Can My Dentist Treat My TMJ?

I was talking to my dentist about some jaw pain. He asked me a few questions and said he thinks I have TMJ disorder. We scheduled a follow-up appointment to run some additional tests and discuss treatment. After I got home I started wondering if instead of just going to my general dentist about this I should schedule an appointment with a TMJ Dentist. What do you think? Is it safe to stay with my dentist for this?

Miranda W.

Dear Miranda,

A woman holding her jaw from TMJ pain

Your doubts are based on a common misunderstanding about TMJ. There isn’t really such a thing as a TMJ Dentist. By that I mean there isn’t a recognized TMJ specialty with the American Dental Association (ADA). All TMJ dentists are just general dentists. That being said, it doesn’t mean every general dentist is qualified to treat TMJ. It does require specialized training. So how do you know if your particular dentist has what it takes?

The first thing I’d do is check their website. If they have a TMJ page, check to see if they list any specific training. If they don’t have a page, check their bio. They should list some respected institute where they did post-doctoral studies in TMJ diagnosis and treatment. For instance, Dr. Delaune trained at the esteemed Dawson Academy. Other respected institutes would be among the following:

  • The Las Vegas Institute for Advanced Dental Studies (LVI)
  • The Kois Center
  • The Pankey Institute
  • Spear Institute

There are others, but these are among the best.

Warning Signs about TMJ Dentist

One thing to be aware of is aggressiveness in treatment. Dentists with expertise in TMJ will start with the least invasive treatment options first. If your dentist goes straight to suggesting a full mouth reconstruction, I’d quickly get a second opinion. Those are only necessary in severe cases and other solutions are tried first.

Often jaw pain can be caused by teeth grinding or clenching. Patients may not even recognize they’re doing it, especially if it only occurs while they’re sleeping. In that case, wearing a simple custom-fitted night guard is all you need to solve the problem.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

My Lumineers Will Not Stay On

I’m in the middle of a Lumineers nightmare. I spent a small fortune to get Lumineers placed on my four front teeth. They keep falling off. I can’t even get through a full week before at least one of them falls off. While my dentist doesn’t charge me for bonding them back on, I can’t keep taking time off work to get these re-bonded. Now today, I think I accidentally swallowed one! I can’t find it and I had it before lunch. Maybe it fell off while I was eating?? I don’t know what to do. Will I get sick? Will my dentist make me pay for another one? What do you recommend?

Livvie L. – South Dakota

Livvie,

Woman covering her mouth
If you want a beautiful smile, Lumineers isn’t the way to go.

You’re correct in describing this as a nightmare. I can’t believe you’ve been as patient as you have. This is absolutely unacceptable and completely the fault of your dentist. For any brand of porcelain veneers, including Lumineers, to fall off is highly unusual. To have them constantly fall off reeks of incompetence. Your dentist obviously doesn’t understand proper bonding techniques.

It doesn’t surprise me that he gave you Lumineers instead of another brand of porcelain veneers. The Lumineers brand is highly marketed to inexperienced cosmetic dentists as being easy to place. Obviously, not for your dentist though.

When Your Lumineers Keep Falling Off

First, don’t panic. You won’t get sick from swallowing one. It will pass through in the normal course of events. As far as your dentist charging you, he shouldn’t. It’s his fault it fell off to begin with. These should last decades without problems when well placed and well taken care of by the patient.

That being said, even if your dentist is willing to make another one, I wouldn’t expect him to do any better with another one. I’m going to suggest you just ask for a refund. Not just on the missing Lumineer, but all of them. You’ve missed enough work from his incompetence to justify one. If he doesn’t give it to you, tell him you’ll go to the ethics committee.

Now, you’ll want to replace them to get the smile you originally paid for. To do that, you’ll need an expert cosmetic dentist. Look for one through the mynewsmile.com website. They only recommend highly skilled and artistic cosmetic dentists. Anyone on that list will give you a gorgeous smile makeover.

I’m sorry you’ve had to go through this.

This blog is brought to you by New Orleans Cosmetic Dentist Dr. Duane Delaune.

Is U.S. Violating UN Agreement on Mercury Fillings?

I thought the United States agreed to phase out mercury fillings when they signed the Minamata Convention Agreement, yet there are still thousands of dentists using amalgam fillings all over the country 5 years later. Can we demand our dentist (and more helpful financially our insurance) stop using them because of the agreement?

