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Full Mouth Reconstruction Disaster

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I wanted to put crowns on my front top and bottom teeth but my dentist said that he needed to open my bite for that to work because I ground down some of my teeth, which meant getting a full mouth of either crowns or bridges. This has ended up a bit of a disaster. Aside from the fact that the procedure itself was a nightmare, I’m having more trouble with the results. On one side of my mouth the teeth aren’t meeting together at all. On another side, one of the bridges is crashing with the opposing teeth in a way that is causing pretty bad pain. Can he grind down the teeth in that bridge in a way that won’t hurt the teeth they’re hitting? Oh! One other thing I didn’t mention. My jaw is now clicking pretty much every time I open it. Is that from the bridge or something else?

Andie

Dear Andie,

Woman in pain from TMJ

What your dentist did is known as a full-mouth reconstruction. However, it sounds like he is in over his head. These type of procedures are one of the most advanced in the dental field and require extensive post-doctoral training. If not done correctly, it can throw off your bite and even lead to painful TMJ Disorder. I suspect this is what has happened to you based on your description.

While it is possible that the bridge can be ground down, there are two things that make me think this would be a bad idea. First, he said your bite needed to be opened. Grinding those teeth down would not contribute to that. Second, it sounded like the other side of your bite was not touching at all. If that is the case, he’d have to grind them down too much.

This case needs to be completely redone. Your dentist should take responsibility for that. You can either give him another chance or have him pay to have it redone by the dentist of your choosing. Either way, the dentist should work the case provisionally first. By that I mean that he would make certain everything is lining up properly with temporaries first. Then, once everything is perfect and feels completely comfortable and natural to you, the permanent ones can be made.

If you want to find a different dentist to fix this, I want you to make sure they have the right training. Look for a dentist who has trained in at least one of these institutions. These will be the best dentists for your situation:

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

This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.

Dentist Wants to Treat My TMJ Disorder with Crowns

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Can you give me some advice? I grind my teeth and have worn them down. As a result, I have TMJ Disorder. I’ve been seeing a specialist, who has me wearing a nightguard. They are so worn down that they can no longer get fillings. Through my specialist’s care, my migraines and jaw pain have improved when I am wearing the mouthguard. However, now she is suggesting that if she put crowns and onlays on several of my bottom teeth, she could fix my bite permanently to treat my TMJ Disorder. Is this a legitimate treatment? I’m starting to panic that it might be a mistake. My treatment is scheduled for next week. Should I go through with this?

Sandy

Dear Sandy,

Illustation of TMJ problems

Using crowns to rebuild a bite, especially one that a grinding habit has shortened the teeth to nubs is a legitimate way to treat TMJ Disorder. In fact, in some of the more severe cases of TMJ, a dentist will do what is called a full mouth reconstruction, which consists of crowning every tooth.

One thing I would caution you about is your dentist calling herself a TMJ Specialist. You should know that there is not a recognized specialty in TMJ, though I wish there was. Maybe she explained that to you already. TMJ is a complex disorder. In order for a dentist to understand how to treat it correctly, they would need post-doctoral training. It’s possible your dentist has that training. But, if she doesn’t I would get this procedure done by someone else. Otherwise, you could end up with a lifetime of pain.

Here is a list of some of the best post-doctoral institutions that train dentists in TMJ disorder:

  • The Pankey Institute in Key Biscayne, Florida
  • The Dawson Academy. Their headquarters are in Florida, but they have training centers in several different states
  • Spear Education in Scottsdale, Arizona
  • The Las Vegas Institute for Advanced Dental Studies in Las Vegas, Nevada
  • Piper Education and Research Center in Tampa, Florida

Find out if your dentist studied TMJ at one of the places listed above. If so, you should be perfectly safe. If not, go elsewhere for the treatment.

This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.

Should I Finish My Full-Mouth Reconstruction?

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I had a problem with grinding my teeth. I did not realize it was a problem until I switched to a new dentist. She showed me how much tooth structure I had lost and asked if I’d been having any jawpain or headache. I had and she explained that having my bite so far off could be leading to TMJ disorder. Her suggestion was that we crown the teeth that have been ground down. I went ahead with that and not sure I want to finish. My jaw is not hurting as much as it used to. I was really emotional about how perfect the bottom teeth were. I miss the quirky nature of my original smile. Can I just stick with my upper teeth as they are? I am a bit embarrassed that the upper teeth will be darker than the bottom teeth, but maybe I can whiten those. Yet, that causes problems of its own because I used zoom once and my teeth were super sensitive. Help!

