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writeradmin writes blog posts on behalf of Dr. Kasia Lopez

Does TMJ Require a Full-Mouth Reconstruction?

I’m trying to figure out if I really need a full mouth reconstruction for TMJ. My dentist had been trying to treat my TMJ himself, but it only seems to get worse. Last week I had to eat through a straw because my jaw locked up. He sent me to a TMJ Specialist. He says I need a full mouth reconstruction. If that’s my only option, I’ll do it. I just want to be sure first.

Lana – Sacramento


A full-mouth reconstruction is an option, but it’s usually an option after all other, less invasive, options have been tried.  However, there may be circumstances that I’m unaware of.

This is a major undertaking. You’re talking about putting a crown on possibly all your teeth. If you do this, make sure your dentist is a TMJ Specialist. By that, I don’t mean a special degree, because there isn’t a recognized specialty in TMJ.

However, there are post-graduate training programs that will give the dentist expertise. For instance, Dr. Lopez received TMJ training at the Las Vegas Institute for Advanced Dental Studies.

This blog is brought to you by Dr. Kasia Lopez.

Has the ADA Admitted Amalgam Fillings are Dangerous?

I read on a natural health website that the US signed an agreement to get rid of amalgam fillings. Does that mean the ADA has finally admitted they’re dangerous? If so, why are dentists still using them?

Kate C. – New Hampshire


I don’t know of a treaty that requires the United States to get rid of amalgam fillings. You may be thinking of the Minamata Treaty. The US did sign that. It’s more related to how mercury affects the environment, not dentistry. However, it did list specific precautions which were supposed to be taken regarding the disposal of amalgam fillings. This is designed to keep mercury from negatively impacting our environment.

Neither the FDA nor the ADA has admitted there is anything unsafe about amalgam fillings. In fact, they still insist the fillings are perfectly safe. Most patients don’t care what the party line is on that one. All they hear is that amalgam fillings consist mostly of mercury. Mercury is a toxin. Put those both together and they don’t want amalgam fillings in their mouths. I can’t say I blame them.

If you’re concerned about amalgam fillings I’d suggest you go to a holistic dentist or a mercury free dentist. They’ll be certain to give you fillings you will feel safe to have in your body.

This blog is brought to you by Dr. Kasia Lopez.

Invisalign Versus Lingual Braces

I’m a 40+ year old professional with a public speaking job. I had braces in my younger years so my teeth are okay. They’ve just drifted a little and I need to look my best. I’m trying to decide between Invisalign or Lingual Braces. Do you have a recommendation?

Jane F. – Maine


Both are great treatments. In your professional capacity, I’d recommend Invisalign. The biggest reason for that is your speaking roll with your job.

Lingual braces are great. They’re behind your teeth. The biggest issue with them is a patient’s tongue is generally drawn to them. And, they will affect your speech.

Invisalign sometimes can affect patient’s speech in the beginning. However, most patients recover from that quickly. If you happen to be among the few that struggles with the adjustment, there is a simple solution.  Take them out before you speak for an important public engagement–so long as you wear them the prescribed amount of time.

This blog is brought to you by Dr. Kasia Lopez.


Do I Really Have the Most Difficult Bite to Treat?

My orthodontist says I have the most difficult bite to treat and that is why my orthodontic quote is so expensive. Which of these bites are the most difficult:  overbite, under bite, deep bite, or cross bite? I have a deep bite.

Munsey D. – Georgia


Most orthodontic problems can be treated with traditional braces; however, the most difficult bite to treat would be an open bite. You didn’t mention that one. An open bite is when the upper front teeth don’t touch or even go over the lower front teeth. This is usually caused

An open bite is when the upper front teeth don’t touch or even go over the lower front teeth. This is usually caused from thumb sucking or strange position of the tongue. Even after wearing braces to correct this problem about 20% of patients still have an open bite to some extent.

