Dr. Hall,
I have TMJ and currently use a full mouth guard at night from a dental specialist. The clicking and my migraines have decreased under her care and that of my neurologist. I am 67 and have worn my molars to the place they can no longer be filled. I have one cracked and in need of a crown.
My question: The specialist suggested she could adjust my bite with inlays or full crowns on my molars (bottom teeth only). Thereby positioning my jaw to relieve or eliminate the TMJ. Is this too radical a procedure? Have you ever heard of this for the treatment of TMJ? Should I try this or just have my dentist place a typical crown on the tooth? Time is of the essence.
-Paula from Cleveland
(See Dr. Hall’s answer below.)
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Paula,
I’ll answer your question and then clarify a few points.
Doing crowns to rebuild your bite and change the way your teeth come together is a very common and accepted way to treat TMJ disorder. So no, that isn’t radical at all. Sometimes, what is recommended is a full-mouth reconstruction, involving crowning all the teeth.
But I want to clarify something. You said you were seeing a dental specialist. TMJ treatment isn’t a recognized dental specialty, so we need to be careful how we use the term TMJ specialist. I think it would be helpful if it were, because ordinary dental school education does not prepare a dentist to treat most cases of TMJ disorder. It requires some post-graduate training in what I would call complex restorative dentistry. The mechanics of the movements of your jaw are complicated.
I would advise a patient with TMJ disorder to seek treatment from a dentist with advanced training from one of these post-graduate institutes:
- The Pankey Institute in Key Biscayne, Florida
- The Dawson Academy, with headquarters in Florida but training centers in various states
- Spear Education in Scottsdale, Arizona
- The Las Vegas Institute for Advanced Dental Studies in Las Vegas, Nevada
- Piper Education and Research Center in Tampa, Florida
Each of these institutes offers a curriculum of several courses, and a dentist will be most prepared if they have taken the complete curriculum. For the highest level of expertise, look for dentists who are graduates, rather than dentists who have merely attended a course.
Another option is to go to a prosthodontist. Prosthodontics is a recognized specialty in crown-and-bridge dentistry and other prosthetic treatments, and they have had advanced training in occlusion and treating TMJ disorder.
I will say that it sounds like your dentist knows what she is doing and I believe that you are in good hands, though it could be worthwhile to ask some questions. The fact that your mouth guard (nightguard or splint) has relieved your symptoms speaks well of her treatment.
– Dr. Hall
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.
Great read! I didn’t realize crowns could be part of TMJ treatment. It’s great to see such detailed information about options for managing TMJ disorder