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TMJ Treatment: Form AND Function

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I have a teeth grinding problem. My dentist said my teeth were too worn down and I needed crowns. Now, I’ve worn those down too. The problem I have is while my last crowns felt okay, they looked awful. I’ve been told you need a TMJ dentist to do the crowns, which is fine but is it possible to get crowns which also look beautiful?

Karyn

Dear Karyn,

Illustration of how TMJ is affected by neuromuscular issues

You haven’t been given adequate treatment. If your teeth grinding hasn’t been addressed, that means you will grind down these new crowns as well. It’s also why you’ve ground down the ones you have. A simple night guard would have protected both your teeth and your crowns, saving you a small fortune. While you will need new crowns, make sure you get a mouth guard as soon as they’re completed. You likely won’t need to replace your crowns for a long time with protection.

You don’t have to choose between a pain-free life with TMJ and having an attractive smile. However, it will require you finding the right dentist.

Finding a TMJ Dentist Who Can Do a Functional and Beautiful Smile

The first thing you need to find is a qualified TMJ Dentist. What you’re looking at is a full-mouth reconstruction with porcelain crowns. This requires advanced training and experience. For instance, Dr. Hadgis has done extensive post-graduate studies at the Las Vegas Institute for Advanced Dental Studies (LVI), including studies on full-mouth reconstruction.

That is the type of dentist you want. Don’t hesitate to ask for their qualifications. When this is done improperly, it can ruin your bite, leaving you in tremendous pain and costing tens of thousands of dollars to fix.

In addition to the technical know-how for the reconstruction, you’ll want an AACD accredited dentist. You’re talking about completely remaking your smile. The really great news about that is you can end up with a gorgeous smile. Expert cosmetic dentists can create any type of smile you want. So, while you’re researching your dentists, look at different smiles and see what is attractive to you. The dentist can help you with this too because he’ll know what will most compliment your facial shape.

Whatever you do, don’t go back to the dentist who did your last case. He or she has cost you unbelievable amounts of money and time unnecessarily.

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

Can I Be Forced to Get TMJ Surgery?

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I’ve been having some significant pain in my jaw. I’ve done some research online (I know, don’t groan) and it looks like I have TMJ Disorder. From what I can tell, my choices for healing are jaw surgery or complete bite reconstruction. If I went to the doctor and it turns out I have TMJ can he force me to get surgery? I’m only 25 and don’t think I want that. I just want some medicine to help with the pain.

Madison

Dear Madison,

Illustration of how TMJ is affected by neuromuscular issues

I’m sorry you’re having jaw pain. Before anything else, I want to make sure you understand that while other countries, with national health care plans, can force you to have certain treatments or deny them if they so choose, we live in a country where a doctor can’t force you to get a certain procedure done without your consent. That would be illegal. You are a sentient human being with control over your body. Don’t be afraid to see a dentist to have your jaw pain examined.

Next, I want to assure you that there are many solutions to TMJ disorder. You’ve named the two most invasive. Let me assure you there are many other simple solutions to TMJ. The key is going to a dentist with the right TMJ training who can properly diagnose and treat you.

Finding a TMJ Dentist

There isn’t such a thing as a TMJ specialty. While some dentists call themselves TMJ Specialists, they should make it clear it’s not a recognized specialty from the American Dental Association. They really just mean that they’ve made additional effort to train and treat TMJ. So how do you know who is qualified?

Taking a look at Dr. Hadgis’ TMJ Specialist page should give you an idea of what type of training you want in a dentist who treats you for TMJ. This will protect you from some disastrous treatments. In many cases, TMJ can be treated simply. After you Google some TMJ dentists, check their training credentials against Dr. Hadgis’. If they don’t list any, don’t hesitate to call their office and ask. If they have a problem with the question, they’re not the practice for you.

If their training checks out, I’d go one step further and give a peek to their reviews. You want to make sure there treatment protocol is effective and they’re good with patients.

