Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

February 3, 2018

My mouth seems to be collapsing


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Hi Dr. Hall,
I really hope you can help me.
I am not sure if my issue is related to my lips, teeth or jaw but I absolutely can’t stand my smile. It feels very forced to be able to show my upper teeth. When my mouth is in repose it is just empty space and you cannot see my teeth (especially my upper) and it makes me extremely self-conscious.
I also have jaw pain and wear a night guard and when I wear it my mouth feels more comfortable and I feel like it supports my lips better. It also gives an impression of upper tooth show that I would very much like. I also find I have difficult pronouncing certain words especially when it’s cold, almost as if my jaw tighten and I can’t open it properly to speak. P and T words are especially uncomfortable.

Are my only options veneers? Do I even have any options?

It’s very frustrating for me. I can attach pictures as well if need be.
– Laura from Toronto

Laura,
You’re going to need to be very careful how your proceed here, and if a dentist has told you that porcelain veneers will solve your problem, I would find another dentist. While that could help with your appearance, it could exacerbate your other problems—the jaw pain and trouble with pronunciation.

It sounds to me like you’ve worn your teeth down, making you overclosed. This could cause TMJ disorder, which would be characterized by jaw pain and possible tightness in your jaw. The fact that you feel better wearing a nightguard lends credence to that diagnosis, but you’ll need an examination by a dentist trained in TMJ therapy to confirm that.

The needed treatment, unfortunately, is likely to be extensive—probably a full-mouth reconstruction.

The problem is finding a dentist you can trust to do this. This is way beyond the capability of your average family dentist. I would look for a dentist with advanced training from one of three institutes:

  • The Pankey Institute in Florida
  • The Dawson Academy, also in Florida
  • The Las Vegas Institute for Advanced Dental Studies

Good luck.
Dr. Hall

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About David A. Hall

Dr. David 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 complete Internet marketing for dentists.

August 8, 2016

Jaw pain after a long dental appointment

Filed under: TMJ — Tags: , — mesasmiles @ 5:25 pm

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Dear Dr. Hall,
Last Wednesday I had my upper arch prepared for 4 crowns and the rest of the teeth veneers, and am now in the temporaries. I like the way they look … very natural. But I am very concerned about the terrible jaw pain that I am now having. My dentist suggested that I take Advil. I have been and it does help a lot, but it has been 4 days now and the jaw pain is very bad without the Advil. The aching seems to get worse throughout the day until it feels like my cheeks are a little numb and my back crowns ache as well. I’ve been trying to take Advil as little as possible as I really try to stay away from most meds, but I usually break down and take it around 4 … and then again around 10pm.

If you have any advice, I would appreciate it a lot. Is this normal at 4 days out? I know that it was a lot of trauma to my mouth, but I didn’t experience this with the bottom arch.

My dentist is on vacation and I’m not sure if I should try to see another dentist before she returns in two weeks.
Thank you so much.
– Adrienne from New York

Adrienne,
I don’t find your pain to be anything unusual, given the extent of what you have been through, and I don’t think another dentist would be able to do anything for you besides tell you to do what your dentist has told you. I wouldn’t be surprised if the pain continued a week or two. It sounds like you have had the second half of a full-mouth reconstruction, which isn’t unlike having major surgery.

To prepare your entire upper arch for crowns and veneers would have required your mouth to be propped open for quite a while, and doing that can provoke the kind of pain you seem to be telling me that you have. There isn’t a lot you can do for that at this point other than taking Advil, maybe applying warm towels to your jaw, and just resting your jaw until it gets better.

If she is gone for two weeks, I imagine she has made arrangements with some other dentist to take care of any emergencies or follow-up care for her. I would wait until it has been a week, and if it isn’t any better, I would pay a visit to that dentist to see if there is anything else that can be done to make you more comfortable. That other dentist may have access to your records or have made some special arrangement with her for follow-up.
– Dr. Hall

Do you have a comment or a question or anything else to add? We’d love to hear from you. Enter your comment below.

Click here to ask Dr. Hall a question of your own.

About David A. Hall

Dr. David 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 complete Internet marketing for dentists.

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