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TMJ Dentist or General Dentist

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I am not sure what to do. I’ve never had a cavity so I’m not sure if this is it. The back area of my mouth, where my molars are has periodic sharp pain. I do grind my teeth but have never had pain from it. I mentioned it to a friend and she thought it was TMJ. Do I see a TMJ Dentist first or a general dentist to check on the cavity thing?

Cady L.

Dear Cady,

Woman grabbing her jaw with pain

First, let me congratulate you on having never had a cavity before. That’s fantastic. Not many adults can say that. There are several possibilities going on here. However, I want to clear up a common misunderstanding before we get into that. There isn’t a TMJ Specialty. That means a TMJ dentist is a general dentist who, hopefully, has invested time in TMJ training. Look at Dr. Hadgis’ TMJ Dentist page to get an idea of what you’re looking for.

TMJ or Other Dental Concern?

I’m concerned that your dentist hasn’t addressed your night grinding. In fact, that could be the very cause of your pain. Grinding your teeth can damage your jaw, leading to TMJ. It also wears down your teeth and can lead to cracked or loose teeth. This should have been addressed long ago. A simple nightguard can protect your teeth from the grinding.

It’s possible your molars have suffered some damage and that’s why you’re in pain. It’s also possible you have a cavity or the beginning of a tooth infection.

Your best option is to see a dentist who also is familiar with TMJ. He’ll do some x-rays to try and diagnose the problem. If it’s a cavity, a simple composite filling is an easy solution. What you don’t want is to continue the grinding without prevention because you’ll end up losing a tooth. Then you’re stuck looking for tooth replacement options.

This blog is brought to you by Dr. Theodore Hadgis.

Is 75% off dental implants too good to be true?

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I just received an advertisement in the mail that said I could get dental implants for 75% off. Is that a legitimate offer? I know how much my dentist charges for dental implants. 75% off would be extremely helpful. Is it OK to go to this dentist with the sale just for this one procedure and then go back to my dentist for everything else?

Bethany – Minnesotta

Bethany,

There is an old adage/proverb that says, “If something seems too good to be true, it probably is.”

Let’s do a little math. In general, a single implant costs around $2000. At 75% off it would be $500. If they’re using high quality fixtures that have been approved by the FDA and ADA, the fixtures alone will cost from between $300 to $500. That doesn’t leave the dentist much profit, if any.  If the dentist used a service to market his special they’ll take about half of his fee, which could leave the dentist in the red.

Now a dentist may have gone into the field because they like helping people, but they won’t stay in business long if they don’t make money. So, how do you think the dentist will handle the implant situation?

Many dentists are honest and will honor their special even if it means losing profit. However, there are dentists who will do whatever it takes to stay in the black, even if it is dishonest. Maybe he’ll use cheap dental implant fixtures. If so, that not only puts you at risk for dental implant failure, but can put your health at risk too.  Maybe they’ll save money by placing mini implants instead of traditional implants. Or maybe they’ll  raise their rates right before the 75% off, so as not to lose so much per procedure.

Whatever you decide, talk it over with your dentist. He will find  out about you going somewhere else the next time you came in for an exam anyway, so you might as well get his input.   Your dentist may even know the ohter dentist and can give you his opinion of hin or her.

The trust between a dentist and patient is irreplaceable.

This blog is brought to you by Grosse Pointe Woods dentist Dr. Theodore Hadgis.

Do I need a TMJ specialist?

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Can I go to a dentist for TMJ treatment, or do I need a TMJ specialist?

Elwyn T.- Minneapolis

Elwyn,

TMJ is not a recognized specialty, so many doctors call themselves TMJ specialists, including general dentists, orthodontists, and oral surgeons. So, if anyone can call themselves a TMJ specialist, how do you know who you can go to for treatment?

Treatment can vary from using an oral appliance, to neuromucular treatment, to orthodontics, or even surgery. You want to make sure you have someone with real expertise, because some of these treatments can cause irreversible damage.

Whoever you go to for treatment needs to have extensive post-graduate training. The knowledge necessary to adequately correct this is not available just in general dental school. Find someone whose had training at the  Las Vegas Institute for Advanced Dental Studies or at the Dawson Academy.

It is always wise to begin with the most conservative treatment first, unless the core issue is very obvious.

This blog is brought to you by Grosse Pointe Woods Dentist Theodore Hadgis.

 

Anterior Repositioning Splint

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My dentist is suggesting I get an anterior repositioning splint. Can you tell me a little about them?

