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Is This Dentist Pulling Our Leg?

Posted on by writeradmin.

My wife has been doing splint therapy for TMJ Disorder. Our dentist said that would help her migraines. It hasn’t and now he’s suggesting Botox. Is this dentist just pulling solutions out of thin air? I thought Botox was for wrinkles. I half suspect she’s paid him under the table to suggest this treatment. I think she’s always wanted to try it.

Carl

Dear Carl,

Advertisement for Botox

I can almost guarantee your wife did not slide a briefcase filled with a bribe under the dental tray. TMJ Disorder is very complicated, with a vast array of causes. While migraines can be a symptom of the disorder, sometimes it is not enough to simply do splint therapy. You are correct that Botox is used to deal with wrinkles. However, the same treatment can also relax muscles and help alleviate the excruciating pain that accompanies a migraine.

It has been approved by the FDA for use in the treatment of migraines under certain conditions. First, the patient must be over 18 years of age. Secondly, the patient must have a minimum of 15 migraines per month. In some cases, it is even covered by insurance.

If your wife suffers from migraines and splint therapy has not worked, then I would definitely do the Botox treatment. I don’t know if you’ve ever had a migraine, but they can be debilitating. This will give her some relief. Make sure she understands that it often takes a few treatments before there are more permanent results, but she will see results.

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

Her Dentist Won’t Take Out all the Teeth She Wants Out

Posted on by writeradmin.

I have an infected wisdom tooth and a tooth near it that had a root canal treatment a year ago. I want them both removed but for some reason, my dentist is only willing to take out the wisdom tooth. I’m putting off getting the wisdom tooth removed until I can talk him into doing both. Do you have any tips for getting a dentist to do what you want?

Danny

Dear Danny,

Woman holding her jaw in pain

Before you pressure your dentist, I want you to think about why he would NOT want to extract this tooth. Extracting it makes more money for him. Leaving it does nothing for him To me this speaks volumes. My assumption is he truly doesn’t believe there is anything wrong with the tooth and feels it would be an unnecessary procedure and expense for you. Plus, while you do not have to replace wisdom teeth, you do need to replace other missing teeth. By not replacing it, your bite will shift which risks you developing painful TMJ Disorder.

Now, in addition to the cost of the additional extraction (which makes him money), you will have the cost of a tooth replacement, such as a dental implant (which also makes him money). It sounds to me like you have a dentist with integrity that is trying to give you the best oral health possible without costing you money for procedures you don’t need.

If you still want to extract the tooth, then you can pressure him by saying, “either you extract it or I’ll go somewhere else to have it done.” That may have him extract it or he may tell you to go somewhere else.

Whatever you do, do it quickly. You have an infected wisdom tooth. Tooth infections are considered dental emergencies for very good reasons. Think about how close your jaw is to your heart, lungs, and brain. Tooth infections spread. If it reaches a sensitive area, such as those I mentioned then you put your life at risk. If you still want to insist on both teeth being removed at the same time, I am sure you will find a dentist willing to take the fee.

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

Form AND Function with TMJ Treatment

Posted on by writeradmin.

I had a serious problem with my bite when I started grinding my teeth. I’d ground them down to nubs. He put crowns on each of my teeth. However, I don’t think he did them right because now I have a slanted bite both upper and lower, plus a crossbite. I feel I’m in worse condition than I was before. I decided then to go to a neuromuscular specialist. He put me in an orthotic for a little over two years, which opened up my bite. Now my crowned teeth are ground completely down to nubs. Again, I am in worse condition than I started. I also learned that there isn’t a neuromuscular specialist, which makes me feel I’ve been swindled. I am out a fortune and in horrible pain. I didn’t even talk about how bad the crowns looked to begin with but both of them said I could have a healthy bite and a decent smile, but it would never be a Hollywood smile. I wasn’t asking for a Hollywood smile, but rather, I was looking for a natural-looking smile.  This one looks like beige-ish chicklets. Is the bite even fixable at this point? If so, can it look like a normal smile?

Madeline

Dear Madeline,

a woman holder her jaw from TMJ pain

You have been through a lot with dentists. Though you were thinking rightly in wanting a neuromuscular dentist, as you have discovered, there isn’t a recognized specialty in neuromuscular care, though it does actually take a significant amount of post-doctoral training in order to do it well. You are dealing with a serious case of TMJ Disorder at this point, even more so than when you started treatment.

I will say right off the bat, though you will need a tall order in a dentist, you will not have to choose between form and function. You will need a dentist with expert post-doctoral training in both TMJ Disorder and Cosmetic Dentistry. Both have to be post-doctoral because what is taught in general dental school isn’t enough for your situation.

Look on the mynewsmile.com website. These dentists are prescreened for their technical skill and artistry. They cannot pay to be listed on the site, they actually have to have the skills needed.  Once you have found all the dentists listed on that site within a reasonable driving distance to you, that is when I’d like you to look a their TMJ training AND experience

How to Find a Qualified TMJ Dentist

There are several schools that have great TMJ programs. Here are some of them:

  • Dawson Academy
  • Kois Center
  • Las Vegas Institute of Advanced Dental Studies
  • The Spear Insititute

While there are others, these are among the best schools.

