Question: What can be done about my headaches and TMJ problems?
David Wilhite says:
The common denominator of TMJ (Temporomandibular joint) headaches and migraines is what is known as bruxism (clenching and grinding).
Now the big question: what causes people to clench and grind?
This has been a subject of controversy in dentistry for many years. Some dentists seem to only consider only one of the many possible causes.
The possible causes include, but may not be limited to, stress, a bad bite, habit. a sleep disorder, certain medications, recent incorrect dental restorations, and deterioration of the joint.
Since there are many possible causes, no one treatment is going to be an effective treatment for everybody. Additionally, it is certainly possible for a patient to have more than one cause.
There are a variety of possible treatments. Most so-called TMJ problems are related to pain in the jaw muscles as opposed to the joint itself. We start out with a complete, comprehensive examination to determine the most likely cause of the problem. Some patients are able to find relief by doing TMJ exercises.
Related: TMJ Pain Relief
Some of the possible treatments are a bite splint, Botox in the jaw muscles, as bite adjustment, muscle relaxers, and a snore appliance.
There are pluses and minuses to all of these treatments. An example would be the case of a patient receiving a bite splint and the grinding getting worse or the patient being unable to wear the splint. This would be a good indication that the patient actually has sleep apnea and needs a snore guard. In this case, the bite splint took up too much tongue space and shifted the tongue backward which made the apnea or snoring worse.
Related: What can be done about sleep apnea and snoring?
Sometimes various treatments have to be tried until the right one or more is found to be effective.
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Additional TMJ Information:
TMJ Disorders – Mayo Clinic
TMJ Home Remedies
TMJ Exercises for Pain Relief
TMJ Disorders – National Institute of Dental and Craniofacial Research
QUESTION: My dentist told me that due to my heavy clenching I could only have gold crowns on my molars. Are there any alternatives?
David Wilhite says:
BruxZir crowns are a brand of crowns made from zirconium. These are excellent crowns for people who clench and grind their teeth.
Prior to these crowns, the best material that we had for a patient who clenches and grinds their teeth was gold. Many patients did not like any metal showing in their mouths and wanted a strong and esthetic alternative.
Until 5 years ago, the only alternative was a porcelain fused to metal crown (PFM). The problem with these crowns is that the porcelain could chip off the underlying metal and the metal would be exposed.
We frequently give patients porcelain crowns as well, although BruxZir crowns may be the best solution in your case.
When zirconium crowns first came out, they were very strong but very light colored and did not meet patient expectations. As improvements were made, as more different shades became available, the aesthetics greatly improved to the point where they match the natural teeth very well.
Ready to learn more about BruxZir crowns?
Additional BruxZir information:
What is BruxZir Solid Zirconium
BruxZir® Scientific Studies
BruxZir® Technical Information
BruxZir case studies
QUESTION: I would like to whiten my teeth.
How does it work?
Dr. David Wilhite says:
For 25 to 30 years patients have been whitening their teeth in dental offices.
We have been using the ZOOM products for many years now and have gone through many generations of their equipment and materials.
Prior to any whitening procedure, a thorough cleaning is recommended.
This removes the plaque and tartar from the teeth so that the whitening solution is in more intimate contact with the teeth, thus enhancing the results. The cleaning should be done no more than a week before your whitening appointment with the same day being the best.
On the day of your whitening appointment, your teeth will be isolated to protect your lips and gums before the whitening gel is applied to your teeth.
After the gel is applied, a ZOOM whitening light is placed in close proximity to the teeth. The gel is changed periodically for 2-4 sessions.
Some people call this laser whitening but that is an incorrect term. In the early days of whitening, a laser was used with a few products, but it rapidly fell out of favor due to its harshness and subsequent sensitivity. Today only visible light is used.
Related: Is Teeth Whitening Safe?
Some people with extremely sensitive teeth cannot tolerate this procedure and need a modified version of the light assisted whitening called EZ White. A similar gel is used, but the light intensity is lower. In an extremely low number of cases, only the whitening gel in custom made trays will work with the patient’s sensitivity.
Prior to whitening, it needs to be understood that only tooth structure is whitened, no dental restorations are whitened.
Most patients are quite willing to change out old restorations to match their newly whitened teeth. The patient needs to wait 7-10 days after whitening before any restorations are done. This allows time for the whitening chemicals to dissolve out of the teeth and for the newly whitened shade to stabilize.
Did you know that whiter teeth make you look younger? >How Teeth Whitening Can Change Your Life
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