Menu Phone
Phone: 504-885-8869 Main Site Pen Icon Reviews: GoogleFacebook

Will Jaw Pain and Popping Recur with a New Bridge?

Posted on by AllSmiles.

I had jaw pain and popping with my last dental bridge and had to see a TMJ specialist to correct it. I got that bridge in 2001, so it is time to replace it. I relocated and switched dentists in 2014. Three weeks ago, I asked her about a new bridge, and she recommended a zirconia bridge. The pretreatment estimate includes a porcelain upgrade, which my dentist did not explain. I’ve had a billing issue in the past with this practice, so before I call, can you explain the porcelain upgrade? Is this related to my previous TMJ issues? Or should I be concerned that the jaw pain and popping will recur? Thanks, Hannah

Hannah,

We understand your concerns about a new dental bridge, especially if you’ve had TMJ concerns that required a specialist to resolve.

Will Jaw Pain and Popping Recur with a New Dental Bridge?

X-ray side-skull view of the temporomandibular joint (TMJ)

Get a second opinion to prevent or resolve temporomandibular joint (TMJ) complications

Jaw pain and popping will not recur with a new dental bridge if your dentist has advanced occlusion and bite training. A dentist with post-graduate occlusion and bite training understands how your teeth should meet when you close your mouth or chew. Also, the contact force between your teeth affects your facial and jaw muscles.

Are TMJ and Zirconia Crowns Related?

Online articles about zirconia crowns have varying opinions about how zirconia crowns affect your TMJ (jaw joint) risks. Your dentist must take accurate impressions of your mouth and ensure your bridge fits well and is in harmony with your lips and bite.

What Is a Porcelain Upgrade for Your Bridge?

The dental office’s terminology of a porcelain upgrade is not a term that dentists commonly use. You should call the office and ask for an explanation of the terminology. You can check the insurance company for their opinion on the upgrade if you have dental insurance. Your pretreatment estimate will help you anticipate out-of-pocket costs.

Although we are unsure of what “porcelain upgrade” means, below are possibilities:

  • Your dentist may be planning for premium crowns if the bridge affects your front teeth.
  • The framework for your crowns may be a more expensive metal or metal-free.

However, ensure your dentist gives you a thorough explanation before you agree to treatment. If you are uncomfortable with the answer, we suggest getting a second opinion from a dentist with TMJ training.

 

Metairie, Louisiana, dentist Dr. Duane Delaune sponsors this post. Learn more about TMJ symptoms and treatment.

My Mouth is Collapsed

Posted on by writeradmin.

I have always had problems with some teeth grinding. I wear a mouth guard at night as a result. That is the only time I feel like people can see my teeth and my jaw even hurts less. When I am not wearing it, my jaw hurts, you can’t see my teeth even when I smile, and I’m having trouble pronouncing some letters. My dentist is suggesting porcelain veneers. I just want to make sure I understand all my options. Is this the way I should go?

LeeAnn

Dear LeeAnn,

Woman holding her jaw in pain

I want you to be very careful here. While porcelain veneers could improve the appearance, if your dentist has artistic skill with cosmetic work, it will not solve the pain your are in. It sounds like your bite has collapsed as a result of the teeth grinding. This is going to lead to TMJ Disorder, which will put you in even more pain.

The solution in a case like yours is to have a full-mouth reconstruction, which means putting a crown on every tooth in order to build your bite back into the right position. However, this is the single most advanced procedure in general dentistry. It is not taught adequately in dental school. You will need a dentist who has invested a lot of post-doctoral training in both TMJ Treatment and Reconstructive Dentistry.

If this is done incorrectly, you will end up in more pain than before. In your position, I would look for a dentist who has significant training in one of the following institutions.

  • The Pankey Institute
  • Dawson Academy
  • The Las Vegas Institute for Advanced Dental Studies

The first two are located in Florida. The last one is (obviously) located in Las Vegas. They will have the knowledge necessary to make sure when they do build up your bite, they do it correctly.

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

full mouth reconstruction disaster

Posted on by writeradmin.

My dentist has been fixing my teeth because of my teeth grinding. He said I’ve been grinding them for years. Now they need to be repaired. He’s using crowns and bridges. When he did the temporaries they fit sort of okay. Some of the teeth weren’t fitting together okay but he said he would straighten that out with the permanent ones. The permanent ones are in, but it doesn’t feel right. Some of them aren’t touching each other and some are touching in some spots and not others. Is that normal? I know teeth vary. The problem is it hurts when I’m chewing and I’ve been getting pretty bad migraines. What do you recommend?

Joseph

Dear Joseph,

man grabbing the side of his jaw in pain

If I am understanding you correctly, the first thing I suggest you do is find another dentist. You said he told you that you’ve been grinding your teeth for years. In all that time, did he mention it to you or did he wait until they were down to nubs?