One you did mention is also challenging– an under bite. This type of bite is when the lower jaw protrudes out farther than the top jaw so the lower front teeth bite over the upper front teeth. This is usually caused from a nasal obstruction, thrusting of the tongue, or mouth breathing. Most of the time these patients need corrective jaw surgery to place the jaw in its proper position which cost thousands of dollars.

The good news for you is that you have one of the most common and easiest bites to fix. This is when the top teeth cover the lower teeth too much. In most cases, orthodontic appliances are used before the braces get put on to create spacing and some movement. After that braces are needed for however long it takes your teeth to shift.

I’m not sure why he’s blaming the cost on your bite, but you’re welcome to get a second opinion from a different orthodontist.

This blog is brought to you by Dr. Kasia Lopez.

Is a Full Mouth Reconstruction Necessary for TMJ?

I mentioned to my dentist I’ve been having headaches. He instantly started messing with my jaw. He said he feels certain that I have a TMJ and that I need full-mouth reconstruction to fix it. I was beside myself. I’ve never even heard of something like that. Then, to make matters worse, the assistant brings me in an estimate and says my insurance probably won’t cover this so-called necessary treatment and that to cure my headaches, I’ll have to pony up more than I make in a year. It sounds like snake-oil to me. Is there any truth at all to this or is he just trying to make a quick buck?

Monica C. – Arkansas

Dear Monica,

Headaches are indeed a symptom of TMJ disorders. It doesn’t sound like they took the time to explain why you received the diagnosis, though. A TMJ disorder occurs when the temporomandibular joint isn’t working properly. That’s the hinge point of your jawbone.

Most commonly people begin to experience pain in the jawbone as a result of grinding your teeth or clenching. Sometimes it happens while you’re asleep so you may not even be aware you’re doing it. You could also clench when you’re agitated or stressed.

Any of these things can affect the wear on your teeth and cause pain throughout your mouth, jaw, head and neck. Typically, a full-mouth reconstruction is only needed when the problem has been ongoing and no other treatment is working. Doctors usually try to treat TMJ disorders conservatively at first, perhaps with a bite splint to wear overnight. However, we also don’t know the root cause of your issue, nor do we know the extent of the damage, so it’s impossible to say whether full-mouth reconstruction is warranted.

Doctors usually try to treat TMJ disorders conservatively at first, perhaps with a bite splint to wear overnight. However, we also don’t know the root cause of your issue, nor do we know the extent of the damage, so it’s impossible to say whether full-mouth reconstruction is warranted.

However, it doesn’t sound like your dentist tried anything else. If I were in your position, I’d get a second opinion from someone with specialized training in TMJ.

IF it is determined you do need a full mouth reconstruction, you’ll want to be absolutely certain the dentist that does it has a lot of TMJ training. Also, you’ll want them to have cosmetic expertise.

This blog is brought to you by Dr. Kasia Lopez.

Why Won’t My Dentist Remove My Filling?

I’ve been reading a lot about the dangers of mercury that are found in our dental fillings with growing alarm.  I spoke with my dentist about it and he didn’t seem the least bit concerned and said the ADA has declared them safe. I appreciate his offering comfort and another perspective, but it is my body and I want the fillings out. He  says no. Why not? Also, don’t I have the right to determine what goes in my body?

Corrie S. – Tennessee


Yes, it is your body and you have a right to determine what goes into it. However, these fillings are already in your body. The question then becomes is this dentist able to safely remove them? My guess is the answer is no…at least in his case.

When amalgam fillings, which are loaded with mercury, are removed, you expose yourself to mercury vapors, which are rather potent. There is a sanitary amalgam removal procedure. However, most general dentists don’t have the training or equipment to do it.

If you’re set on getting them removed, and that is definitely your prerogative, then you’ll need to see a mercury-free dentist. They’re much more likely to have the expertise to do the removal safely. Don’t hesitate to ask them what they do to protect you from the mercury bits and mercury vapors during the removal. The whole reason you want them out is to protect your body.