If it’s a TMJ Worst Case Scenario

If for some reason you do need a full mouth reconstruction, which should only be resorted to after all other less-invasive treatments have been exhausted, you want to make sure your dentist has an additional skill. On top of the reconstructive skill necessary to do such an advanced procedure, you also want to make sure they’re a skilled, artistic cosmetic dentist. These are usually done with porcelain crowns. You want your smile to be beautiful.

Ideally, you’ll want a dentist who’s reached accreditation level with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top cosmetic dentists in the world. It would be worth it to drive to another city to get one. If you can’t find one in a reasonable distance, check with the mynewsmile.com website. They have a “find a cosmetic dentist” link. You input your zip code and how far you’re willing to travel and they’ll recommend artistic cosmetic dentists that can give you a beautiful smile. In fact, all of them should have some form of a beautiful smile guarantee.

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

Lumineers for Collapsed Bite? No!

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I told my dentist that I was embarrassed by my smile. You can never see my upper teeth. It’s even difficult to see them when I smile. I also have trouble talking in cold weather. He said I have a collapsed bite and that he just got certified in Lumineers and could fix my smile. I was wondering if I should be concerned about the bite as well as the appearance? What do you think? A “second opinion” never hurts, right?

Amy L.

Dear Amy,

A chart illustrating the relation of muscles, joints, and teeth with TMJ Disorder

I am so glad you wrote for a second opinion. Do not go further with this treatment! Your dentist means well but doesn’t know what he’s talking about in this case. An open bite is very complicated and usually requires a full-mouth reconstruction with dental crowns. Even then, it has to be done by a dentist with significant TMJ Disorder Training.

I sincerely doubt your dentist has this based on his treatment suggestion. Also, so you know, getting certified to place Lumineers does not make someone an expert cosmetic dentist. They’re marketed to inexperienced cosmetic dentists and only have to participate in a short seminar to become certified.

Treating Severe TMJ with a Full-Mouth Reconstruction

The first huge issue is finding the right TMJ dentist. You need a dentist with advanced training. Look for someone who’s completed training at one of the following:

  • L.D. Pankey Institute in Florida
  • The Dawson Academy in Florida
  • The Las Vegas Institute for Advanced Dental Studies in Nevada

There are some others, but these are very reputable and give superb training in restorative dentistry. There are too many horror stories of patients whose bites have been completely destroyed by dentists without the right training.

Next, make sure they do a provisional reconstruction first. When that’s perfect, then they can copy what they did for a provisional. By perfect, I mean that you love the appearance, your speech comes easily and naturally, and you can see your upper teeth as you would with a normal bite.

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

TMJ Scam?

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I’ve been having horrible jaw pain in the mornings, along with headaches. I looked up some of my symptoms and it sounds like the problem could be TMJ related. I mentioned it to my sister-in-law. She thinks the whole thing is a scam made up by dentists and that a simple whole foods diet will take care of my problem. She’s really big on the whole foods thing anyway, so I’m not sure how much I buy into her idea. I noticed you treat TMJ. What type of success do you have in helping patients with it?

Laurie M.

Dear Laurie,

Woman grabbing her jaw with pain

Many things can be fixed by a whole foods diet, but TMJ isn’t one of them. In fact, it can exacerbate the problem. Consider you’re having jaw pain, then you start chomping down on a carrot. It will likely make the pain worse from the strain.

Sometimes TMJ can be tricky to solve, but it can be solved. It’s a matter of figuring out the source of the problem, not merely treating symptoms. You mentioned that your jaw pain is worse in the morning and you have headaches. That is usually a symptom of TMJ.

In fact, it sounds like you probably grind your teeth at night. You wouldn’t realize you were doing it because it happens in your sleep. But, an astute dentist would be on the lookout for that and inform you that your teeth are ground down.

A simple mouth guard can be custom designed for you by your dentist. Make sure he’s done extensive TMJ studies as a post-graduate. If not, you may be better served to visit another dentist just for this issue.

