TMJ Training Archives - Marie Moeckel, DDS

Porcelain Veneers are the Wrong Solution for Her

Posted on December 24, 2020 by writeradmin.

The older I get the more I hate my smile. The teeth seem to get shorter and when my mouth is in repose you can’t see any teeth. It’s just a dark chasm. My jaw aches quite a bit lately. My dentist is suggesting porcelain veneers. From what I’ve seen that can really give you a pretty smile. I’m wondering if that will help the jaw pain, though. Any advice?

Catherine

Dear Catherine,

My first piece of advice is for you to find another dentist. It sounds like you’ve been dealing with teeth grinding or bruxism that is wearing your teeth down. This can lead to serious TMJ problems, for which you are already showing symptoms. This could have been prevented if he’d have done his due diligence, noticed the signs and provided you with some protection for your teeth. His suggestion of porcelain veneers is a bad one as well.

While a skilled cosmetic dentist can provide a beautiful smile for you with porcelain veneers, that isn’t what you need. I’m not convinced you’d get a beautiful smile from him either. The solution you need is probably a full-mouth reconstruction, which means placing a dental crown on each of your teeth to build the bite back to the right position. This is extensive and very advanced. I would like you to see a dentist with the type of TMJ Training that would qualify them to do this procedure.

For instance, Dr. Doan studied TMJ under the famed practitioner and instructor Dr. Mark Piper. Other great institutions that would qualify a dentist to provide the treatment you need would be:

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

This blog is brought to you by La Jolla Dentist Dr. Stephan Doan.

Serious TMJ Issues

Posted on May 11, 2020 by writeradmin.

I need some serious advice. I needed to have every tooth crowned because I grind my teeth. Once they were done, I was disappointed in how they looked. Even though my teeth were damaged, they were whiter and more sparkly than the crowns I received. However, there wasn’t much I could do about it. Before too long, I seem to have grounded those down as well and I was in serious pain. At that point, I did some research and felt I need a neuromuscular dentist. Again, I spent a fortune on dental crowns. He also gave me an orthotic device, but that ended up opening up my bite too much. I don’t know what to do. At this point, to get it fixed I’m going to have to go into debt. I’ve spent every dime I have on the last two procedures. If I weren’t in so much pain and absolutely humiliated by the state of my smile at this time I would just give up. What do I do?

Victoria

Dear Victoria,

I’m sorry you’ve had so much trouble with this. You’ve had some expensive lessons, which weren’t even your fault. First, let’s talk about the ugly dental crowns you received. Most dentists got into their field because they like to fix things. They have a more engineering mindset. Unfortunately, that means they care about structure but not appearance. It doesn’t have to be one or the other, though, if they seek out the right training. To get a smile that is both functional and gorgeous, you’re going to need a dentist who has invested in cosmetic training. Unfortunately, it isn’t a recognized specialty. That makes it challenging for patients to know who can create beautiful smiles and who can’t.

Second, let’s talk about what started this whole mess— the teeth grinding. This is a serious problem, as you’ve discovered. The worst part of this is the protection of your teeth would have been simple if your dentist would have been proactive. There are nightguards which protect your teeth from grinding. This could have prevented needing dental crowns to begin with. Secondly, it would have protected the first full-mouth reconstruction you had. Though, there are bigger problems with that one because of the pain it left you in.

That brings me to the third issue. You were on the right track looking for a neuromuscular dentist. The problem you ran into is, like cosmetic dentistry, it isn’t a recognized specialty. Having every tooth crowned is known as a full-mouth reconstruction. Because it is dealing with advanced dental issues, such as occlusion of the teeth, which aren’t taught in-depth in dental school, it does require some post-doctoral training. To be blunt, it doesn’t sound like either of the dentists you went to invested in that training. The fact that they didn’t get that training has caused you to have serious TMJ disorder issues. Here is the link to Dr. Doan’s TMJ Page. On it you’ll see the type of training you want in a dentist who needs to do your full-mouth reconstruction.

Because you also want a beautiful smile, you’ll want to also look for a dentist who is AACD accredited. These are the top cosmetic dentists in the country. When you find a dentist with training in both of these, you will get a smile that has both the correct function and stunning form. It will be worth it to drive a bit, if necessary.

This blog is brought to you by La Jolla Cosmetic Dentist Dr. Stephen Doan.

When Do You Need a Full-Mouth Reconstruction?

Posted on August 26, 2019 by writeradmin.

I’ve already had braces, but at my last appointment, my dentist suggested my bite was off. He wants to do a full-mouth reconstruction. I felt like if my bite were that bad I would have noticed something. Is this serious? Should I go through with it? I will if it is necessary, but it seems like an awful lot of money.

Candace

Dear Candace,

I am suspicious of what your dentist is recommending. Everyone’s bite is off to one extent or another. That doesn’t necessarily mean they require such extensive treatment as your dentist is recommending. A full-mouth reconstruction requires you to have every tooth crowned. This is usually reserved for the most challenging TMJ cases.

I don’t think this is your issue. You didn’t mention any TMJ symptoms. Because of that, and the serious nature of the procedure, I think you should get a second opinion. Look for a dentist with extensive TMJ training. You can read our TMJ page to get an idea of both what the symptoms are and what type of TMJ training you want in a dentist.

