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Does TMJ Really Require Crowns on Every Tooth?

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I mentioned to my dentist that I wanted whiter teeth. I thought we’d talk about teeth whitening. Instead, he’s said there is something wrong with my bite and I need to have all my teeth crowned to repair it. This really surprised me because I had braces when I was younger and my teeth/ bite have never bothered me.  He thinks I have TMJ and it’s the only option. I’m thinking of getting a second opinion.

Chelsea – South Dakota

Chelsea,

Whoa!  Did you even mention bite problems? Normally, TMJ would have some symptoms such has your jaw locking, popping, migraines, jaw pain, etc.  If you’ve had none of these symptoms, TMJ would be a surprising diagnosis.

Even if you had TMJ, a full mouth reconstruction is a last resort procedure, especially if your teeth are otherwise healthy. Why grind down healthy tooth structure? There are many other procedural options.

If I were in your place, I’d definitely get a second opinion.  For teeth whitening, you wouldn’t need crowns either, unless you have a tooth that is already crowned. Even then, you would do traditional teeth whitening on all of your other teeth and just get the one crown replaced.

His recommendation is dubious to me. Especially if you’ve given me all the information.

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

 

Are There Dentists Who Specialize In Fearful Patients?

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Are there dentists who don’t mind working with fearful patients? My dentist seems to get tired of how frightened I get during my dental appointments. It’s to the point where I am considering not going to the dentist anymore.

Denise – Kansas

Denise,

I’m sorry your current dentist is making you self-conscience about your anxiety. It shows a lack of consideration to his patients.  There are dentists who not only don’t mind fearful patients, they enjoy treating them.

Generally, they are driven by both compassion and a desire to help you feel differently about dental care.  You can find them by doing a search for a “sedation dentist” or a “cater to cowards dentist.”

Many of them used some form of sedation, such as oral conscious sedation. It allows you to have appointments that are completely pain free, simply by taking a pill.

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

Can I Trade My Porcelain Crowns with Veneers?

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I’ve had porcelain crowns for quite a few years. They’ve started picking up stains. My dentist says it’s time to replace them.  I don’t understand why I have to replace the whole thing if they only thing that’s wrong is the front of them. Can’t I just porcelain veneers to put on them?

Mark A. – MA

Mark,

Porcelain Veneers are a great treatment, but they only work on natural teeth. Unfortunately, the only thing to do with porcelain crowns once they’ve lived out their usefulnes, is to replace them.

Eventually, you’ll have big problems with the gums pulling away from the edge. That would leave you very vulnerable to things getting  trapped, causing decay.

I’d suggest listening to your dentist, in this case.

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

Can A Crown Make Make TMJ Worse

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I have TMJ. My dentist said it’s because I don’t wear a nightguard and I grind my teeth. It was annoying, but livable. Then I had to get a dental crown.  Something seemed off on how it fit because I always his that “tooth” first. It caused a lot of pain and now I feel like my jaw pains has gotten worse too. Can that be from the crown?

Amanda E. – Boston

Amanda,

Yes, it is likely that the crown is aggrevating the problem.  In fact, an improper bite can actually cause TMJ. It takes a good deal of training to understand the anatomy and mechanics of a proper bite.

Not all dentists have the training needed to do that properly. Often those dentists just adjust and adjust the crown until the patient, out of weariness of returning, says it’s fine and just deals with it. Other times they ground down the crown until it falls beneath the rest of the bite. Neither of these are a good solution.

My suggestion is to go to a dentist familiar with TMJ and neuromuscular dentistry and have him look at your crown. I would also highly suggest you get a mouthguard. Teeth grinding can cause severe problems later on in your bite.

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

Can I still have sedation if I have to come alone?

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I need to have a procedure that will require sedation dentistry for me.  But, my dentist said that I’d have to have someone drive me to and from the appointment as well as stay with me for a bit afterwards. I don’t have that luxury. I’m new to town and don’t know many people. So far, the only people I know are at work. I doubt two of us can get off the same day.

Sara L. – Idaho

Sara,

The type of sedation dentistry your dentist is talking about is quite strong. You’ll feel fine, but you will be quite clumsy.  In fact, there’s a high likelihood of injury if there isn’t someone watching you.

I don’t know how understanding your boss is, but maybe you could explain the situation and see if he or she will let someone else go with you.  Or maybe you can call on a family memeber to come in from out of town.

If neither of those is possible, you could ask your dentist if it’s possible to do the procedure just using ntirous oxide and a local anesthetic.  This wears off so quickly that you won’t need someone to drive you back and forth. You’ll be back to normal by the end of the appointment.