Depending on how ground down your teeth are, you may find you need some crowns, but if you’re catching it early enough, you could be fine.

Let untreated, this can lead not only to severe migraines but lockjaw and broken teeth, which you’ll need to completely replace.

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

Can You Please Explain The Difference Between TMJ and TMD?

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I’ve been getting horrible migraines when I first wake up. I was talking to a friend about it hoping she’d know what would give me some relief. She told me there’s medicine I can take that will relieve me of pain. But, the more important thing is to get to the reason why I keep getting them. That’s what I love about her. She gets right to the point. Aside from some tests she suggested I have my doctor run, she also mentioned TMD as a possibility. I looked that up and it seems there are similar symptoms with that and TMJ. What’s the difference between the two?

Caroline G.

Grosse Pointe TMJ Dentist

Your friend is bright, as I’m sure you know. It’s always better to get to the root of an issue rather than just medicate it to mask the symptoms. She’s also right that TMD could be the cause of your migraines as well. However, there are usually other symptoms which go along with that, such as pops and clicks in your jaw.

It’s worth looking into though, especially if there have been changes in your bite. The terms TMJ and TMD are used interchangeably.

TMD refers to Temporomadibular Disorder.
TMJ refers to the Temporomandibular Joint, also known as the hinge joint.

It’s the joint that’s usually the problem and cause of the disorder. If it’s not in its proper place, it can cause loads of problems for you, including migraines.

TMJ treatment can vary. One end of the spectrum is simply wearing an orthotic device, temporarily, which will help guide your hinge joint into place. On the other end of the spectrum would be major reconstructive work. Skilled TMJ dentists will also start with the least invasive solution possible based on your diagnosis.

It’s important you go to a dentist with a lot of testing specifically for this type of situation.

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

Are Headaches Really a Dental Problem?

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I think my doctor is blowing me off because he doesn’t know what to do. I’ve been having horrible headaches for months now, especially in the mornings. He’s done CT scans and all kinds of lab work, but can’t seem to find the real cause. At my last appointment, he told me to see a dentist. Is he just passing me off or can a dentist really help headaches?

Gracie L.

Dear Gracie,

I don’t think he’s just passing the buck. I think he’s more out of ideas and knows this is a possible solution. My doctor once told me when he can’t find what’s wrong with a patient who just “doesn’t feel well” for no explicable reason, he sends them to the dentist. There’s usually a beginning tooth infection. When it’s dealt with the patient suddenly feels better.

Our oral health directly affects our general health as well. In your particular case, it’s likely your doctor thinks you might have TMJ Disorder, especially if your headaches are strongest in the morning. TMJ has been known to cause migraines. It can also lead to jaw pain and popping. Some more severe cases even cause your jaw to lock-up on you.

I wouldn’t just see any dentist, though. Make sure you go to one with significant TMJ/neuromuscular dentistry training. For instance, Dr. Hadgis did post-graduate studies at the Las Vegas Institute for Advanced Dental Studies, which is known worldwide for its expertise in dealing with TMJ issues.

In many cases, TMJ can be dealt with using simple solutions. But, if yours is more complicated and some crowns need to be done you want to be certain your dentist truly understands how your bite needs to come together to fix your TMJ. You don’t want someone who’ll make it worse.

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

My Friend Says Invisalign Is Giving Me TMJ

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Can you advise me? I’ve been on Invisalign treatments for several weeks. Recently, I started having jaw pain and massive headaches. A friend insists it’s Invisalign giving me TMJ. I don’t want to stop these treatments if she’s wrong. I’ve been looking forward to having straight teeth for many years. Do you have any recommendations for me?

Lucy N.  – Denver, CO

Lucy,

There are many causes for TMJ. Some are genetic. Some are lifestyle related. Stress can be a major cause if it’s leading you to clench down. You could even be doing that without realizing it. Biting down or tensing up adds stress to your jaw joint. That can lead to both head and jaw pain. Sometimes medications you’re on can lead to clenching, such as Adderall. If you’re married, ask your husband to keep an eye out for you grinding your teeth at night.

