Botox is good for wrinkles, but what about for TMJ pain/migraines?

I’ve been dealing with TMJ for many years and also many treatments that never seem to work. I was just about at my wits end when I read some information about Botox being used successfully to treat myofascial pain and migraines caused by TMJ. And of course, I can’t help but consider the cosmetic benefits, too. Can any dentist administer Botox, and if not, how do find someone who can? — Chonda

Chonda,
If you suffer from TMJ pain and/or migraines, Botox has been found to relax the masseter and/or temporalis muscles. It must be placed in several spots in the belly of the muscles and if done correctly, you will notice a difference pretty quickly. It’s important that any TMJ treatment be done by a TMJ specialist — a maxillofacial surgeon, oral surgeon, or general dentist with an extensive background in TMJ. They will be able to assess your bite, understand the underlying causes of your TMJ and they might even have experience with injecting Botox. If not, ask if they work closely with a professional that does. It’s extremely important to do your research before making any sort of decision to move forward. Find out if your provider does this type of treatment, how many patients per month, and what the outcomes were. Best of luck!

This post is sponsored by New Orleans cosmetic dentist Dr. Duane Delaune. Read more about why many consider Dr. Delaune to be the best dentist in New Orleans.

My wife may be addicted to teeth whitening. Is it ruining her enamel?

I’ve jokingly call my wife a teeth whitening addict, but I’m starting to worry that’s she’s getting out of hand with it. Don’t get me wrong, she has a beautiful smile — it’s one of the reasons she caught my eye. But, she really obsesses over it. About two years ago, she had in-office teeth whitening done, where they put her under the lights and everything. Right after it, she started using the take-home kit. When her take-home kit ran out of gel, she switched to whitening strips. Now, she buys more gel every six months when she gets a checkup, and uses it right away, and then she uses the strips about once a month between visits. She started talking about going back in for another in-office teeth whitening procedure and I think it’s just nuts. I’m afraid she’s going to destroy her enamel and wind up with serious problems. Are my worries justified? — William

William,
Your wife is probably ok  with the amount she’s using teeth whitening products. Some people do touch up every month or so, but these are usually people who do a lot of things that stain their teeth, like drink coffee daily or smoke. Most people only tend to want to boost their color after a year or so. Bear in mind, the gel she gets in the office is stronger than the over-the-counter stuff, so when she isn’t using that, it’s harder for her to achieve the shade she wants.

Excessive treatments can cause problems, like translucent teeth or sensitivity. If she isn’t experiencing these issues and her dentist thinks her teeth are healthy enough for another round of in-office treatment, she should be good to go.

On the other hand, she could be inadvertently sabotaging her own results. Teeth have microscopic holes in them, but they’re normally closed up. As part of the bleaching process those spaces open. It can take a few days to weeks for them to close entirely up again. So, if she’s prone to doing things that stain (drink coffee, cola or wine or smoke), then the teeth will absorb the stains fairly easily right after treatment. If she can avoid these things, she’ll probably stay happier for longer. Regular brushing right after or even rinsing her mouth, can help slow down the staining process. Over time, her teeth will regain the stains, but her habits play a big role in how quickly this occurs.

The bottom line is that if she isn’t experiencing issues and her dentist has given her the green light, her current schedule is fine.

This post is sponsored by New Orleans cosmetic dentist Dr. Duane Delaune. Read more about why many consider Dr. Delaune to be the best dentist in New Orleans.

Is my dentist trying to talk me out of replacing amalgam fillings?

I recently made an appointment to have amalgam fillings removed from two back teeth and replaced with composite. My dentist kind of “warned” me that there might be some staining on my teeth from the silver fillings and to not expect my teeth to look completely white. Maybe I’m crazy, but it just really felt as if he was trying to talk me out of doing it altogether. Will these teeth be stained from the old fillings and if so, is there a way to remove the staining? Also, the fillings are pretty large – probably about 70% of my tooth. Will the white fillings be better than amalgam as far as strength and durability? — Steve

Steve,
It’s no secret that taking out old amalgam fillings and replacing them with white composite fillings will definitely look better. Your teeth might be slightly discolored from the amalgam fillings, but since it is on the back teeth, it shouldn’t be very noticeable at all.

With that said, it does sound very much like your dentist is in a round-about way trying to talk you out of the composite fillings. It’s probably because he is simply not comfortable doing them, but doesn’t want to come right out and say it. There’s a big difference in how composite fillings are placed in back teeth compared to amalgam and when it’s not done correctly there can be all sorts of problems and even damage to the teeth. If your dentist seems reluctant, don’t push the issue and instead, find another dentist who is trained in that area.

Another red flag to consider is the size of the fillings. If they are as big as you say, your dentist really should have done crowns. However, if you stick with fillings, composite will  definitely be stronger and more durable because they bond to the tooth where as amalgam fillings just sit in the tooth, making it’s easier for the tooth to break or fracture.

This post is sponsored by New Orleans cosmetic dentist Dr. Duane Delaune. Read more about why many consider Dr. Delaune to be the best dentist in New Orleans.

Did the emergency dentist blow off a possible infection in my tooth?

I’m completely put off by the emergency dentist I just saw. I’m partially to blame for the situation I’m in because I’ve blown off getting a filling for about a year on one particular tooth. When I called, I told them about that tooth, but also explained to them that I thought the tooth next to that one also needed a filling. I was assuming they would schedule enough time for the dentist to take care of both. It was one of the last appointments of the day, and when I finally got in the chair, he basically took a few minutes to look in my mouth and proceeded to tell me I needed a filling – but only on the tooth next to the one I already had a cavity in. I questioned him on it and he changed his tune and said I did need two fillings, and that I’d have to come back to have them done. Seriously? I am in pain and now I have to wait even longer! What’s the point of seeing an emergency dentist? It feels like this guy just wanted to get out of there so he hurried me along. He looked at my teeth so fast that now I am wondering if he missed an infection or something more serious. — Jackie

Jackie,
Here’s the thing about cavities… they can be very painful depending on how deep they are in the tooth. It doesn’t always mean there is an infection or a need for a root canal (which is usually pretty obvious had you had a full-blown exam and x-rays).

Dentists perform “tests” to try and figure out what tooth/teeth are bothering you so they can offer the best diagnosis and treatment plan. Teeth often refer pain to neighboring ones and even a cracked tooth can cause a lot of pain. Sometimes things can be missed even if there are x-rays.

It is strange that your dentist missed the second cavity until you called him out on it. It’s understandable that you felt hurried along or maybe even misdiagnosed. Get the fillings done as soon as you can – and maybe find another dentist to do it. Dentists don’t always schedule time for the actual work to be done – especially if they haven’t done a thorough exam. It’s simply too difficult to know the exact course of treatment or how long it will take. If you try a different dentist, be sure to let them know your diagnosis and recommended treatment from the emergency dentist at the time you make the appointment. This should help the office in determining if the dentist can set aside the extra time to do the fillings in addition to the initial exam.

This post is sponsored by New Orleans cosmetic dentist Dr. Duane Delaune. Read more about why many consider Dr. Delaune to be the best dentist in New Orleans.