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writeradmin writes blog posts on behalf of Dr. Kasia Lopez

Worried I Can’t Trust My Dentist

I’m confused and unsure of what to do. I’ve had orthodontics done. Over two years of braces AND I was the good girl who wore her retainer the whole time she was supposed to. My teeth look fine to me, but my dentist says my bite isn’t right. He wants me to get crowns on ALL my teeth to fix it. In all fairness, I’ve already had a couple of cavities, and I think we got on this because I said I wanted my teeth whiter, but getting crowns everywhere seems excessive to me. Should I get a second opinion from a TMJ specialist or is what he’s telling me on the up and up?

Stephanie – Boston

Dear Stephanie,

We need to reign this in very quickly. And, yes, a second opinion from a TMJ specialist would be a good idea. I haven’t the slightest idea why your dentist is recommending a full-mouth reconstruction. You haven’t indicated any TMJ symptoms. Usually, patient’s mention jaw pain, popping, grinding, clicking, or generalized mouth pain. Even migraines can be a symptom of a TMJ problem. If you have these kinds of severe symptoms, you should have a consultation with a TMJ specialist.

As for having the crowns done, this is one way to go about correcting bite issues, but there are also less invasive and less expensive ways to go about doing it, too. In fact, the simpler solutions should always be checked first. Crowns aren’t the solution for whiter teeth either.  The simplest solution would be teeth whitening.  It will do the job beautifully while preserving your healthy tooth structure. Like a full-mouth reconstruction, it’s way too large an overtreatment. Unless you’ve already got crowns on your front teeth, you can have whitening done.

If you were suffering from TMJ issues, it doesn’t necessarily mean it’s because of your bite. Like I said earlier, there are many other TMJ treatments (and causes). However, let’s say for arguments sake you have TMJ and your bite is the problem. It would require someone with serious expertise in TMJ. Someone who has undergone additional training and routinely performs full mouth reconstructions. It’s an advanced procedure. When done incorrectly can cause more problems than it solves.

My bottom line on this is ALWAYS try to preserve healthy tooth structure and get a second a second opinion.

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

Why Can’t Children Have Mercury Free Fillings?

I took my son to the dentist and discovered he has a cavity. I told the dentist I didn’t want a filling that contained mercury and preferred he do a white filling. He told me children can’t have white fillings. Is that true? Why?

Danielle – Idaho

Danielle,

No, it’s not true. Though, I wouldn’t push this dentist to do the white filling. It would likely fail. It takes a special skill to do composite (mercury-free) fillings. It’s a different technique than the old amalgam fillings. He may not know the new techniques. Or, he may know how to do it, but doesn’t like doing it on children.

It is more challenging to do young children. It requires them to be very still and keep their mouth open. The composite material needs to remain dry throughout the procedure for the bonding to stay secure.

Some children have trouble doing that. However, there are ways around that. Sedation dentistry is a good option for children who struggle with following directions or are afraid in the dental chair. It is safe and gives them a calm, cheerful feeling.

You’re more likely to find a dentist to do what you want by looking for a mercury-free dentist or a holistic dentist.

I’m glad you’re looking out for your child and doing some research before caving to your dentist.

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

Did the Dryer Destroy My Invisalign?

I mistakenly put my Invisalign aligners in the washer/dryer. It went all the way through the washer cycle and got about 15 minutes into the dryer cycle before I realized my mistake.  I had them in the pocket of my PJs during breakfast. I’d tossed them in the washer. It wasn’t until after I brushed my teeth that I noticed they weren’t with me.  I grabbed them out of the dryer as soon as I could. They still fit, but feel different on my teeth. Did I ruin them?

Cyndy M. – Tennessee

Cyndy,

We’ve all accidentally watched something, so I wouldn’t feel too bad about it. However, I wouldn’t continue wearing them. Your Invisalign aligners are likely warped. Wearing them will set your treatment back.

If you’re close to the end of this two-week cycle, you could just go on to your next set of aligners. You don’t want to switch early very often, because it puts the roots of your teeth at risk of coming loose. But, just this once should be okay.

If you’re at the beginning of your two-week cycle, you’ll need to have the aligners re-made. Your dentist can do that without too much trouble. But, call the office as soon as possible so they can get it made quickly for you. If you’re without aligners for even just a few days your teeth with start to shift. That will be disastrous for your treatment.

Hopefully, you still have your last set of aligners handy and can wear them until the new ones are ready. That will prevent any shifting.

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

Do Braces Require Extractions?

I’m getting braces and wondered if it’s normal for an orthodontist to insist on extracting teeth. I thought dentists want to save teeth. I’d hate to lose healthy ones for no good reason.

Jose L. – Florida

Jose,

Yes, that’s standard operating procedure in some cases. There are several reasons an orthodontist might do that, but the most common one is overcrowding. If you have a small arch and a full set of teeth, it causes overcrowding. They press up against one another and go crooked. It also makes it hard to clean which leads to decay.

If you’re still concerned, you can go to another orthodontist. Don’t tell him anything about the earlier dentist. If he recommends the same course of treatment, you know you’re on safe ground. If he doesn’t, you can decide which you like better and move forward.

This blog is brought to you by 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

Lana,

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

Kate,

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

Jane,

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

Munsey,

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

Corrie,

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.