This blog is brought to you by Dr. Kasia Lopez.

Invisalign Trays for Whitening

I am in the middle of Invisalign treatment. I love it. I can tell my smile is shaping up already and I’m not worried about looking silly with all that metal. The trays I use look similar to the whitening trays a friend of mine uses. Could I use them to whiten my teeth too? I found some whitening gel online, so I could get my teeth whitened for hardly any cost.

Amanda – Washington


Your Invisalign trays can double as whitening trays. However, I recommend you speak to your dentist first. If you have any fillings, they won’t whiten with your natural teeth. You can still do the whitening, but you’ll have to replace the fillings to match your teeth when you’re done.

I’m a little concerned about the gel you found online. Do you know if it is from a reputable company? Do you know what strength it is?

Your dentist will likely be happy to provide you some gel. It won’t cost very much. Most of the cost for teeth whitening is in the labor. Using your Invisalign trays cuts down on that significantly.

This blog is brought to you by Dr. Kasia Lopez.

Metal or Ceramic Braces?

I am 27 years old and finally getting braces. Can you give me an idea which is a better choice:  metal or ceramic brackets?

Loriee – Arkansas

Dear Loriee,

Both metal and ceramic brackets for orthodontics will straighten your teeth. The biggest difference is cosmetics. Ceramic is slightly less noticeable. Bear in mind, though, that even with ceramic brackets, you’ll still have a metal wire that goes through them. They will not be invisible. The biggest con we see with ceramic brackets is they stain easily.

If you’re looking for something that is less noticeable, you might want to look into Invisalign. It actually is invisible, even at a conversational distance.  They use aligners instead of wires and brackets. Not everyone is a candidate, but it’s at least worth looking into.

This blog is brought to you by Dr. Kasia Lopez.

Will a Dentist Help Me With Metal Allergies?

I’ve had some weird, unexplained medical problems. I had a Clifford’s test done and it turns out that I’m allergic to all kinds of metals, including those in my dental work. I can’t seem to find a dentist willing to work with me. Can you point me in the right direction?

Sandra M. – Ohio


The Clifford’s test is still controversial, so I’m guessing most of the dentists you spoke to turned their ears off the moment you mentioned it.  That doesn’t mean there aren’t dentists who can help you.

My suggestion is you look for a holistic dentist in your area. They’ll be more open to what you’re going through. One of the first things they’ll probably recommend is to replace your metal-based dental work.

While for some people, metals are no big deal, everyone’s body is different. Obviously, yours is much more sensitive to it. Removing them is a fairly simple process. But, you’ll want a holistic dentist to do it, so that they can do a sanitary removal.

This blog is brought to you by Dr. Kasia Lopez.

Does TMJ mean Jaw Surgery?

I’ve been having some pain and popping in my jaw along with headaches. My roommate said that it sounds to her like I might have TMJ. I looked it up and it is possible. Does that mean I’ll need jaw surgery?

Amelia A. – Denver, CO


TMJ surgery is very rare. Most of the time it is performed to treat patients if there is clear joint damage, or sometimes lock jaw. But, even with lock jaw it’s  only done when all other conservative therapy has failed.

The key is to see a dentist who has some expertise in TMJ. There isn’t a recognized TMJ specialty, so any general dentist can say they are a TMJ dentist. So, how can you tell who has the expertise to give you quality care? You’ll want to be sure they have post-graduate training specifically in TMJ. For instance, Dr. Lopez studied at the Las Vegas Institute of Advanced Dental Studies (LVI), a world renowned institution that deals with TMJ issues.

Have someone in that caliber properly evaluate you. There are many conservative treatments that should be undertaken before resorting to surgery. Sometimes it can be solved by wearing a simple orthotic device while you sleep for a few weeks.

This blog is brought to you by Dr. Kasia Lopez.