June 2011 - Ryan Perry, DDS

I hope you can help me. I’ve been fooled too many times, and really just need some good information. I thought I would right in and ask you, since you have nothing to gain by lying to me like my dentist did.

I just turned 30, but I’ve had porcelain crowns on all my teeth for more than 10 years. I have a severe teeth grinding habit. Because the original crowns were not properly placed, I have worn those down, too, and now have a lot of pain and clicking when I chew or move my jaw. The last dentist I trusted (she retired) said that I have an upper and lower slant which makes my jaws crooked and a posterior crossbite. Beyond all of the more serious physical issues, they are ugly. That might sound silly, but I am only 3o! They look terrible, and it really impacts how I feel about myself.

I went to see a dentist who billed himself as a “neuromuscular dentist”. He had me in a device for two years. Things have shifted around, but nothing is better! Now I get headaches every single blessed day. I don’t know who to turn to next. Should I see a prosthodontist? A cosmetic dentist? I just know that I can find someone who can make my teeth function properly AND look good, but I need to know where to look. Can you help?

Thanks so much.

Ava in Topeka, KS

Dear Ava,

You actually were smart to work with a neuromuscular dentist. The problem might have been that the dentist you worked with SAID they were a neuromuscular dentist, but did not have the proper training to ethically make such a claim. As you may have discovered, neuromuscular dentistry is not a legally recognized specialty. Like cosmetic dentistry, any professional can claim to provide those services without any specialized training at all.

You need to look for a dentist in your area that specializes in TMJ treatment, and preferably one that also has cosmetic dentistry training, too. Look for a dentist that has received training at an institute like the Las Vegas Institute for Advanced Dental Studies, which is one of the leading facilities for training dentists in treating TMJ disorders. A dentist that has had the kind of training you are looking for won’t be shy about displaying those credentials.

This post brought to you courtesy of Baton Rouge dentist Dr. Perry.

Last year I had to have a filling put in one of my front teeth. My dentist used that new white filling material, and I’ve had nothing but trouble since. First I had to go back in and have her sand out the filling materials that was causing dental floss to get stuck between my teeth. Then a few months after that I bit into a hot sandwich and almost passed out from the pain. It was unreal! I called my dentist and she said to try and wait it out, and I did, for as I could stand it, but things have slowly but steadily worsened. Now I can’t even stand to bite into the softest foods or drink room temperature liquids. I am on a constant diet of Alieve.

What should I do? I am afraid to go back in to hear her say that I need to have a root canal treatment and then another white filling. I can’t take anymore! Isn’t there another choice besides a white filling? It is one of my front teeth, and I suggested a crown, but she did not seem comfortable with putting one on only one of my front teeth. Any direction you can provide would be great.

Brian in Memphis, TN

Dear Brian,

From what you describe, you are probably going to need a root canal. Pain from the tooth being irritated from the filling should have abated by now, so something more is going on. Pain that gradually improves would be a better sign, but you describe exactly the opposite.

Following the root canal treatment, you may need a porcelain crown (also called a dental crown or a cap) placed over the tooth. If the cavity is not too large, it would still be a good idea to use white composite fillings, but if it is too large, you may need the crown.

If you do have a root canal treatment, you may want to tell the dentist not to leave any gutta percha (root canal filling material) inside the crown of the tooth, but to make sure to trim the material below the level of the tooth attachment. Gutta percha left in the crown of the tooth will cause it to darken over time. If you get a crown, this won’t matter, but if you get another filling, it will.

Post courtesy of Baton Rouge Dentist Dr. Perry.

TMJ Disorder—Serious Case

Problems and discomfort following a white filling

Archives for June 2011