Category Archives: TMJ Treatment

Do I need a TMJ specialist?

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

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.

Jaw problems

For many years my jaw has often cracked and popped when I ate. As I get older it is doing this more and more. Sometimes, now, it even feels like I have lockjaw. The only solution I’ve ever been given is to break and reset my jaw. Recently I came across your website and started reading your information on TMJ.  I’ve begun wondering if that could be the problem. What do you think?

Justin from Colorado

Justin,

Without examining you it would be hard for me to say anything definitive. However, I will say I think breaking your jaw seems a little on the extreme side. I also think it is very possible you have TMJ disorder, specifically related to the disc in the  temporomandibular joint.  I wouldn’t go to anyone who calls themselves a TMJ dentist. Look for someone with specific TMJ training, like at the Las Vegas Institute (LVI).

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

Doctor wants to break my jaw

I have always had problems with my jaw popping and cracking. Recently, it has gotten significantly worse and occasionally feels like I have lock-jaw. My doctor offered the solution of breaking and re-setting my jaw. That seems like a drastic step without having a diagnosis. Are there other options for me?

A frustrated patient in Wyoming.

I can see why you are frustrated. I haven’t examined you, but yes, I would find that a little extreme as a course of action without a solid diagnosis. What you’re describing sounds like a problem with the disc in your jaw-joint related to TMJ disorder. You’ll want to find a TMJ specialist to examine you. Look for a dentist who has had training with the distinguished Las Vegas Institute (LVI). TMJ is complicated and requires  post-graduate training.

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

I don’t really think I had five cavities.

I just started going to a new dentist. I’ve always been really diligent about taking care of my teeth, in part because both of my parents had terrible teeth, with full upper and lower dentures before they turned 60. I don’t want that, so I floss every single day, and I brush at least twice a day, and more often if I’ve had a lot of sugar. I don’t drink pop. My old dentist always used to say what great teeth I have, so imagine my shock when I start with this new dentist and she tells me I have five cavities. Five!

The cavities were all in my back teeth, and the dentist used white fillings to fill them. The problem is that ever since she did that, I have a lot of pain. She tried to adjust my bite, saying it was out of whack, but that didn’t help at all.

I just feel like something is hinky here. I went to my old dentist less than a year ago, and those xrays did not show any cavities. Now with this new one the xrays show five, and that just seems impossible, especially when I take such good care of my teeth. I kind of want to get copies of my old xrays, and copies of the xrays from the new dentist and take them to a different dentist, to see what they think, but I can’t think how to do that without making the new dentist suspicious. Maybe I don’t care if the new dentist is suspicious.

This is really difficult! I never imagined I would have to do something like this.

Anne in Shreveport

Dear Anne,

While being your own advocate is always a good idea in any kind of healthcare, you shouldn’t have to stress over things to this degree. In any case, you don’t seem to have any kind of trust or rapport with this new dentist, so now might be the perfect time to request all your records including xrays so you can switch to a new dentist.

It is possible that the angle of an xray might miss a cavity or two, but five is highly unlikely. The best method for getting an unbiased second opinion is to tell the second opinion dentist that you would simply like an opinion on the dental work that was done. Tell them as little as possible, just let the dental work and the xrays do the talking for you.

The primary concern here is that you are having pain in your teeth. That indicates that the dentist that placed the white fillings may not have used the proper technique and that material has not bonded correctly. A new dentist will work with you to diagnose the exact nature of your pain and work for a solution. A slim possibility is that you have developed a disorder of the temperomandibular joint, and will need to find a dentist experienced with TMJ treatment. The reason this seems unlikely is that your problems coincided with the placement of the white fillings. That would be a pretty strange coincidence.

Seek a second opinion.

Posted courtesy of Grosse Pointe Woods cosmetic dentist Dr. Hadgis.

What causes erosion along the gumline?

My teeth where they meet my gums are quite eroded and abraded. My old dentist always said this was from brushing my teeth too roughly, but he retired and I had to find a new dentist, and she says is probably caused by bruxism. I am not really comfortable with this new dentist and did not want to admit that I don’t know what that is.

