Do I Have tmj or tmd?

I’m a little confused about which problem I have. I’ve been having problems with severe headaches and pain in my jaw. Someone said they think I have TMJ . I went home to look that up and there seems to be two things. One is called TMJ and one is called TMD. How do I know which one I have?

Carol

Dear Carol,

close up of temporomadibular joint

There’s a good reason you are confused about this. Even though they have two different technical meanings, people (especially patients) use them synonymously.

TMJ refers to the temporomadibular joint. I’ve placed a picture of it above so you can see a close up of it. TMD refers to the disorder of the temporomandibular joint.

Generally, when people say TMJ they mean TMJ disorder (or TMD).

If You Have TMJ Disorder

The symptoms you’ve described above do relate to TMJ Disorder.
There are many possible reasons for developing jaw problems. Your next step would be to see a dentist with expertise in TMJ problems, so he can properly diagnose the cause.

You want a dentist who’ has invested in significant post-doctoral training in TMJ diagnosis and treatment. For instance, Dr. Delaune has done extensive training with the world renown Dawson Academy.

There is not a recognized TMJ Specialty so any general dentist can call themselves a TMJ dentist. That makes it especially important you know that the dentist you’re dealing with is actually qualified.

Treatments vary depending on the cause. It can range from a simple orthotic device up to a full-mouth reconstruction. Good dentists start with the most conservative treatment except for the most rare, devastating cases.

I hope this helps. This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

Lumineers versus DURAthin

I’m planning on a smile makeover. I’ve been looking at images of both Lumineers and DURAthin. I like the DURAthin a lot better based on what I’ve seen, but wondered about cost. Are the DURAthin much more expensive?

Lisa

Dear Lisa,

A woman getting a porcelain veneer placed on her teeth

I’m concerned you are going about this the wrong way. It really isn’t the brand of porcelain veneers you get. It is the dentist. Let’s say two sculptors purchase the exact same type of marble to sculpt the same subject. It’s very likely one of them will have much more lifelike and beautiful work than the other. The skill of the artist truly matters.

The same is true for cosmetic dentistry. Whether you get Lumineers, DURAthin, or another brand won’t matter as much. I will say that most expert cosmetic dentists do not like the Lumineers brand. This is because they force dentists to use their lab which isn’t known for beautiful results.

What I’d like you to do instead of shopping brands is to shop dentists, but not by price. Instead, shop them by skill and artistry. Then, let them pick the best brand of porcelain veneers for the smile you want. They know the characteristics of each brand.

Finding an Expert Cosmetic Dentist

Smile makeovers aren’t taught in dental school If a general dentist is interested in doing cosmetic dentistry, they have to take the initiative to learn it. That means going to post-doctoral institutions to learn about things such as color theory, bonding techniques, the aesthetics of porcelain veneers, etc.

So how is a patient to know if a dentist has done that? One way is to just ask them where they received their cosmetic training. You’d also want to look at their smile gallery to see what type of results they’ve gotten on the cases they completed. Be certain to ask whether or not the smile gallery represents their work and isn’t just stock photos. You want to see what they produce. You’ll also want to be certain they’re willing to stand behind their work with a beautiful smile guarantee.

However, you should be aware there is a website which has already done this research on cosmetic dentists. You could just go to mynewsmile.com and click on their “Find a cosmetic dentist” link. They’ve screened every dentist on there for both their technical training as well as their artistry. You’ll be in good hands with any dentist they recommend. All you have to do is input your zip code along with how far you’re willing to travel and they pull up a list of highly qualified dentists who can give you the smile of your dreams.

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

Worried Dentist Ruined My Porcelain Veneer

I just had a set of porcelain veneers placed. I did like them but noticed one of them had a scratch on it. I mentioned it to him and he said it’s no problem he could even fix it before I left. I was thrilled and he bonded them on. Then he did some something he called “buffing out the scratch”. It looked fine and I left happy. It’s been a couple of days and now that tooth he buffed looks different from the rest of them. It looks duller. I’m worried something is wrong with it. Am I overreacting?

Alora

Dear Alora,

A single porcelain veneer being placed

No, you’re not overreacting. Your worry is quite founded in reality as well. It sounds like your dentist removed the scratch by removing the glazing. Not only is the glazing what gives your porcelain veneers their shine, but it’s also what protects them. Your veneers will quickly begin to pick up stains.

You need to have him replace this porcelain veneer. It’s best you call him right away. If you wait, he could try to say you did something to it. This way, if you call right away, he’ll have to admit it’s something he did.

Make Sure Your Dental Office Knows How to Care for Porcelain Veneers

Though as a patient this shouldn’t be your responsibility, it sounds like your dentist isn’t a true cosmetic dentist and doesn’t quite understand how he’s supposed to care for or repair porcelain veneers.

The key for you, in keeping them healthy, will be making sure your hygienist doesn’t use anything like a power prophy jet during your cleaning. It will take the entire glazing off your teeth.

When You Need an Expert Cosmetic Dentist

There isn’t a recognized specialty in cosmetic dentistry. A cosmetic dentist is actually just a general dentist who does cosmetic procedures. However, it isn’t something really taught in dental school. For a dentist to become skilled in it they have to invest in post-doctoral training.

However, it’s hard for patients to know who is trained and artistic. One way I’d recommend patients get an edge is by going to the mynewsmile.com website. They have a link to help patients find excellent cosmetic dentists in their area. All of them are pre-screened. Dentists can’t just pay to get listed, they have to show their technical knowledge, skill, and artistry.

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

considering dental implants

I need to replace three teeth. I’ve been considering dental implants but wanted to know what things I should consider ahead of time about them. Any input?

Laurie

Dear Laurie,

Abutment and crown being placed on dental implants
Dental implant parts and placements

While dental implants are the top of the line replacement there are some things to consider. First, are you committed to the long haul?

The journey starts with the surgery to place the dental implants. From there, is a healing period. This is to allow the bone to integrate with your implants, keeping them secure. Once that’s completed, your dentist can place the dental crowns. That process takes a while.

You also want to be committed to a lifetime of good oral health. You don’t want to invest all that time and money on something if you’re not willing to take care of it. It would be like buying your dream house, but never bothering to clean or care for it until it sits there, nothing but a shambled ruin.

A third consideration is your long term smile goals. If you want a white smile, it’s important you have any teeth whitening done before you get the dental implants. While a skilled cosmetic dentist can match your implant crowns to the color of your teeth, the color is permanent. If you want them white, you’ll need to make sure you do that before the crowns are created.

All that being said, the most important consideration is the dentist.

Finding an Implant Dentist

Dental implants are an advanced procedure. Too much can go wrong if you have an inexperienced dentist. It’s something which requires extensive post-doctoral training.

Never hesitate to ask a dentist about their implant training. if they name their dental school, that’s not enough. If they seem offended, they don’t have enough. No dentist with skill minds those type of questions.

Instead, they want patients to feel confident and secure going into any procedure. You can take a look at just some of Dr. Delaune’s credentials to get an idea of the type of dentist you’ll want to do your implants.

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