Tag Archives: tmj treatment

Dental Double Cross

I’ve kind of had it. I had a dental crown placed on a back tooth. It didn’t feel right from the beginning. The dentist adjusted it, then it fell out. He put it back. It felt worse. He adjusted it again, but nothing got better. He told me I’m just not used to crowns and I’d become accustomed to it. I was frustrated, but what could I do? Now, a piece of it broke off at dinner. I’d had it with the dentist that placed it. Instead, I went to see an emergency dentist. All I needed him to do is reattach the broken piece, but he’s insisting the entire crown needs to be re-done. Now, I have to pay for an entirely new crown. Can’t he just fix it? I’m willing to live with the pain at this point. I just need a dentist who’s not going to do a double cross.

Karen

Dear Karen,

A Dental Crown being Placed

I don’t blame you for your frustration. It doesn’t sound like your dentist has done his job. Nor does it sound like he’s shown any interest in the fact you’re in pain. I have to say, in most cases the “You’ll get used to it line…” is code for I don’t know what I’m doing or how to make it right.

As for the emergency dentist, I don’t think he was trying to cheat you. It’s very likely that the crown broke in a way where a true repair is impossible.

What Caused Your Emergency Dental Visit

There are a couple of things which can cause pain on biting with a crown. The first is a lingering infection. I don’t know if your crown was due to large decay or a root canal treatment. If it was a root canal for an infection, it’s possible there is still an infection there causing pain. There are canals in the tooth which can be quite adept at hiding. It’s possible your dentist missed one.

The second thing which can cause pain is when a crown is seated too high. I tend to lean toward this because of the fact that it broke when you bit down. Generally, our biting force, which is quite substantial, is spread out as our teeth meet together. However, if a crown is seated too high it absorbs all the force. This could lead to it breaking.

Crowns on molars are a little trickier because you have to factor in the occlusion with the other teeth. It’s very likely your dentist could do a fine crown on other teeth, but a molar is a bit beyond his skill set. The fact that his bonding didn’t hold makes me question his skill set already. But, occlusion requires the kind of extra training you would see with dentists who take an interest in treating TMJ Disorder.

Your Options

Option One: You could ask your original dentist to make you a new crown (free of charge). His didn’t meet even the minimum standard of longevity. I don’t know that you’ll get any better results the second time with him, but you’re certainly able to try.

Option Two: You could ask for a refund and allow the emergency dentist to make a new crown for you. The refund would keep you from having to pay for two crowns and you may have better luck with this dentist.

Option Three: As it didn’t sound like you were thrilled with either dentist, you could take the refund and find a completely different dentist altogether.

I hate that you’re having to go through all of this trouble for a crown.

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

My Mouth Is Sinking In

I need some advice. You can barely see my front teeth when I smile. It makes it look like I don’t have any and is embarrassing. I do have jaw pain which I wear a night guard for. My face feels more comfortable and natural when I wear it. But, most of the time, my jaw tightens and I have trouble forming certain letter sounds. My dentist suggested porcelain veneers but I wanted to get a second opinion. What do you think?

Pamela

Dear Pamela,

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

I’m concerned by some things I’m hearing. I think you need a different dentist. While it is true that getting porcelain veneers can give you a gorgeous smile, it will not help the root of your problem. In fact, it’s likely to make it worse, specifically your jaw pain and issues with pronunciation. You may actually end up with a locked jaw.

Go see a dentist with a lot of training and experience in TMJ Disorder. You’re probably thinking, “Great, that’s not a specialty. How do I find one of those?” Well, I’m glad you asked. You can look on their website or ask their staff where they received their TMJ training. If they only mention their dental school, that’s insufficient. Here are some great institutions. I’d want them to list at least one of them:

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

It sounds like this has happened over time, which may mean you’ve worn your teeth down causing them to oveclose. If that’s the case, then it’s very likely you’ll need a full mouth reconstruction. Picking the right dentist for that is just as important as finding an expert in TMJ Treatment.

You want to have a functional smile, but one you’ll also be proud to show everyone. In your place, I’d start by finding an expert TMJ Dentist, but then also see if they’re an expert cosmetic dentist. It is possible to get both. For cosmetic dentistry, the ideal is to get a dentist who has attained accreditation with the American Academy of Cosmetic Dentistry.

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

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.

Do I Really Need to Destroy Healthy Teeth to Fix TMJ?

I’ve been having horrible jaw pain and merciless migraines. Sometimes it’s so bad I can’t even eat and have to drink my dinner of broth through a straw. I went to several doctors and two different dentists before I was diagnosed with TMU. But, he says the only way to fix it is to crown all my teeth to fix my bite. That would mean not only a fortune in dental bills, but destroying healthy tooth structure as well. Is that really the way to go?