Orthodontics, including Invisalign, aren’t generally a cause. In fact, improving your bite can actually improve TMJ. That being said, if you already had some mild TMJ, adjusting your bite could be aggravating symptoms that weren’t as noticeable before.

I’d see your dentist. He’ll examine your jaw and bite, as well as run other diagnostic tests, to see if they can run down the root cause of your pain. It doesn’t necessarily mean you won’t be able to continue your treatmment. If for some reason you have to it would only be temporary while you and your dentist figured out the best way to treat you. Then you can resume treatment.

Occasionally, someone isn’t a good candidate for Invisalign. If that is the case with you, don’t despair. There are other ways to give you a gorgeous smile. A good cosmetic dentist with experience in neuromuscular dentistry will be a key component for you.

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

Why Did My Parkinsons Doc Tell Me to Get a Dentist?

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I have Parkinsons Disease. I was just diagnosed. I saw the specialist today. He prescribed some medication then asked me to make sure my dentist keeps an eye on my teeth. I mentioned I don’t have a dentist because my teeth have always been healthy, and I’m not fond of dentists. He said get one and then left. Will this medicine destroy my teeth?

Leon – Washington

Leon,

Parkinson’s Medication can cause teeth grinding. That’s likely what your dentist is concerned about. Teeth grinding causes serious problems. Not only can it cause TMJ, but the grinding destroys your teeth.

Healthy teeth can go down quickly. You mentioned not being fond of dentists. You should know you’re not alone in that feeling. If it’s because you’ve had some rough experiences with the dentist, I’ll recommend you try sedation dentistry. This allows you to have a pain-free dental experience. It’s worth looking into now that you’ll need to go to the dentist more regularly.

You can likely tell if you start grinding your teeth during your waking hours. Unfortunately, most of it is likely to happen at night while you’re asleep and won’t notice. If you start getting jaw pain or headaches in the morning, that is a sign you are grinding your teeth.

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

Does TMJ Require a Full-Mouth Reconstruction?

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I’ve had jaw pain and severe migraines for months. My doctor did everything he could. As a last resort, he sent me to a dentist. The dentist told me I had TMJ and said that I need a full mouth reconstruction. I’m a little jumpy at the idea. My teeth are fine. It seems weird to do a full-mouth reconstruction. I have a friend in your neck of the woods who says you’re one of the best with TMJ.  Is that what you’d recommend?

Bess – Arkansas

Bess,

I’m glad you wrote. Full-mouth reconstruction is usually a last result except for the most severe cases. Generally, you try other less invasive TMJ treatments first. What your dentist is recommending is done when all else has failed.

Your doctor was right to recommend you to a dentist. My suggestion is to get a second opinion. You want a dentist, who like Dr. Hadgis, has significant TMJ training.

Look for someone who has gotten training at the Las Vegas Institute for Advanced Dental Studies (LVI). I have confidence that they’re diagnosis and suggested course of action will be trustworthy.

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

Why Does My Dentist Want Me to Go to an Occlusion Specialist?

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I’ve been going to my dentist to figure out my TMJ issues for a few months. Now, after I’ve spent all this money he wants to send me to an occlusion specialist.  Why the sudden switch? Why didn’t he do this BEFORE I spent all the money?

Sara L. – Michigan

Sara,

I want to make sure you understand up front, there is no such thing as a recognized occlusion specialty.  What your dentist means is he wants to send you to someone who’s had significant training in occlusion.

Sometimes a TMJ issue is solved fairly simply. It’s always best to check the easy things first, as they have the simplest, least invasive solutions.  That’s likely why your dentist worked with you first. When those didn’t solve your problem, rather than waste your money he decided to send you to someone with more training.

In reality, he’s doing you a favor and trying to get you the best care possible.  He tried to save you money, by not requiring another clinic in addition to his care. While I know it may have seemed like he was taking advantage, he was actually just trying to get you the best care possible after the little things were eliminated.

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