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

Can mouthwash gray porcelain veneers?

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I thought porcelain veneers were supposed to last for many years. I’ve only had mine about seven or eight months and mine are already turning gray.  I have been using a mouthwash, which I just found out was a no-no with veneers. Could that be it or are mine defective?

Causton V. – New Mexico

Causton,

Using mouthwash in and of itself will not damage your porcelain veneers. Mouthwash that contains alcohol is the big problem, because it can damage the bonding.  Even if you were using the kind with alcohol, however, it wouldn’t turn your veneers gray. There are two things I can think of of that can do that in such a short period of time.

  1. One reason would be you didn’t actually receive porcelain veneers. But even then, less than a year is not a long time. Even a composite veneer should have stayed bright in that amount of time.
  2. Your veneers were damaged by something like a prophy jet. If you’ve recently gone to  have your teeth cleaned at the dentist’s office, it’s possible the hygienist didn’t realize you had veneers or is inexperienced in caring for them. That will damage the the glaze on your veneers, which in turn causes them to pick up stains.

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

Is a Leaky Veneer a Thing?

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I had porcelain veneers done.  One of them turned colors. My dentist kept saying they looked fine and color is his specialty. I finally got frustrated and went to another dentist. He said it’s a leaky veneer. I’ve never heard of that. Before I for out more money, I just wanted to make sure it was legit.

Avery – Boston

Avery,

Yes, there is such a thing as leaky veneers. It  means the bonding is failing on your porcelain veneers.

This allows things to get under your veneers and will cause discoloration.

There is a simple solution to this. It just needs to be re-bonded on, but properly.

Your dentist should do this for free. If he refuses have the other dentist do it and maybe pressure from one of his peers will pressure him into taking responsibility for his failures.

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

Can My Mom Come with Me During Sedation?

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I’ve just been released from the hospital after a rape. I went to the dentist because one of my teeth didn’t feel right. He says I need an extraction. I’m terriefied of being under sedation without my mom there.  Will a dentist let her come back with me?

Joy L. – Miami

Joy,

I’m so sorry for what you’ve experienced. That is an indescribably difficult thing to go through.

While every dentist has a different policy, in general, dentists who do sedation do so because they’re compassionate about anxiety. I’m certain if they understood your situation most, if not all, of them would be happy to let your mother back with you for your peace of mind.

I realize you may not feel like telling them about what happened, because it is an emotional and uncomfortable topic. If they give you a hard time, you could have your mom talk to them or just call another dentist.

I’m confident you’ll find someone willing to work with you.

You’re in our thoughts.

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

 

Is there a difference between lumineers and porcelain veneers?

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I want to get a smile makeover and am trying to decide what to get. Is there a difference between porcelain veneer and lumineers? Everyone says to get porcelain veneers, but I also see a lot of advertising for lumineers.

Celia M. – Florida

Celia,

You’re right that Lumineers are heavily advertised. As far was differences, Lumineers are a brand of porcelain veneers.  There are differences in brands, but it is more important that you choose a great cosmetic dentist than it is that you pick the brand.

There are so many subtleties with each brand. They all have their strengths and weaknesses. Your cosmetic dentist will know what those are and how they affect your desired smile outcome.

Besides, two dentists can use the exact same brand for the exact same smile and come out with completely different results. You want a dentist who is not only technically skilled, but artistic.

Finding a dentist like that isn’t easy. Your best bet is to get a dentist who is accredited with the American Academy of Cosmetic Dentistry (AACD). They are the top cosmetic dentists in the world and will give you a gorgeous smile.

This blog is brought to you by Theodore Hadgis.

Is there such a thing as a TMJ specialist?

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My dentist suggests that I have TMJ. I did some research and he is likely right. There seem to be a lot of dentists who advertise as TMJ Specialists. My dentist says there is no such thing as a TMJ specialist. Which is it?

Tina S. – Bryant, AR

Tina,

Good question. In a way, both are right. There isn’t a recognized specialty in TMJ. Any general dentist can, with the right post-graduate training, treat TMJ.

Generally, if someone says they’re a TMJ specialist, what they mean is they have taken the time to get a significant amount of TMJ training.

If you’re concerned about your dentist’s training, just ask him. Here are some good places for him to have received training in TMJ:

  • The Las Vegas Institute of Advanced Dental Studies (LVI)
  • The Kois Center
  • The Dawson Academy
  • The TMJ Institute of America

If your dentist names a place other than this, feel free to ask about it.

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