The reason I am suggesting you see a dentist with the right TMJ training is just on the minuscule chance you actually need the reconstruction. In that case, I want to make sure you get a dentist who can do it properly. I can’t stress enough how advanced a procedure this is.

Treating TMJ

Even if it turned out you did have a TMJ problem, a full-mouth reconstruction is one of the last solutions tried. First, your dentist would look at the root cause of your problems and try to address it that way. Maybe it is because your bite is “off”. That doesn’t necessarily mean you’ll need crowns. A simple bite adjustment with Invisalign is far less invasive and less expensive.

There are countless causes for this problem and just as many solutions. A good dentist will start with the most conservative treatment to see if that will solve the issue. Yours is diving headlong into a worst-case scenario solution without you even bringing up symptoms.

After your second opinion, if it turns out there was nothing really wrong, I’d like you to find a different dentist. Yours has my warning bells going off.

This blog is brought to you by La Jolla Dentist Dr. Stephen Doan.

Does TMJ Really Require a Full-Mouth Reconstruction?

Posted on January 29, 2019 by writeradmin.

I’m really concerned and don’t know what I need to do. I’d been having serious migraines and talked to my doctor about it. He’d been running tests but we haven’t had any real success in finding the cause. I mentioned it when I saw my dentist because I was having one right then. He started messing with my jaw and said he thinks the problem is TMJ Disorder. He suggested I get a full-mouth reconstruction. This costs more than I make in a year. Is there any other treatment or does it require this? I’ll do what I need because these migraines are unbearable. But, man, I don’t know how I’m going to afford this.

Liv

Dear Liv,

I will say there are some warning bells going on here that have me concerned. First, let’s go over what is accurate. Migraines can be the result of TMJ Disorder. However, the first treatment is rarely a full mouth reconstruction. These are for the worst cases and only after other, more conservative treatments have been tried and failed.

In your place, I’d like you to get a second opinion. If your jaw was in that bad of a condition that it required such an invasive procedure, why hadn’t he mentioned it before?

Who Should Treat You TMJ?

There isn’t really a recognized TMJ Specialty. That means any general dentist can treat TMJ regardless of their level of training. I want you to see someone with a significant amount of TMJ training. This is especially true if you do end up needing a full-mouth reconstruction.

For instance, Dr. Doan has done extensive training with the Dawson Academy, which is one of the top TMJ training centers in the country.

However, when you are talking about a full-mouth reconstruction, you will want the form of your smile to be beautiful along with proper function. This means not only will you want a dentist with expertise in TMJ, you’ll also want an expert cosmetic dentist.

If you were having every tooth re-done, you want a top-of-the-line cosmetic dentist. My recommendation would be to find a dentist who is accredited with the American Academy of Cosmetic Dentistry.

AACD accredited dentists can give you a stunning smile you’ll be proud to share with the world.

This blog is brought to you by La Jolla Dentist Dr. Steven Doan.

Are There TMJ Options to Full-Mouth Reconstruction?

Posted on July 1, 2018 by writeradmin.

My dentist is pretty sure I have TMJ. I have constant headaches and jaw pain. Occasionally, it gets so bad that I have to eat a liquid diet through a straw. My dentist didn’t feel qualified to treat my particular case so he gave me a name of a TMJ dentist he thought could help. The dentist saw me and recommended a full mouth reconstruction. If he could guarantee it would solve the problem, I’d think it was worth it, but he said he can’t. We’re talking about thousands of dollars plus grinding down perfectly healthy teeth. Please tell me there are other options.

Marylin

Dear Marylin,

TMJ can cause severe jaw pain.

It’s great that your dentist knew he was out of his depth. I want to make sure you understand that there isn’t a TMJ Specialist. It’s actually just a dentist who’s invested a lot of time and training into understanding the causes and solutions to TMJ Disorder.

While full-mouth reconstructions are becoming more popular, they’re usually only done after other less-invasive treatments have been tried and failed. It’s also a very advanced procedure, so make sure the dentist you’re currently seeing for treatment has extensive post-graduate training. For instance, Dr. Doan did TMJ Training at the Dawson Acadamy. LVI is another great institution, as well as others. You can contact us if your dentist went to another institution and you want to know if it’s reputable.

If the treatment isn’t done properly, it can even make your situation worse. That’s the last thing you want.

Alternate TMJ Treatment

In reality, your best chance of a successful treatment is accomplished by finding the cause of your TMJ symptoms. We’ve often found that many TMJ cases are a result of clenching or grinding of the teeth. The patient may not even realize they’re doing it especially if it’s mostly when they’re sleeping. In that case, a simple night guard almost always solves the problem.

Other times if the jaw is out of alignment slightly, it’s a matter of adjusting the jaw enough to realign the joints, as you would do with obstructive sleep apnea. The point is you need to know the cause before the solution.

According to what you’ve said above, this dentist hasn’t pinpointed a reason for the problem or even tried less invasive solutions. In your case, I’d seek a second opinion. It doesn’t hurt to get a third opinion either.

This blog is brought to you by Dr. Stephen Doan.

Treating TMJ

Who Should Treat You TMJ?

Alternate TMJ Treatment

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