Samantha B.- Detroit, MI

Samantha,

Sure. An anterior repositioning splint is a treatemtn used by a TMJ Dentist to properly position the hinge of your jaw. They are used if your jaw joint is in the wrong place. They are made of acryllic and are generally worn around three months. Your speech is only affected if it is worn on the top arch.

While you wear it, your jaw joints are moved into a more forward position, in order to properly place them.  When the treatment is completed, you will notice your pain and any clicking or locking of your jaw joints.

I hope this helps.

This blog is brought to you by Grosse Pointe Woods Dentist Dr. Theodore Hadgis.

Dark spots on teeth

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I have these dark spots on my teeth that I got when I was a child.  My mom said it happened during an illness in my childhood. I’ve always been embarrassed by my spots.  My dentist has been trying to help me with them.  We’ve tried every kind of over the counter whitening product you can imagine. It makes the dark spots look darker because it only whitens the spots around it.  We can’t decide whether to try professional whitening first, or try to sand down the dark spots.  What do you think?

Carrie H. – Mississippi

Carrie,

Your dentist doesn’t understand teeth whitening and she could do serious damage to your teeth.  Professional teeth whitening will do the same thing the over-the-counter whitening products do as well, only better. That means the areas surrounding your spots will be really white. Your brown spots will still be brown.

The best thing you can do is to get porcelain veneers placed over the teeth.  However, this is not something you want just any dentist doing.  If your dentist doesn’t understand teeth whitening, I sincerely doubt they will have the expertise you need for the porcelain veneers to turn out attractive.

I suggest you look for someone in your area who is accredited with the American Academy of Cosmetic Dentistry (AACD).  Accreditation is different from just being a member. Any dentist can become a member. To get accredited, they have to pass a stingent exam, as well as demonstrate the skill and artistry they have on several cosmetic cases.

This blog is brought to you by Grosse Pointe Woods Dentist Dr. Theodore Hadgis.

Picking a Dentist

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How do you go about picking a new dentist? We’ve recently moved and don’t know anyone for recommendations yet.

Olivia R.- Branson, MO

Olivia,

A lot of what you look for in a dentist depends upon your current needs. Do you just want a family dentist, or do you want a dentist who also does cosmetic dentistry?  If you have children and want to stay in the same clinic as a family, you want to look for someone who is comfortable treating children. If you don’t mind going to a separate dentist from your children, you can look for someone who specializes in pediatric dentistry for them and then look for another dentist for yoursef.

No matter what the circumstances, you want someone who’s done more than go to dental school. The dental industry has made huge advancements. No longer is dentistry just about cleaning your teeth and doing a few fillings. There is teeth whitening, dental implants, all-porcelain crowns, and porcelain veneers. It will be helpful if your dentist has post-graduate training in some of these procedures as well. This way you don’t have to constantly be referred out when more advanced needs pop up.

I’d start by doing a Google search in your area for dentists. If they have reviews, read them. Then, go to their website and read about the procedures they offer and what kind of training they have. If you’re looking for someone who is strong in cosmetic services, you’ll want to find someone who is accredited with the American Academy of Cosmetic Dentistry (AACD). If you’re looking for some advanced treatments, such as dental implants, look for someone who has done additional study with a place like the Las Vegas Institute of Advanced Dental Studies (LVI).

Dr. Hadgis is one of those rare dentists who is both an expert in advanced dentistry as well as an artist.  He is both AACD accredited and is a fellow with the Las Vegas Institute of Advanced Dental Studies.

I hope this helps.

This blog is brought to you by Grosse Point Woods Dentist Dr. Theodore Hadgis.

Ugly crowns

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I have a problem and really need to re-make my smile. Many years ago I got dental crowns. They are in bad condition and you can see this line at my gumline. How can I fix this. Money is not an issue.

Teddy S.- Baltimore,MD

Teddy,

The best way to fix this issue is to get all new crowns. This time, you’ll want to get all-porcelain crowns. You will not want anything with a metal foundation. That is why you have a dark line at your gumline.

Equally important to what type of crowns you get is what dentist you get to place them. Don’t just get  your average family dentist who does some cosmetic work to do these.  You want to get someone who is an expert cosmetic dentistry.

I would look for someone who is accredited with the American Academy of Cosmetic Dentistry (AACD). If you can’t find someone with accreditation within driving distance, then I would get on mynewsmile.com and see who they recommend from your state. They are very strict with their qualifications. Any one of them can give you a gorgeous smile.