If he knew it and didn’t mention it, that is gross negligence. He could have saved your teeth from this procedure by providing a simple nightguard for you. This is a device you wear, similar to a sports mouthguard, which is custom-fitted to your bite and protects your teeth from the grinding, which mostly happens while you are asleep.

Because he didn’t do that, you are spending thousands of dollars on a full-mouth reconstruction, instead of what could have been a couple of hundred bucks.

Plus, you told me the temporaries weren’t occluding well either. He said he’d fix that with the permanents, but that isn’t how it works. The permanent crowns and bridges are patterned after the temporary ones. He had to fix those first.

You Need a TMJ Dentist

A full-mouth reconstruction is extremely advanced. It is something well beyond the skills of someone who simply graduated from dental school. It takes advanced TMJ training.

Some of the better schools are:

  • The Dawson Academy
  • The Las Vegas Institute of Advanced Dental Studies
  • Texas Center for Occlusal Studies
  • The Pankey Institute

In your place, I would get a refund and then find a dentist who has studied at one of these institutions. You can find them by doing a search for a TMJ Dentist online, then look at their bios to see where they did their post-doctoral training.

Bonus points if they are also a mynewsmile.com recommended cosmetic dentist, then you’ll know they can also create a beautiful smile.

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

solving a collapsed bite

Posted on by writeradmin.

I’m trying to find out what to do about my smile. I hate it. You can never see my teeth when my mouth is at rest. Actually, they’re almost impossible to see all the time. Even smiling my hardest you can barely see them. There is also almost constant jaw pain. When I wear a nightguard, it does help things feel more normal, but obviously I can’t wear that all the time. I want a smile I can be proud of. I was thinking of porcelain veneers but wanted to get all my options before deciding.

Margot

Dear Margot,

Woman covering her mouth with her hands

You don’t have to spend your life ashamed of your smile. I will say, though, I’m very glad you wrote before seeing a dentist. Too many would make things worse instead of better. It sounds like you’re dealing with a collapsed bite, along with complications from TMJ. Disorder This will take a dentist with advanced post-graduate training in a variety of skills.

Porcelain veneers aren’t the best option for you. You’ll need a procedure that will build up the teeth. This should be done with dental crowns, but it has to be done in a very specific way.

This should start with a provisional restoration. Once that is successful, the permanent restoration should be built from it. However, this isn’t easy. Successful will mean your teeth show under normal circumstances, your jaw doesn’t hurt, your speech is normal, and you love how they look.

You will need a dentist who has advanced training in restorative dentistry, neuromuscular dentistry, as well as cosmetic dentistry. That is a tall order.

See what dentists have advanced TMJ Training in your area, then check to see if they’re listed on the mynewsmile.com website. These dentists have the cosmetic training to create beautiful smiles. Combined, it will cover all the aspects you need.

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

dentist said no to porcelain veneers

Posted on by writeradmin.

I had dental bonding done on my front four teeth. The bonding has since worn out. I decided I wanted to upgrade a bit and get porcelain veneers. My dentist said I’m not a candidate for that because of the bonding. Instead, he wants to do crowns. I’m not crazy about that option. Do you have a recommendation?

Laurie

Dear Laurie,

A woman getting a porcelain veneer placed on her teeth

My first recommendation is you see another dentist. Under no circumstances should you let your dentist put dental crowns on your front teeth. This will grind them down to nubs. If this were necessary that would be one thing, but it is completely unnecessary.

You can have porcelain veneers placed after dental bonding. The only reason your dentist is saying you can’t is likely because he doesn’t know how to place them.

In dental school, we’re taught to always be confident with patients. Without that confidence, patients will grow anxious. So, instead of saying, “i’m not comfortable doing porcelain veneers” or “I haven’t done many porcelain veneers”, which could make you (understandably) uncomfortable, he says you’re not a candidate and avoids the issue altogether by suggesting a procedure he does know.

Find a Great Cosmetic Dentist

Cosmetic dentistry isn’t taught in dental school. A dentist has to make an effort to invest in cosmetic training after they graduate.

Even if you needed crowns, I would suggest a different dentist. To get a beautiful smile, you need an expert cosmetic dentist. Otherwise, the results would be disappointing.

In your case, I’d go to the mynewsmile.com website. They have a “Find a Cosmetic Dentist” link. You’ll input your zipcode and how far you are willing to travel to see a cosmetic dentist.

The key to this site is they have pre-screened each dentist who wants to be listed. They can’t just pay to get on the site. Instead, they have to show their technical knowledge and skill, as well as demonstrate their artistry in their work.

Anyone they recommend can give you a beautiful smile.

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

Do I Need to Replace Every Crown for them to Match?

Posted on by writeradmin.

I’m kind of hoping you give me the answer I want, but am willing to follow your advice regardless. I had crowns on eight teeth on my top arch for a smile makeover. One of them became loose. I went back to my dentist. He said there is decay on the edge and the crown needs to be replaced. However, he wants me to replace all of them so they’ll match. I want my teeth to match but don’t have a ton of money. Is that really necessary?