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

 

 

Tanda Pearl Ionic Teeth Whitening System Review

Posted on by writeradmin.

I have TMJ Disorder and wearing my teeth whitening trays for an hour tends to aggravate my jaw.  I recently read about the Tanda Pearl system which allows you to whiten your teeth in just five minutes a day. That is very appealing to me. Do you know if it actually works? They say their light makes it work that fast.

Kathy

Dear Kathy,

custom-fitted teeth whitening trays

What I’d like to do is go over some of the differences between the Tanda Pearl System and the type of whitening you get with a dentist, which should help you make a decision.

The Trays

The teeth whitening trays you have from your dentist, should have been custom fit to your bite. The fact that it seems to be aggravating your TMJ Disorder makes me wonder though.

They also have separate trays for each arch of your teeth. This allows you to go about your day more easily. You could even wear them while shopping if you wanted to and no one would notice (whether or not you’re wearing a mask). Many people simply sleep in them to get the most teeth whitening for their time.

The Tanda Pearl trays you create at home by biting onto impression material. This is a single tray that you have to clench onto in order to keep it in. In truth, this will do way more to harm your TMJ issues than help them. Clenching is one of the worst things you can do, even for just 5 minutes.

The Light

This system claims to have a patented ionic technology. I’m skeptical about this. There doesn’t seem to be any information given about the light. If it were really such a breakthrough, they would make a ton of money selling it to dental offices. They’ve never even tried, which makes me think the light is more for psychological effect than any real use.

One thing I recommend is you talk to your dentist about the pain you are experiencing in your jaw. In the meantime, you can cut down on the amount of time you are wearing your trays each day. If a shorter time appeals to you, wear them a shorter time, at least until your dentist figures out why they are causing strain on your jaw. Really, in as little as 15 minutes, the gel has time to soak into your teeth adequately enough to make a difference.

One Appointment Whitening

Another option for you is to get Zoom Whitening. Not every dentist has this option so you may have to call around, but it allows you to get your teeth completely whitened in just one appointment.

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

Is Grinding my Teeth No Big Deal?

Posted on by writeradmin.

I mentioned to my dentist that my jaw hurts and I realized that sometimes I clench and grind my jaw. He said it is no big deal and not to worry about it, but my jaw hurts.  Is there anything I can do about it? It seems like a big deal from where I’m sitting.

Tracy

Dear Tracy,

Woman holding her jaw in pain

Grinding your teeth IS a big deal.

The first thing I’m going to say is you need to get a different dentist. This is not only a big deal, it is a HUGE deal. First, the pain you are experiencing alone is enough to do something about it. But, in addition, you are slowly grinding down your teeth. Eventually, you will wear them down to nubs. If that happens, the procedure to deal with that is a full mouth reconstruction. That requires getting a dental crown on every tooth. While proactive treatment will only bring in a couple of hundred dollars. A full-mouth reconstruction is a cost of $30, 000 or more. Plus, you are at a much greater risk to develop TMJ disorder.

There are a few things that can be done to help this. First, you’ll want to get out of pain.  Believe it or not, some Botox can help with this, as well as any migraines you may be experiencing as a result.

The next thing you’ll want to do is protect your teeth. While it is easy enough to notice when you’re grinding your teeth during the day. While you’re sleeping is when most of this likely occurs. I suggest you have a nightguard made. This will protect your teeth from grinding and clenching while you sleep.

However, I don’t think your dentist is the best one to handle this.  I’d like you to see a dentist with TMJ training. They can help get to the root cause of all this and solve the source of the problem.

This isn’t something that is taught in general dental school, so you’ll want a dentist who has invested in post-doctoral training. For instance, Dr. Delaune did advanced training in TMJ Disorder through the well-respected Dawson Academy.

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.

chronic migraines

Posted on by writeradmin.

I have chronic migraines. My doctor just puts me on a daily medicine, but it doesn’t seem to be helping. My sister-in-law said her dentist cured her migraines. What dental treatments are available for that.?

Cassie

a woman holder her jaw from TMJ pain
TMJ Can Cause Migraines

Dear Cassie,

There are two things that come to mind when you speak of a dentist helping you with chronic migraines. The first is the possibility of you having TMJ disorder.

Chronic migraines are just one symptom of TMJ. You’ll notice them especially in the mornings. There are other symptoms as well:

  • pops or clicking in the jaw
  • chronic headaches
  • pain in your jaw muscles
  • neck or shoulder pain
  • worn or chipped teeth

If you suffer from these, it will benefit you to see a dentist who has training in treating in TMJ Disorder. Sometimes a simple treatment can solve the whole problem.

There is another treatment certain dentists can provide while you get to the root causes of your migraines.

Botox for Chronic Migraines

Botox can relieve migraine pain

Some dentists and doctors can provide relief by giving you Botox injections. When we think of Botox, we often think of women who’ve had so many anti-wrinkle treatments that haven’t been able to crack a smile in years.

These are tiny injections that are placed by your pain receptors. This enables it to block the release of chemicals responsible for the transmission of pain, giving you relief.