This blog is brought to you by Grosse Pointe Woods Dentist Dr. Theodore Hadgis.

Discolored Fillings

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I have decent teeth that I am fairly happy with. There is one problem that really bothers me though.  My front tooth has a filling on it that doesn’t match my other teeth. I talked to my dentist about it and he said that if I wanted my tooth to look uniform I should get Lumineers to cover the filling and tooth. Do you agree with that treatment plan. I looked into the Lumineers and they are quite pricey.

Cindy T.- Illinois

Cindy,

No, I don’t agree with his treatment plan. All your dentist would need to do to fix the discolored fillings is to use a dental bonding material to match your teeth. With some cosmetic skill you can make the bonding match any tooth color under the sun. However, you saw the qualifier, with cosmetic skill. It is very obvious to me that your dentist doesn’t have that. If he can’t match dental bonding to your teeth, than he can’t match Lumineers to your teeth. Plus, Lumineers tend to make your teeth look bulky.

You said you are fairly happy with your teeth. To me, if you are happy with their shape and color, then I would go to a great cosmetic dentist and do the dental bonding procedure. However, if you wouldn’t mind changing the shape, size, and/or color of your teeth, than you might want to look into porcelain veneers (Lumineers are just a specific brand of porcelain veneers). I wouldn’t worry about which brand to get. Instead I would focus on which dentist to use. An expert cosmetic dentist can give you a gorgeous smile makeover.

To find one you can either contact the American Academy of Cosmetic Dentistry (AACD) and tell them you are looking for an accredited dentist in your area, or you can go to the mynewsmile.com website and see who they recommend for an the area you live in.

This blog is brought to you by Grosse Pointe Woods Dentist Dr. Theodore Hadgis.

Lumineers are too thick

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I recently got Lumineers and I really like how they look. However, my lip keeps getting caught on them when I’m talking. IS there anything I can do about it?

Corinne E.- Minnesota

Corinne,

Lumineers are often marketed as a no-prep technique. In many other brands of porcelain veneers, your teeth are shaved just a smidge  (about the depth of a fingernail). When you don’t do that, they can be a little bulky and a few millimeters too long. I suspect this is why your lip is getting caught.

If your dentist is an expert cosmetic dentist, then it is possible to gently shave the Lumineers and then re-polish them. However, your dentist would have to be in the top 1% of dentists in order for that to turn out well.

Your only other option is to have the Lumineers re-done, but this time with some tooth preparation.

This blog is brought to you by Grosse Pointe Woods Dentist Dr. Theodore Hadgis.

Why won’t ovate pontic work for me?

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I need to get a bridge to replace two of my front teeth. I asked my dentist to do the ovate pontic technique that I keep reading about, but he said it won’t work for me because my gums are already healed. He said that they only work when teeth have first been extracted. I don’t understand that, and to be honest that is the first I’ve heard of that. I realize I am not a dentist, but I have done a lot of research on this. Am I confused about something? Why won’t it work after your teeth are extracted?

Andrea H.- Albany, NY

Andrea,

You are right. It is not accurate that a dental bridge can only be placed by that technique when the teeth are freshly extracted. In fact, I suspect  that your dentist is uncomfortable doing the ovate pontic procedure and does not want to lose your confidence. We are taught in dental school that a dentist must display confidence at all times. This is for your benefit too. It helps to reduce your anxiety in the dental chair. So, if he isn’t skilled in a procedure, he needs to deflect you from it. He does that by telling you the procedure works in your situation. He’s the dentist and therefore “knows best”. Generally a patient will drop it from there.

I would not push him into the procedure, even though you are correct and he is not. When a dentist feels pressured to perform a procedure that he is not highly skilled in, generally disasters follow.  You will end up with a dental bridge that makes you embarrassed to smile.

Another thing to be aware of, especially because it is your front teeth is the need to have a highly skilled cosmetic dentist to do the procedure. There is more than just technique with your gums to be concerned with. The color and translucency of the bridge will be very important to having a beautiful smile. It takes significant post-graduate training to make a smile look both natural and beautiful. So more than just looking for someone who can perform a certain technique, I’d also look into their cosmetic training. You’d be safest to find a dentist who is accredited with the American Academy of Cosmetic Dentistry (AACD).

This blog is brought to you Grosse Pointe Woods Cosmetic Dentist Dr. Theodore Hadgis.