full mouth reconstruction Archives - Dr. Duane Delaune's Blog

Help! My Dental Implants are Falling Out.

Posted on May 31, 2021 by writeradmin.

I had a full mouth reconstruction done a year ago and the dental implant crowns have been falling off leaving me with nothing but the screws. Now one of the implants themselves have fallen out. I’ve been trying to reach my dentist for months, but they keep blowing me off. Now I learn he’s actually fled the country. Is there any way I can get some teeth now?

Liz

Dear Liz,

I am sorry for what you are being put through. It seems your dentist was a crook. I think he or she knows they are in trouble as they fled. I wonder how many other victims there are. It will be hard to recoup your money unless he comes back to the country. I can, however, tell you how to get the smile you want.

You made a good choice in getting dental implants. They are the best tooth replacement. I hope you actually needed a full-mouth reconstruction and that wasn’t just another part of his unethical behavior. Either way, you need one now. To be frank, this is one of the most advanced procedures. Unfortunately, this procedure is not taught in dental school. In order for a dentist to get the training to do this properly, it will require a dentist who invested in a significant amount of post-doctoral treatment, specifically in three areas:

Cosmetics – to ensure your smile looks beautiful
Dental Implants – for obvious reasons
TMJ and occlusion – to make certain they know you your teeth should meet with proper occlusion.

I know that is a tall order. Start with the the cosmetic training. I would not look for the cheapest dentist. That usually means they cut corners in order to keep profits up. That is the last thing you need. Look for someone listed on the mynewsmile.com website. Any dentist listed there has had their technical training as well as their artistry evaluated. They cannot just pay to be listed. Next look at their implant training. Dentists with implant training often have TMJ training as well because proper occlusion is necessary for a good outcome with dental implants. For instance, Dr. Delaune did implantology training with the Zimmer Institute, but he also invested in advanced TMJ training with the renowned Dawson Academy.

Please don’t be surprised if they mention you need a bone grafting procedure to get these implants done correctly. Your implants will probably have to be removed, if more of them haven’t failed by then. When that happens, you lose some bone structure. In order for your dental implants to remain secure, you will need that bone support. In fact, it is imperative that bone integrates with the implants for a successful case.

Following these guidelines, you should receive an amazing smile you will be proud to share that will serve you well for many years to come.

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

What causes receding gumlines

Posted on March 15, 2020 by writeradmin.

I see that some of my teeth have gumlines that are receding. I’m fairly good at my oral hygiene. I brush twice a day and floss once. What could be causing this? Is there a way to fix it?

Candace

Dear Candace,

I’m glad you wrote. I can tell you care about your teeth a great deal and do your best to take care of them. There are a few reasons you could be dealing with receding gums.

Gum Disease

If plaque or food gets trapped under your gums, it is not only an irritant but can cause the teeth to become loose. I don’t know who your dentist is but most dentists check for this at each of your cleanings and checkups. Some discount clinics, though, will skip this step. You can call your dentist and ask how your gums looked at your last checkup or just go in for another one.

Brushing too Aggressively

If you are super aggressive about brushing and using a hard-bristled toothbrush. I always recommend to use a soft-bristled brush. It does a great job and is safer for your gums.

Bruxism

This is when you grind or clench your teeth. This can cause notches on your teeth at the gumline. When that does happen, it will cause your teeth to recede. This is also dangerous for your teeth. A simple nightguard, which your dentist can custom fit to your bite, which will protect your teeth. Without that, you will end up grinding your teeth down to nubs, which will require every tooth in your mouth to be crowned. That is known as a full mouth reconstruction and can cost you up to $60k.

Repairing Receding Gums

There is gum surgery which can be done to repair your gums. Periodontists do the surgery. Some dentists do it as well. A few, including Dr. Delaune, invest in further training to learn the pinhole technique.

Unlike traditional gum grafting surgery, this requires no scalpels or sutures. It’s worth looking into.

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

full mouth reconstruction disaster

Posted on December 30, 2019 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.

does tmj mean surgery?

Posted on June 6, 2019 by writeradmin.

I’m 27 years old and have been dealing with a significant amount of jaw pain. I did some research online and it sounds like I may have TMJ. Everything I read says the treatments for this are jaw reconstruction or having all your teeth re-made. That sounds terrifying to me. In fact, I’m a little too scared to see a dentist about it in case they say that is what I need. Are there any other options? What happens if I just don’t treat it and just deal with the pain with medications?

Morgan

Dear Morgan,

close up of temporomadibular joint — TMJ disorder has various causes and solutions

Before you panic, let me assure you there are many causes and solutions for TMJ Disorder. As you can see from the image above, your TMJ joint is similar to your knee joint. It has movable parts and a disc which serves as a buffer. There are also lots of muscles that help with the various movements requisite to good jaw function. This is known as the temporomandibular joint (hence the TMJ).

Treatments like full-mouth reconstruction or jaw surgery are for the most severe cases, usually after years of going without treatment or a tragic accident. It doesn’t sound like that is what you’re dealing with.

The first step to any treatment is a diagnosis of what is causing the problem in the first place.

Two Causes for TMJ Disorder

One common cause for this is pressure you’ve put on the jaw joint. This is done through clenching your jaw or grinding your teeth. This often happens without a patient even realizing it because they do it in their sleep.

If you get treatment for this early on, before too much damage is done, there is no invasive treatment. It can often be handled simply by wearing a night guard to protect your teeth and add some cushion to assist with the pressure on your jaw.

Another cause is misalignment of your bite. Our teeth shift over time. It could be that yours have shifted in a way that has caused pressure on your jaw.

In some cases, this can be fixed with orthodontics such as Invisalign. Other, more severe cases, will require a full-mouth reconstruction. This latter treatment can also happen if you don’t get teeth grinding under control and your teeth get worn down to nubs.

Full-Mouth Reconstruction

With this procedure a dentist has to crown all of your teeth. This is either because they are too worn down from grinding or your bite is so far out of alignment this is necessary to repair it.

This is quite an advanced procedure and would require a dentist with significant training in TMJ Disorders as well as cosmetic dentistry.

Look for a dentist who trained at one of the following:

Dawson Academy
J.D Pankey Institute
The Las Vegas Institute of Advanced Dental Studies

This will take care of their TMJ qualifications. To find out if they’re also a great cosmetic dentist, go to the mynewsmile.com website to see if they’re recommended . They pre-screen cosmetic dentists for both their technical skill and artistry.

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

Can My Dentist Treat My TMJ?

Posted on July 31, 2018 by writeradmin.

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,

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.