I’d like to do something about my teeth, but I have a lot of questions first. If I get porcelain veneers, will they look ugly along the gumline, or be more prone to decay?

Do porcelain veneers stain, and if so, typically how long does that take, assuming excellent oral hygeine?

Finally, do you have to change what you eat and drink to try and avoid staining the veneers?

Thanks for your help,

Lupe in Oregon

Dear Lupe,

Before we address your questions about porcelain veneers, we’ll talk about what caused the erosion and abrasions in the first place. Bruxism is biting stress, and the wear/erosion pattern you describe is typically found when someone clenches and/or grinds their teeth. The constant stress on the teeth causes them to flex right where the tooth meets the gum (the “neck” of the tooth), and you wind up with eroded notches there, just as you describe.

So first, you need to seek a cosmetic dentist who also has experience in TMJ treatment. This more than anything will maximize the lifespan of porcelain veneers, which do not respond to grinding or clenching any better than natural teeth do.

When your dentist has addressed any bite issues, he or she can discuss placing porcelain veneers with you. If they are done properly, they will completely cover the notches at your gumline. There is no need to restrict your diet, as the veneers are actually more stain resistant than your natural teeth. It is still best, though to avoid frequent snacking, as that eating pattern often leads to decay.

This blog posted courtesy of Grosse Pointe Woods cosmetic dentist Dr. Hadgis.

Teeth really damaged from bulimia

I’ve suffered from bulimia since I was 14 years old. Years of counselling have helped me get the disease under control, but my teeth are severely and irreparably damaged. They are only about half the size they should be, and are very thin and chipped. Most of them don’t meet anymore, and where they do, it is not a comfortable fit.

I’ve had a lot of headaches lately, and I noticed that my jaw sticks out when I open my mouth. Is there anything that can be done? The damage just seems so severe. I want to see a cosmetic dentist, to see if he or she can make my teeth look nicer and function better, too. These headaches are really debilitating.

Thanks,

MaryJo in Grand Rapids

Dear MaryJo,

Your instict to work with a cosmetic dentist is a good one. Most experienced, trained cosmetic dentists have the skills to improve your smile. You may have to have bonding done, if your teeth are very thin, so the underlying structures are strong enough to support porcelain crowns.

Your headaches are most likely caused by your misaligned jaw. This is usually called TMJ, or TMJ disorder. Luckily, many trained cosmetic dentists have also pursued training in TMJ treatment. This will involve restoring your bite to its natural position.

The problems you describe are extensive, and will be expensive to fix. You will probably need porcelain crowns on all your teeth. The bright side is literally bright–your smile will be radiant, which is just what you need to move forward into this new part of your life free of bulimia.

Best of luck to you.

This blog post provided courtesy of the dental office of Dr. Hadgis, Grosse Pointe Woods cosmetic dentist.

What is a neuromuscular dentist?

I am writing because I am a natural born skeptic, and some advice I recently received sounds a little dicey to me. I’ve been suffering for quite some time with headaches and dizziness. I’ve seen three different doctors in the practice I go to, and they’ve each tried something different, and nothing has worked. Now the newest and youngest member of the practice says that I should talk to a neuromuscular dentist.

I don’t even know what that is! He was in such a hurry, and rattled it off really fast, like I should know. I was too embarrassed to ask him to repeat it. Good thing he wrote it on the paperwork. Iwent home and looked it up on the Internet, and all I found was a bunch of letters from people that talked about how badly dentists claiming they did neuromuscular dentistry messed them up! My doctor made this recommendation after he found out that I had lost a tooth shortly before my troubles started.

Is this a reputable field? I don’t even know how to find a neuromuscular dentist. Any help you can offer would be greatly appreciated.

Thanks,

Veronica in Chicago, IL

Dear Veronica,

It is good that you are approaching this with some caution. Neuromuscular dentistry is a legitimate field, but it is not yet recognized as a speciality by the American Dental Association. For this reason, anyone can SAY they do neuromuscular dentistry, whether they have the training or not.

Neuromuscular dentistry is used to treat disorders of the temporomandibular joint, also called TMD or TMJ. This field of study looks at not just the teeth, but the related muscles and functionality of the joints.