Sydney C.

Dear Sydney,

Sometimes a full-mouth reconstruction is the only option, but it’s usually used as a last resort. There are several other treatments which should be tried before that. Additionally, it takes a significant amount of reconstructive and TMJ training to do a full mouth reconstruction. Done incorrectly, it can cause even more pain then what you’re currently in now.

Also, if you do need it, you may find a dentist who uses the composite resin, like you get for white fillings to adjust the bite instead of porcelain crowns. However, don’t push a dentist to use one type of treatment or another. It’s best they use the materials they’re most comfortable with.

In your place, I’d like to see you get at least two more opinions from dentists with lots of TMJ expertise. For instance, Dr. Burba studied at both the Dawson Academy and Spear Institute. Both of these give advanced training in TMJ. There’s never any harm in asking a dentist what type of training and success they’ve had in specific procedures, especially when you’re talking about such a huge, invasive procedure.

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

Orthly App Versus Invisalign

I recently read about an app called Orthly.  It’s a lot cheaper than Invisalign. In fact, I can’t afford Invisalign, but I can this app. Is it safe?

Benjamin H.

Benjamin,

This app hasn’t been available long. It could be a wonderful product, but there are a few things which concern me. The first is that it is developed by students who, like many people including yourself, couldn’t afford Invisalign. That in itself isn’t so bad, but they admit themselves they have no knowledge of dentistry.

They evaluated how Invisalign works and came up with what they felt was an affordable solution. Unfortunately, one of the ways it saves so much money is by keeping dental professionals out of the treatment plan, except for a few “check-ups” by photo to see how your teeth are coming along.

Here’s my concern with those check-ups. How can an orthodontist measure and track things such as mobility, root absorption, periodontal disease, and oral hygiene through a photo? The answer is they can’t. Unfortunately, any of those issues can mean serious problems for your teeth. They can even lead to you losing your teeth.

The jury is still out on Orthy. In your place, I’d talk to your dentist. Let him or her know your financial concern. It’s likely they can work out a payment plan of some type for you which will work with your budget.

Straightening your teeth can do a lot more than give you confidence in your smile. It can help with things like jaw pain and migraines if they’re being caused by your bite.

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.

Why Do I Need an Occlusion Specialist?

I’m a little confused. My dentist has been treating me for TMJ for almost a year. We’ve tried a couple of things, but now he wants to send me to something called an occlusion specialist. Is he just trying to pawn me off?

Elle W. – California

Elle,

I don’t think he’s trying to pawn you off. It’s more likely he realized the cause of your TMJ problems are from your bite and wanted you to see someone who had more training in that area. To me, that means he cares more about getting you the right care than he does about taking your money.

If your bite is off, it really can be the cause of your TMJ. It can throw your temporomandibular joint completely out, that can cause jaw pain, migraines, popping, even lock jaw.

Getting your bite in line can give you the relief you’ve been seeking.

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.

Could an accident cause TMJ problems?

I was in a acr accident the other day and got knocked around quite a bit.  Now  I have a lot of jaw pain and my jaw keeps making a popping sound whenever I chew. Could I have developed TMJ from this? Someone told me that’s what the popping is.

Brenna L. – New Mexico

Brenna,

Popping is a symptom of TMJ and it is possible to get it from a car accident, if your jaw was knocked out of alignmet. The only way to know for sure is to see a dentist who treats TMJ.

Do not hesitate to ask about their TMJ training credentials. There is not a recognized  TMJ specialty. That means any dentist can call themselves a TMJ dentist even without additional training.

Some training qualifications will be Spear, Dawson Academy, The Kois Center, LVI (Las Vegas Institute for Advanced Dental Studies). Those are good qualifications and you can feel assured the dentist will have a valuable understanding of TMJ and how to properly treat it.

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

Numbness in my fingers

I’ve been having muscle spasms in my neck and shoulders. I thought it was stress, but now my fingers are going numb. I’ve been doing some research and wondered if all my problems could be from TMJ, even  the numb fingers?

Elinor D. – Maryland

Elinor,

Yes, you’re likely on the right track. The muscles spasms could be caused from TMJ. These in turn can impinge on your nerves. Those nerves lead down your extremities.  That could be causing the numbness in your fingers.

You’ll need to see a dentist with experience treating TMJ. They can do some diagnostic work in order to determine if TMJ is really your problem.

Sometimes, it is a simple fix that can bring you immense relief.  Just be sure whatever dentist you go to has specific training in neuromuscular dentistry. The Dawson Academy and Spear Institute  are two good institutions for training, as well as LVI. Don’t be hesitant to ask what training they have.

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