Candace

Dear Candace,

A porcelain crown being placed over the prepared tooth

I think the biggest problem here is your dentist isn’t a cosmetic dentist. Was there a particular reason he gave you a makeover with dental crowns instead of with porcelain veneers? Veneers are the standard treatment for a smile makeover because it doesn’t require your teeth to be ground down the way crowns do.

While there’s nothing you can do about that now, and those teeth will always require crowns now that the tooth structure is gone, you don’t have to replace all of them in order to get them to match. Though, to get a good result you will have to use a different dentist for this procedure.

Your Crown Replacement Options

You basically have two choices here: replace them all at once or replace them one at a time. The benefit to doing them all at once isn’t for them to match. A great cosmetic dentist can match a single tooth. It’s more to save you time. You’d replace them all and be done.

If you do them one at a time, it means a new trip to the dentist every time one goes bad. That could get annoying. The benefit to that is you’re only having to fork out money a little at a time instead of all at once.

Either decision will still require you to find a skilled cosmetic dentist if you want an attractive result.

Finding a Cosmetic Dentist

I’m going to suggest you go to mynewsmile.com. They have a “find a cosmetic dentist” link. You simply input your zip code and the distance you’re willing to travel. They’ll provide a list of qualified cosmetic dentists for you. The best part about this is they’ve carefully screened every single one of them for both technical knowledge as well as artistic ability in their work. No matter which dentist on their list you choose, they can give you a gorgeous smile.

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

Tooth Replacements for Clumsy Stuntman

Posted on by writeradmin.

I’m a stuntman by trade. Lately, I seem to be losing more teeth than usual. I’ve been losing one a year. I don’t know if dental implants will help that or if I should get a dental bridge. But, that’s a lot of teeth to grind down unnecessarily. What do you think? Will dental implants hold up?

Carl

Dear Carl,

Abutment and crown being placed on dental implants

I’m sorry you’re having such bad luck with your teeth. I don’t know if that’s common to your particular field or if you’re just in an unusual spate right now. If it’s unusual, the first thing I’d do is talk to your dentist and see if you can figure out if there is something else contributing to your tooth loss. At a rate of a tooth a year, it won’t be long before you’ll be in serious danger of facial collapse.

One of the leading contributors to teeth coming out early is gum disease. If you’re suffering from that, treating that is your priority. You won’t be a candidate for dental implants while having gum disease anyway.

If it’s a matter of just being unlucky at the moment, I’d make sure you’re wearing some type of mouthguard. This will give your teeth a bit of a buffer when things are going wrong.

Will Dental Implants Hold Up?

Before we go into dental implants, I want to address your comment about a dental bridge. When you’ve lost a lot of teeth, it’s not really a great option. If the teeth are all in the same area, you would need quite a large bridge. If one part of it breaks, the whole thing has to be replaced. It’s a better option when you’re missing a single tooth.

But, you’re missing several teeth. If they’re all in different places, you will have to crown two adjacent teeth for each false tooth. You were right in being concerned about grinding down healthy tooth structure.

While dental implants are a fantastic tooth replacement and they’re as stable as your natural teeth, they are only as stable as your natural teeth. This is another reason to wear a mouth guard and address the root cause.

Who Should Place Your Dental Implants?

You don’t want just any dentist placing your implants. Look for two particular skill sets, both of which require post-doctoral work to be significant enough to make a difference. The first is training in reconstructive dentistry. The second is training in cosmetic dentistry. It isn’t encouraging to replace your teeth but to end up with an ugly replacement.

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

Is It Possible to Replace My Metal Crowns with Porcelain Veneers?

Posted on by writeradmin.

I see these gorgeous pictures of porcelain veneers, then look in the mirror at my horrible ugly crowns and get discouraged. Is there a way I could replace my crowns with veneers? They’re cloudy looking to me. Now they’ve developed some kind of weird line at the gumline. I don’t want to be ashamed every time I smile.

Sandy M. – Little Rock, AR

Sandy,

I have bad news and good news. I always start with the bad news so we end on a hopeful note. It is impossible to replace crowns with porcelain veneers. When you had your crowns placed, your dentist had to grind down a good deal of your tooth structure to make room for the crowns. Porcelain veneers need to be bonded to intact teeth. With that tooth structure gone, there’s nothing for the veneers to bond to.

However, that doesn’t mean you are stuck with an unattractive smile. A good cosmetic dentist can give you a stunning smile using all-porcelain crowns. Based on what you described, you have metal-based crowns. They’re the ones that develop a gray line at the gumline. It also explains the cloudy look you mentioned. The crown is made more opaque to cover the metal.

All-porcelain crowns solve all of those problems. They can be as translucent as natural teeth. Combine that with the artistry of a great cosmetic dentist and you have a recipe for a smile you’ll be proud to show.

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