Maggie

Dear Maggie,

Image left of silver amalgam fillings loaded with mercury. Image right: mercury-free composite fillings

First, you’re right that there has been very little evidence the United States followed through with the agreement signed. However, the Minamata Convention agreement wasn’t about the fillings themselves. There’s no agreement to ban those or phase them out.

The agreement was based on a village in Japan that was absolutely devastated by mercury poisoning in the water. 900 people died as a result and more than double that became ill. There’s no record of the cognitive impact but I’m sure it’s much higher.

What the agreement actually deals with is the disposal of mercury to keep it from polluting the environment and therefore people. Every dentist should be aware of the agreement because the main ingredient in amalgam (silver) fillings is mercury. Whether or not they’re following the recommendations is hard to tell. But, most dentists will be environmentally conscious.

If You Want Mercury-free Fillings

While you’re right that there are many dentists still using amalgam fillings, there are also an increasing number of mercury-free dentists. They’ll be happy to give you composite fillings. In fact, in many cases it’s all they offer.

If you happen to have some leftover amalgam fillings you want to rid yourself of, most mercury-free dentists know how to do sanitary amalgam removals. That allows you to safely switch out your fillings for healthier options without worrying about inhaling the mercury vapors.

White Fillings and White Teeth

When you have white fillings, you want your dentist to match them to your teeth, especially if you have any visible fillings. They can. However, you need to be aware that once the fillings are made the color can’t be changed. So, if you’ve considered whitening your teeth at some future time, you may want to do it before you get your filings switched out.

This blog is brought to you by Dr. Duane Delaune.

Can You Really Whiten Teeth with Charcoal?

My sister-in-law has been whitening her teeth using charcoal. She swears by it. I haven’t seen a ton of difference in her teeth, but I think there has been some. I have a couple of questions, though. One, does this actually work? Two, if so, is it safe?

Mandy L.

Dear Mandy,

An image of charcoal
Is Charcoal Safe for Teeth Whitening?

There are always fads in things like teeth whitening and wrinkle cream. This particular fad is because of a group of YouTubers. I worry about the impact this is having and how many people will end up ruining their teeth because of it. It’s important to ALWAYS consult your dentist before trying anything on your teeth. You obviously know to do that because you wrote the blog.

The first thing you should know is charcoal whitening is referring to activated charcoal and not the kind you use to grill your favorite burger. So, I wouldn’t run down to home depot to stock up thinking you’ll get a bright, white smile.

Here are some good things about activated charcoal:

  • It’s non-toxic, so ingesting it is perfectly safe. Some people swear by it as a detox agent.
  • It’s absorbent. This is one of the reasons people use it for detox. It also may be why it sometimes works for whitening. Certain stains can be soaked up.

Here is why you DON’T want to use charcoal for your teeth.

Everything has an abrasiveness rating. Charcoal is more abrasive than toothpaste. It’s so abrasive that it can scratch your enamel. That will lead to your teeth picking up more stains, which is counterproductive.

Safe and Effective Options to Whiten Your Teeth

If you want to do something without a dentist, those over-the-counter teeth whitening strips, such as Crest, actually do work. There are some downsides.

1. They’re not as strong as professional teeth whitening, so you have to use quite a few boxes to get the effects you can get with a dentist. With the number of boxes you’d have to purchase to get your teeth really white, you’re likely going to end up spending more money instead of saving money.

2. It only covers a few teeth (I think about six). Most people have a much wider smile than six teeth.

If you want to whiten all of your teeth at the same time with professional strength teeth whitening gel, you can do teeth whitening through your dentist. It’s still possible to do it in the privacy of your own home during a time which is convenient for you. Just tell him you want whitening trays for at-home whitening.

Finally, you can have all your teeth as white as they can possibly get in just one appointment with Zoom Whitening. This is done in-office, but usually only takes about an hour. Most offices use Zoom Whitening for this procedure, but there are other brands as well.

If You Want to do More than Whitening

If there are other things you’d love to change about your smile, porcelain veneers can give you a total smile makeover. With a skilled cosmetic dentist, they can change the shape, size, and color of your teeth all in one swoop.

This blog is brought to you by Dr. Duane Delaune.