It will not interfere with any of the medication you are currently on for your migraines so you don’t have to worry about contraindications.

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

tmj and sleep apnea

Posted on by writeradmin.

A friend of mine told me I should talk to a TMJ dentist because I’ve been struggling with sleep apnea. I’m not sure how reliable the source is, but thinking back, I really think my jaw problems and sleep apnea did start around the same time.

Back then, I was told to get a nightguard. I got one and I wore it for a while, but I don’t remember there being any difference and I found it cumbersome to sleep with, so I stopped using it and don’t remember what I did with it. I never got diagnosed with sleep apnea officially—my ex said I had it and that I snored. I figured if the fix for that was a full-on mask, there was no point in doing the sleep study since I couldn’t even tolerate the night guard. But, now I’m wondering if I should make my way back into the TMJ dentist again, just to see if I can have a new guard made that will address both. How viable is this?

Thank you,

Oscar

Dear Oscar,

You’re asking some great questions and are sort of on the right track. Let’s break things down a bit.

Sleep Apnea Involves Breaks of Breathing While You Sleep

There are three main forms of sleep apnea.

  • Obstructive Sleep Apnea: With obstructive sleep apnea, the muscles of the throat relax and block airways. It’s more common with people who carry extra weight, have allergies, take certain medications, and those who drink alcohol, among other things.
  • Central Sleep Apnea: With central sleep apnea, the brain doesn’t send the right signals to the muscles which control breathing.
  • Complex Sleep Apnea: When someone has both obstructive and central sleep apnea, it’s referred to as complex sleep apnea.

All Forms of Sleep Apnea Must Be Treated

When you wake up repeatedly through the night, your body has trouble making it through the various sleep cycles, so you never get a full night of sleep, no matter how many hours you spend in bed. That can lead to things like being grouchy, groggy, tired, and listless. In severe cases, sleep deprivation produces symptoms that are worse than being drunk, which makes it unsafe to drive and engage in a number of activities.

TMJ Dentists Help with Jaw Disorders

Most people refer to the concept of jaw issues as “TMJ,” but the acronym is short for temporomandibular joint, which is your jaw joint. When something’s wrong with it, it’s referred to as a temporomandibular joint disorder or temporomandibular disorder (TMD).

TMD Has Many Known Causes

In most cases, it’s the muscles which support the joint that become problematic. For example, a traumatic injury, like from a car accident, can cause TMD. Grinding, clenching, stress, and arthritis can all result in TMD too.

All Forms of TMD Must Be Treated

People who don’t treat TMD wind up with pain and tenderness, popping and clicking sounds as they open and close their mouths, difficulty opening, trouble chewing, and so forth. When grinding and clenching are involved, teeth issues also set in. Teeth may wear down or become loose. Dental work may wear out or break. The symptoms become worse over time if nothing is done.

If Malalignment is Contributing to Your Sleep Apnea, a TMJ Dentist Can Help

Research shows a huge correlation between sleep apnea and TMD. People who have one usually have the other. That’s not surprising, because if your jaw is not aligned properly, it will cause undue stress to your temporomandibular joint and the muscles which support it, plus cause your tongue to lay in an unnatural way. A doctor who performs a physical exam and takes x-rays may be able to give you a definitive answer, but ultimately, you need treatment for both. Go visit the TMJ dentist for treatment and see if that helps your sleep apnea. If not, then you’ll still want to follow through with your sleep apnea treatment.

This blog is sponsored by New Orleans Dentist Dr. Duane DeLaune.

Custom mouthpiece for grinding because of meds?

Posted on by writeradmin.

My dentist is trying to convince me to get this custom-fitted device to sleep with. He says I’m grinding my teeth because of the medicine I take. First, wouldn’t I know if I happened to be grinding my teeth and second, can medicines really make you do that? Does it even matter?

Clark

Dear Clark,

custom-fitted trays
Custome-fitted mouthpiece’s will protect your teeth.

I promise your dentist isn’t trying to pull one over on you. Everything he said is based in fact. Most patients doen’t realize they are grinding their teeth, because it happens at night while they’re sleeping.

The Consequences of Grinding and Clenching

Griding and clenching your teeth is known as bruxism. When you do that habitually, whether intentionally or not, your teeth begin to wear down. In some cases, I’ve seen them worn down to nubs and the patient had to have all their teeth crowned. This is known as a full-mouth reconstruction and is very costly.

In addition to wearing down the teeth, you can also end up chipping or even cracking them . Cracked teeth will also have to be crowned in order to save them.

A nightguard protects your teeth from the force of these motions. Even though you likely won’t be able to stop doing them, your teeth won’t bear the consequences.

Be on the Lookout for TMJ Disorder

With constant motion of your jaw in grinding, you’re in danger of another kind of problem. You could wear down your temporomandibular joint, leading to TMJ disorder.

Here are some symptoms to look out for:

  • Jaw Pain
  • Clicking in the Jaw
  • Migraines, especially in the morning

If any of these pick up, you’ll want to see a dentist who has some special training in TMJ.

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

Do I Have tmj or tmd?

Posted on by writeradmin.

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.