to nubs and all need to be crowned. Talk about expensive!

But, back to your current issue. Here’s what I’d like you to do in the immediate so we can try to get the swelling down and get you eating again. I’d like you to take 800 mg. of ibuprofen about three times a day. In addition, you need to alternate heat and ice packs. Wear them for about ten minutes at a time, a few times a day as you’re able.

You will need to see a dentist to get the appropriate treatment. I know you’re buried in medical bills right now. Many dentists are compassionate and would be willing to work with you on payments so you can get the treatment you need right away and pay it out later.

Even if you can’t find one willing to work you, Care Credit is a fantastic option. It’s a medical “credit card”, but they let you choose your terms.

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

Diet or Dentist For TMJ?

I feel a little foolish asking this question but I’m wondering if TMJ can be a diet related problem? I have horrible jaw and head pain, especially in the mornings. My closest friend truly believes that if I switch to a whole foods diet it will be taken care of. Even as I type it, it seems like a stupid idea. However, I’ll have to admit my friend is a lot healthier than I am. So maybe there is something to what she has to say.  Do I need a dentist or a diet change?

Lucia M.

Dear Lucia,

There is one aspect of TMJ which can be diet related, but one only. Chewing. TMJ is a disorder of the temporomandibular joint.  Changing your diet won’t repair the joint. However, if you’re eating things such as raw carrots and apples it could be adding stress to the joint. It might be a good idea to lay off the hard and chewy foods while your dentist gets to the cause of your problem.

Your symptoms sort of sound like the cause could be teeth grinding. You wouldn’t necessarily even know you’re doing it if it’s happening while you’re asleep.

If that’s the cause, a simple mouthguard could be just the solution for you. Your dentist can custom design one to fit comfortably in your mouth while you sleep. If you start to grind your teeth, the mouthguard will absorb the pressure, protecting your teeth and your joint.

This will also protect your teeth from damage. The grinding can cause your teeth to become loose or cracked, causing you to need a dental crown.

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

I’ve had some degree of dental anxiety ever since I was a child, but I did a fair job of keeping up with appointments until I was in my early 20s. At that point, I was having some minor jaw pain and the doctor also found a couple of cavities that needed to be filled. He knew about the jaw pain, but told me there wasn’t any cause for concern over it. He felt it was related to grinding at night. My experience with the fillings, however, was horrific. He must have made me keep my mouth open for about two hours straight. It hurt so bad and I kept telling him I needed a break, but he kept going and telling me it would only be a minute or two more. By the end of it, tears were streaming down my face and he basically told me I was acting like a child. It really hurt! I couldn’t eat normally for weeks after that and I haven’t been back since. Now, I know my teeth have some issues going on, but my jaw pain is really flaring up again too. I think I should see a TMJ dentist for that, but where do I go first? Can he treat me before I get my cavities filled, so I can get through the treatment or do I need to start with my teeth and then address my jaw? I don’t think I can do more fillings before fixing my jaw pain.

Marie E. – Pittsburg

Dear Marie,

See the TMJ dentist first. It sounds like you’re already familiar with how one can help you. A TMJ dentist can address the root cause of your jaw pain and hopefully get it to settle down so you can be comfortable getting your other dental needs seen to.

With that said, something about what you said jumped out. You mentioned that your prior dentist said you grind your teeth at night and that’s what was causing your jaw pain. If this is the case, getting a simple night guard made might be all you need to address the sore jaw. Undoubtedly, the TMJ dentist will discuss this with you if you’re a good candidate for one. However, what’s striking is that your prior doctor didn’t mention this. It was cause for concern and should have been treated back then.

Continuous grinding not only strains your jaw and muscles, but wears down your teeth. If wouldn’t be too surprising to find that you’ve weakened the biting surface of your teeth enough that they’re either sensitive or highly susceptible to decay. In extreme circumstances, you can wear them down enough or crack them so that they’ll require crowns, but most of the time fillings can repair the damage.

Although this doesn’t matter in terms of getting you out of immediate pain, you may want to keep this in mind for when you go in for a full diagnosis. It’s not the end of the world by any means. You’re on the right path and will get your dental concerns addressed, but it could take some time to restore the damage that’s occurred over years of grinding. Best of luck to you.

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

Could a crown make TMJ worse?

I’ve been diagnosed with TMJ. My dentist suggested a night guard, which I’ve resisted, mostly because the TMJ only bothers me for a short time in the morning.  I recently got a dental crown.  It’s hitting the tooth above it way before my other teeth do, which is uncomfortable. I’ve mentioned it to my dentist and he said he could grind it down or try to adjust it. But, I’ve also having a much more difficult time with my TMJ. The pain has gotten worse. Could that also be from this crown? Should I let my dentist ground it?

Sylvia M. – New Jersey

Sylvia,

I’d like you to take a step back from this dentist and get a second opinion on your crown. Understanding how bites come together properly takes a significant amount of study and training.

Without the bite properly aligned, it could significantly increase your TMJ symptoms. Just grinding it down won’t help and could hurt the crown.

I’d like you to get a second dentist to look at this crown before moving forward.

Also, it will be important to get that night guard, if you truly do have TMJ. It will protect your teeth from nighttime grinding, that you may not even realize you’re doing.

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