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writeradmin writes blog posts on behalf of 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.

Are There Mercury Free Dentists for Children?

I’ve gone to the same clinic since I was a child. My dentist is great, but he’s kind of old school. In fact, he still prefers the old silver amalgam fillings. I have a few in my mouth. They’ve never bothered me. However, I have a son now and I’m a little concerned about mercury filled fillings. My dentist said that children can’t have composite fillings, but I find that hard to believe. Are there dentists who do white fillings for children?

Melinda S. – Conway, AR


It’s not that children can’t have composite fillings. It’s that it is not an easy procedure to do with children because they have to stay quite still during the procedure. Your dentist, who based on what you said, isn’t very experienced in composite fillings anyway, obviously would not be a good choice.

However, there are mercury free dentists who work with children. They’ll be more willing to work with you.

If you’re happy with your dentist, you don’t have to switch. You can just go to a different one for your son. It’s up to you. But, you’ll probably feel more peaceful with a dentist who can give your son white fillings.

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

Gum on my Invisalign

I’m so embarrassed. I just plain forgot that I was wearing my Invisalign aligners. I popped some gum into my mouth and started chewing. Before I realized how stupid I’d been, gum was stuck to everything. How in the world do I get it off? I really don’t want to admit to my dentist how absent-minded I was.

Carlyann – Boston


If there’s any good thing that has come out of it, is that at least we know your Invisalign aligners are quite comfortable. It’s nice when you can forget you’re wearing something, especially an orthodontic.

There are two things you can try. The first thing to try is peanut butter. Spread it over all the gum on your aligners and let it soak in.  The oil should soften the gum and allow you to gently brush it off.

If that doesn’t work, you could try freezing it in twenty minute intervals. Then try to brush it off.

Unfortunately, if those two things don’t work, you may be stuck going to your dentist. Believe me, your dentist has seen it all and won’t think you’re the least bit stupid.  We all have moments of absent-mindedness.

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

Do I Listen to My Orthodontist or Dentist?

My son has a missing tooth and is about to have orthodontic work done. We want to plan ahead for the missing tooth. We’d like to get him a dental implant, but realize he is too young right now. The orthodontist assures me he can repair his teeth, leaving the space. Then our family dentist can put a flipper in. Our dentist said a Maryland bridge is best. How will I know which one is best for the implant?

Serenity H. – Nevada


Hmmm… Did your dentist say why he choose a Maryland Bridge?  That seems a strange route to go. Unless I am misunderstanding, your son has healthy teeth. A Maryland Bridge will affect his tooth structure.

Many dentists prefer the most conservative procedure, having a desire to keep as much healthy tooth structure as possible. I’m a little surprised your dentist is recommending a more aggressive route.

With that in mind, I’d likely go with your orthodontist’s recommendation and get the dental flipper.

If there were something else going on with the adjacent teeth, then my recommendation would change.

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