It sounds as if your most recent doctor thinks you may be suffering from TMJ. TMJ symptoms include the headaches and dizziness that you are suffering from, and can also include facial and jaw pain, muscle tension in the neck or shoulders, numbness in the fingers or arms, locking or clicking of the jaw, and tinnitus (ringing in the ears).

It is a shame your doctor did not take more time to explain his recommendation and the reasons for it. If you feel comfortable, ask your doctor’s office for a referral to a reputable neuromuscular dentist for TMJ treatment. If you would rather find one on your own, make very sure you check their credentials closely. Look for extensive training in reputable programs, and beware of any that want to offer some kind of quick fix.

This blog post sponsored by Grosse Pointe Woods cosmetic dentist Dr. Hadgis.

Wisdom teeth removal?

Although I just turned 60 yesterday, up until last week I still had all of my wisdom teeth. The fillings in the top two were broken. My dentist said it would actually be easier to remove the teeth than it would be to repair the fillings, so I went ahead and had them pulled. The procedure went extremely well, with no complications at all.

Now I am wondering if I should go ahead and have the lower two removed before they start causing problems. What do you think? My dentist says I should have an oral surgeon do the removal if I decide to go ahead with it, but I can’t get a good feel for whether she thinks I should do it or not.

Thanks.

Drew in New Brunswick, NJ

Dear Drew,

Your dentist may seem to be on the fence because there should be a reason to remove wisdom teeth beyond them just being wisdom teeth. If your upper extraction went very smoothly under the care of your general dentist, then it sounds like they were not impacted, but normally erupted. This is consistent with you still having them in your 60th year, as impacted wisdom teeth are best removed as early as possible or they can cause complications.

Even normally erupted wisdom teeth can cause trouble, though. As you discovered, it is often easier to remove them than it is to restore them. One consideration you should now think about is whether or not your remaining wisdom teeth could super-erupt and begin to cause problems with the alignment of your jaw. A misalignment of your jaw can cause headaches, and create problems with your temporomandibular joint (TMJ) that will later require TMJ treatment.

In your case, a wait and see approach may be appropriate. If your dentist determines that the lower wisdom teeth are super-erupting and causing alignment issues, or if you start to experience problems like headaches or other TMJ symptoms, it may be best to go ahead with the extraction at that time.

This blog produced courtesy of the office of Grosse Pointe Woods cosmetic dentist Dr. Hadgis.

Serious TMJ Disorder

I found this blog because I was looking for information about TMJ. I could really use some expert advice, and unlike some of the dentists I have dealt with in the past, your credentials seem impeccable.

Even though I am only in my early thirties, my teeth are a mess. I have a long-standing teeth grinding habit that forced me to get porcelain crowns on all my teeth 10 years ago. I’ve come to understand that the crowns were not well done. They are ugly and fake-looking, and my bite is completely screwed up. My jaw is crooked, and even my gums are messed up from poor placement of the crowns.

I need help, but my past experience has me really nervous about choosing a professional to work with. From what I can tell, I think I have to choose a cosmetic dentist or a prosthodontist. Now I read about this “neuromuscular dentistry” through your website. Your page says that is not a specialty, but should I look for someone like that to help me with my alignment issues?

I’ve spoken with an orthodontist, and he said that since my case is so complicated I should talk to a prosthodontist. I don’t know what to do at all.

Calvin in Grand Ledge

Dear Calvin,

As you have discovered, there is not a legally distinct speciality in neuromuscular dentistry, and this means that anyone can say that they provide this type of treatment, regardless of their training. You are on the right path, making sure you are checking into details of training and experience. This is the only way to establish whether or not a dentist can provide this type of treatment, which is in fact what will probably help you most.

And you don’t have to choose between the way your teeth look and the way they function – with the help of the right professional, you can have a beautiful smile that works beautifully, too. The key will be to find a dentist that is experienced and educated in both cosmetic dentistry and in TMJ treatment.

Grosse Pointe Woods cosmetic dentist Dr. Hadgis supports this blog as a courtesy service.