Stacey

Dear Stacey,

Woman covering her mouth

A smile makeover should last for years.

While you can just stop with your bottom teeth, I want to make sure you understand all the things that come with that. First, your dentist likely designed your full-mouth reconstruction to include both arches. Doing just one, limits its effectiveness. However, the thing that worries me most is the impact on your upper teeth. The ceramics on the bottom teeth will be tougher on your upper teeth than natural tooth structure. If they are already damaged from grinding, this will damage them further and could acerbate your TMJ Disorder issues.

Your main concern seems to be the appearance of the bottom teeth being too perfect. If you are seeing a great cosmetic dentist the teeth can include that quirkiness you are missing. In fact, most cosmetic dentists would jump at the chance to do something other than a Hollywood smile! Communication with your dentist is key.

If you still do not want to complete the upper arch, that is totally within your right and your dentist should respect that. You’ll be more comfortable with your smile if you do go ahead with teeth whitening. Zoom is a pretty strong way of doing that. If you had sensitivity last time, I would go with a different option. There are plenty of take home, yet professional strength, options that are more gentle but will still give you a white smile.

Hopefully, your dentist has already done this but if you’re not wearing a night guard, you really need to. It will protect your teeth from your grinding.

This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.

Fixing a Collapsed Bite

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I have a smile that has always embarrassed me. When my mouth is relaxed, you can’t see my teeth at all. It’s like a big black gap. I often have trouble saying certain letters and have jaw pain almost all the time. The only break I get from it is when I am wearing my mouthguard. You can see my teeth a little better too then. A friend of mine thought that porcelain veneers might be helpful. I just want to make sure that is the right path before I move forward.

Lisa

Dear Lisa,

Woman in pain from TMJ

I am very glad you wrote. This can be fixed, but you have to do it very carefully. The dentist you choose will be the most important thing. Bear in mind that I have not examined you, but based on your description, it sounds like you have two issues going on. The first is a collapsed bite. The second is some TMJ complications.

Fixing this will require more than just porcelain veneers. The solution is to open up your bite with a full mouth reconstruction. It is usually done with dental crowns and possibly some porcelain veneers combined. It is extremely complicated and advanced. It requires a dentist who has advanced post-doctoral training.

Three of the top institutions that offer the training necessary for a dentist to perform this treatment are:

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

If you have a dentist who is not qualified to do this, then you could end up with a disastrous result. There have been patients whose bites were so thrown off by this that they ended up in pain for years. I don’t want that to happen to you. There is nothing wrong with asking a dentist about their qualifications. Start by looking online for dentists who consider themselves TMJ Dentists. Then make sure they have studied at least one of the three institutes I listed above.

This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.

 

Need Advice About Jaw Pain

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I have a teeth grinding habit. To fix it, my dentist crowned all my teeth, but somehow they weren’t done quite right. My bite is slanted and I ended up grinding those down as well. My jaw hurt so much that I went to another dentist who called himself a TMJ dentist. I thought he could help because of the pain in my jaw. He put me in an orthotic device for a little over two years but that seems to have had the result of opening up my jaw too much. I am in agony and everyone I see has the tendency to make it worse. What do I do?

Zoe

Dear Zoe,

TMJ illustration

You have had a rough go of things. One of the things you are up against is the fact that TMJ is not a recognized specialty. Any general dentist can claim to be a TMJ dentist even if they have not invested the time and money in the additional training necessary. This, however, rarely serves their patients well. Your first dentist tried what is known as a full-mouth reconstruction. This is one of the most advanced procedures in dentistry. It does not sound like your dentist has the training necessary to do this, which is why your bite ended up worse.  You should also know that just crowning the teeth won’t keep you from grinding them. The best way to protect your teeth from grinding, once they are repaired is with a nighttime mouthguard.

The second dentist kept you in an orthotic too long, which is what opened up your bite past its natural position. What you have now is a serious case of TMJ disorder. You need a dentist who has the advanced training to give you proper treatment. Three of the best post-doctoral institutions for TMJ Training are:

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

Find a dentist who has training at one of these institutions and you will be in good hands and on the road to getting your bite corrected properly.

