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I was recently diagnosed with TMJ problems. I have been told that my bite is uneven. What makes a bite uneven and why is it a problem?

added on: January 20, 2012

Ideally, teeth should fit together in the place that the jaw closes. Before teeth even erupt, the jaw closes as it rotates in its socket when the muscles pull together. As teeth erupt they meet based on this closure path and the body’s anatomy. Bites can become uneven from a lot of things including missing teeth that are not replaced, faulty restorations, wisdom tooth eruption into a confined space, and bad biting habits such as pen chewing or pipe smoking.

In many people, an uneven bite may go completely unnoticed and have no signs or symptoms. In some, the unevenness triggers bruxism, which is tooth grinding. This can lead to dental, muscular and/or joint problems. Dentally, it causes accelerated wear of the teeth as well as chipping, loosening, shifting or cracking of the teeth. Grinding can also lead to muscle spasm which shows up as headaches, earaches, ringing of the ears, and dizziness. Sometimes it can even cause facial numbing. If it leads to joint breakdown it can be severely debilitating.

Diagnosed early TMJ problems can be easily treated and prevent a multitude of issues.

Are you telling me that if I don’t floss every day my gums won’t be healthy?

added on: January 20, 2012

In a nutshell, yes. It is impossible to clean between your teeth with a brush alone. No a WaterPik won’t improve the situation. WaterPiks remove food particles not the sticky bacterial film called plaque. Remember, plaque forms within hours of eating food. Rinsing with Listerine or a similar product won’t do it either. Plaque needs to be wiped off. It doesn’t doesn’t come off with rinsing. Do this test: brush your teeth as best as you can. Really scrub them. Now, run the the floss between teeth. ring it down to the gumline and wipe the teeth like a shoe shine. Now, look at the floss. I guarantee it will be coated with plaque. It may not look like much but it is that microscopic bacteria that inlames gums and caused the breakdown that leads to the deep pockets that can no longer be cleaned at home. This sets up the viscous cycle where bacteria lies beyond reach eroding bone away and leading to tooth loss. That’s it. Plain and simple. Sorry to be the bearer of bad news. The good news is this is the easiest cheapest remedy for this widespread disease. All you have to do is floss daily and they will be healthy. Period.

I understand that I need fillings replaced by crowns on some teeth. We have had so much discussion about esthetics of these restorations that I was wondering , are these being replaced due to failure or cosmetics?

added on: January 20, 2012

Every time something breaks down in a patient’s mouth it is prudent to question why this happened. When all factors are considered, the next thought is not necessarily how can I fix this. Most dentists instead try to plan how to make things better. Doing so entails designing restorations that are stronger, longer lasting, and yes even more natural than what existed before. This plan can and should incorporate the patient to discuss likes and dislikes and to educate the patient in this thought process. This can be very enlightening to the patient as they share views using photographs, dental models and x-rays, and educational videos.

You may ask why esthetics should be such a concern in this process. The dentist has spent a lifetime examining dental problems and solutions. Every failure turns into an opportunity to improve. Instead the dentist asks, quoting a cherished newspaper writer, why not?

My mother has had upper and lower dentures for many years. I can tell that she is not comfortable chewing with them because she limits what she eats to soft foods. My parents are on a fixed income. What would be a cost effective way to enable her to chew better?

added on: January 20, 2012

It sounds like your mother would be well served with a couple of implants to support her dentures. Typically, the lower denture is the denture that gives people the most trouble. There is very little tissue area contact to support the denture. As little as two implants can give the denture phenomenal retention. Quite literally, the denture goes from slipping all over the place to being rock solid. Not only is it secure but sore spots are eliminated as well since the support goes to the implants instead of the tissue.

The upper denture covers the palate which gives it suction. A well fitted upper denture can give most patients support they need. If the upper denture is very old it should be replaced. If it is less than ten years old, it can be relined with new acrylic for a just like new fit.

I love the way all porcelain crowns look but I am concerned about their strength. I have a heavy bite and have cracked a few of my own teeth and chipped a veneer in the front. What do you suggest?

added on: January 20, 2012

Dental porcelain technology has advanced tremendously in the past few years. There are many types of porcelain for different applications. Some allow the utmost in artistic replication of uniquely colored natural teeth. When it comes to strength the porcelain to chose is made of lithium disilicate. It is marketed under the brand eMax. It is extremely strong yet contains no metal. Until recently porcelain fused to a metal substructure was the standard for strength. EMax crowns have been found to be three times stronger than porcelain fused to metal. The all porcelain nature makes for a very lifelike appearance where the light is reflected back to the viewer by traveling through the porcelain and the body of the tooth- not metal. The result is a beautiful crown with the ultimate in wear resistance.

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