orthodontics Archives - Dr. Duane Delaune's Blog

Can a Tooth Pushed Out of Place Be Repositioned?

Posted on December 31, 2023 by AllSmiles.

Last month, I had an accident that pushed my tooth back. I want Invisalign to reposition the tooth, but my dentist says nothing can be done further to move the tooth. The tooth root got moved forward and poked my upper lip. I could feel it in my nostril. My dentist said he repositioned the tooth as best he could. He said that he might be able to do something cosmetically. But the sensation in my nostril is uncomfortable, and the tooth is clearly out of place. Do I really have to live with this? Will braces help? Thanks. Ryan

Ryan,

We wish you could have seen a dentist within a day or so of the accident. If a tooth injury is new, a dentist can move it back into place and stabilize it to prevent it from moving.

Can a Tooth Pushed Out of Place Be Repositioned?

When a tooth is pushed out of place, a skilled dentist or endodontist (root canal specialist) can do the following:

Reposition the tooth
Stabilize it until it heals
Perform root canal treatment within a few days of the injury
Protect the tooth with a permanent filling or a crown

If your dentist did not reposition the tooth, orthodontics can do it. Now, you must wait until your tooth fully heals. Invisalign or braces will reposition your front teeth relatively quickly. If you have no problems with your bite and no TMJ symptoms, you can only get Invisalign for your upper teeth.

Root Canal Treatment for a Damaged Tooth

When a tooth is knocked out of place, the pulp (living tissue inside) is usually damaged. You will probably need root canal treatment to remove the tooth pulp. Your dentist or a root canal specialist (endodontist) must clean root canal cement and filler inside the tooth’s crown. Otherwise, your tooth will turn dark over time. If the crown is left clean, it takes years for the tooth to darken.

You can schedule a consultation with an orthodontist provider to examine your tooth and determine when you can begin treatment.

Metairie, Louisiana, dentist Dr. Duane Delaune sponsors this post.

What Else is Necessary with Porcelain Veneers?

Posted on January 16, 2021 by writeradmin.

I want to get porcelain veneers. My dentist is fine with that but said he wants me to get my teeth whitened first and my crooked front tooth straightened with Invisalign. I thought that porcelain veneers made your teeth whiter and could make a crooked tooth look straight. What else is really necessary with porcelain veneers?

Kelly

Dear Kelly,

I can give you some guidelines here, but bear in mind that I have not examined you so it would be irresponsible to give specifics. In principle, you are right, porcelain veneers can change the shape, size, and color of your teeth. If that is the case, why would you need anything else?

Let’s start with the teeth whitening. Most dentists will suggest you whiten at least your bottom arch of teeth. Patients generally only get veneers on their upper teeth, so if you want your two arches to blend, whitening the bottom teeth is an inexpensive way to do that. You would only need to whiten the upper arch of your teeth if you were not getting enough porcelain veneers to cover the teeth that are exposed when you smile. Most people have a smile that is 8-10 teeth wide. Let’s say you were getting just six porcelain veneers. Then, the adjacent teeth would not match when you smiled. Whitening them will help them to blend.

The Invisalign is a whole different story. It is rare for a patient to need orthodontics and porcelain veneers. You mentioned you had a crooked front tooth. An experienced cosmetic dentist can make crooked teeth look straight with porcelain veneers. The exception to that would be if you had a pretty complicated orthodontic case. That doesn’t sound like you at all.

This gives me a clue to your dentist. It is quite possible your dentist is using Invisalign like a crutch. He doesn’t feel comfortable shaping crooked teeth with porcelain veneers so he only wants to work with the ideal cases. If it isn’t ideal he suggests other procedures until it is. This is a waste of your money and time.

I suggest you get the teeth whitening with him. It is inexpensive and useful. Then, get the porcelain veneers with an expert cosmetic dentist. I recommend looking on the mynewsmile.com website. The man who runs this site is a retired cosmetic dentist. He prescreens every dentist who wants to be listed there for their training, technical knowledge, and artistry. Any one of them can give you a stunning smile makeover, without having to do unnecessary procedures to get there.

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

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.

Do I Need a TMJ Specialist?

Posted on November 3, 2018 by writeradmin.

I told my dentist about a pain in my jaw. He decided I have TMJ and keeps giving me Botox injections. While the injections help, I don’t want to need them for the rest of my life. If I went to a TMJ Specialist would there be a permanent solution?

Gina

Dear Gina,

TMJ Disorder can be very complex. Often, there’s more than one factor. If all your dentist is doing is the Botox injections without looking for what could be causing it, then yes, you’ll want to see someone else. Unfortunately, there’s no such thing as a TMJ Specialist as far as a recognized specialty goes. But, there are some things to look for when choosing a dentist to treat your TMJ.

You’ll want a dentist who has invested in post-doctoral training in the diagnosis and treatment of TMJ Disorder. Some of the more reputable institutions are:

The Dawson Academy
The Seattle Institute
The Kois Center
Pankey Center
Las Vegas Institute (LVI)

Dentists who’ve studied with one of these institutions will be a practitioner who can help find the root cause or causes of your particular TMJ problems.

A couple of Causes of TMJ

One leading cause of TMJ problems is teeth grinding or clenching. Over time, this not only does damage to the hinge joint, but it is also devastating to your teeth. It can cause them to crack or break, requiring dental crowns. It can even cause them to come loose.

The grinding motion wears them down to nubs and could end up costing tens of thousands of dollars for a full-mouth reconstruction. To make matters worse, if you don’t regularly see a dentist you may never know you’re even doing it until it is too late. That’s because most people do it in their sleep.

Fortunately, for most patients, when caught early, there’s a simple fix. A night guard can protect your teeth. It fits like a custom made comfortable mouth guard and places a barrier between your teeth.

Another cause is malalignment of the teeth. If your bite is off, it can throw off your jaw joint leading to serious TMJ problems, including lockjaw. Sometimes, it is just a matter of simple orthodontics, other times it’s more serious.

A good dentist will always start with the least invasive treatment before moving onto other more drastic measures.

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