This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.

 

 

 

Full-Mouth Reconstruction for TMJ?

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I have been having headaches for a while now. I mentioned it to my dentist. He mentioned that could be a symptom of TMJ and started messing with my jaw. He said I need something called a full-mouth reconstruction and his assistant gave me an estimate that is, frankly, a fortune. Is this really necessary for a recurring headache?

Tamara

Dear Tamara,

A woman grabbing her jaw in pain from TMJ

Based on what you’ve said, it seems like there are some things your dentist is doing is right about and some he is jumping the gun on. First, it is true that recurring headaches can be a symptom of TMJ Disorder. Second, TMJ Disorder does need treatment.

I think he’s jumping the gun on the type of treatment you need. Most dentists who do a lot of TMJ work will start with the most conservative threatment first.

There are several reasons for TMJ Disorder. Which treatment you use depends on the cause. In some cases, Bruxism (the clenching and grinding of your teeth) is the cause. Most people don’t realize they do it because it happens while they are sleeping. Other times it’s because your teeth are misaligned.

Treatment can vary from wearing a night guard to protect your teeth from grinding, to a bite splint, all the way to a full-mouth reconstruction.

Get a Second Opinion from a TMJ Dentist

I want you to get a second opinion before jumping into this. While there isn’t a recognized TMJ Specialty, there are dentists who’ve invested significant time in the diagnosis and treatment of TMJ Disorder.

Here is Dr. Becker’s TMJ Training from some of the most reputable institutions in the country:

  • Dr. Peter Dawson Advanced Dental Seminars
  • Seattle Institute for Advanced Dental Education in State-of-the-Art Esthetics
  • U.S. Dental Institute for Orthodontic Training
  • Pankey Institute for Advanced Dental Education
  • Post-graduate training at Northwestern University Dental School in Periodontal Surgery

If it does turn out you need a full-mouth reconstruction, which involves crowning of all your teeth, make sure it is done by a dentist with the type of training listed above. It’s a very advanced procedure and an inexperienced dentist could permanently mess up your bite.

This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.

TMJ Treatment to Whiten Teeth?

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I mentioned to my dentist that I wanted to whiten my teeth. Everything sort of spun out of control from there. He started messing with my jaw and told me my whole bite was off and I’m getting something called TMJ. He wants me to crown every tooth. He said that will take care of both the bite and the whitening. I am really worried about this. I had braces as a teenager and my bite has always felt fine. How do I know if I’m getting TMJ?

Carey

Dear Carey,

A woman grabbing her jaw in pain from TMJ

I’m quite concerned by what I’m hearing here. When you have TMJ Disorder, there are symptoms. Here are some of the most common:

  • Popping or Clicking in the Jaw
  • Migraines, especially in the morning
  • Facial Pain
  • Jaw Joint Pain
  • A bite that feels off

You haven’t mentioned any of these. However, let’s say for argument’s sake that you did have these symptoms. Crowning all your teeth is known as a full-mouth reconstruction. It would be one of the last treatments tried. Not the first.

TMJ Treatment

There are many treatment options for TMJ disorder. A good dentist would start with the most conservative treatment to allay the problem. It might be a simple matter of wearing an corrective orthotic device for a few months.

To get a full-mouth reconstruction, you’d want someone with significant TMJ training. This isn’t something taught in dental school so they’d need to have invested in those studies on a post-doctoral basis.

Not only does crowning all your teeth cost a fortune, it can actually cause TMJ problems if it is not done properly.

Here’s What You Should Do

Without having any symptoms, I find it hard to believe you have TMJ Disorder, but if you are worried get a second opinion from someone who has done the requisite training. The Dawson Academy is a good learning institution for this. So is the Las Vegas Institute for Advance Dental Studies (LVI).

As far as the teeth whitening goes, this is a simple and inexpensive procedure. Any dentist can do this for you. It certainly does not require you to get crowns. The exception to that would be if you already have a dental crown. In that case, you’d still whiten your teeth normally. Then, if the crown is visible, you’d replace it to match the new whiter color of your teeth.

My takeaway here is get a second opinion… and a different dentist.

This blog is brought to you by Hoffman Estates Dentist Dr.William Becker.