Dr. Hall,
\nI’m sure you’re quite busy, but if you have a moment, please read my email. I don’t know who to believe anymore and your site enlightened me. There ARE many pretenders out there.<\/p>\n
I’m only 32. But due to a teeth grinding habit, I had crowns placed on all my teeth about ten years ago. They were not placed correctly and I have now worn them down and suffer pain and clicking. Now my jaw is crooked (slant on upper and lower), posterior crossbite, gums are in bad shape due to the crown placements – not to mention they’re just plain ugly, dark and “chiclet looking”.<\/p>\n
Because of my jaw pain, out of desperation, I found myself in the hands of a “neuromuscular dentist”. I didn’t realize at the time that this was not a specialty. I now believe that I’ve been taken advantage of by charlatans. Now after 2 yrs in an orthotic that opened my bite too much and moved my lower jaw forward (of course it didnt’ work), I feel like my situation is even worse. Now, with this orthotic removed, I have an open bite and my crowns are further ground down and flat. Obviously I need some restorations, but I’m torn between a prosthodontist and a cosmetic dentist. Do I have to choose between function and appearance?<\/p>\n
I’m worried that the complicated nature of my case – also, how does a dentist know where my natural bite in order to place the crowns? I did consult an orthodontist and he told me my case is complicated (clearly) and that I should see a prosthodontist. Any information you can share will be greatly appreciated. I am so incredibly skeptical of dentists after my experiences. I don’t know who to believe any more. Thank you so much.<\/p>\n
Rachel from Pittsburgh, Pennsylvania<\/p>\n
Dear Rachel,
\nYou were on the right track looking for a “neuromuscular dentist.” The problem, as you have since found out, is that this isn’t a legally distinct specialty in dentistry, and your dentist doesn’t appear to have had the needed expertise for your problem. Grinding your teeth flat sounds like the work of someone who really doesn’t know what they are doing. Sorry to be so blunt, but it sounds like you have figured that out.<\/p>\n
You do not have to choose between appearance and function. They aren’t exclusive goals – you don’t have to sacrifice appearance to have a balanced occlusion. You just have to find a dentist with the proper expertise who actually cares enough about the appearance, too. But the problem is that many dentists who immerse themselves in the technical aspects of dentistry have little or no interest in esthetic issues. This is why there is often a problem in going to a prosthodontist.\u00a0While these specialist dentists\u00a0have strong academic credentials, they tend to be indifferent to appearance-related issues, which is reinforced by their extra time in dental school. But many dentists who are passionate about excellence in function are also passionate about the appearance of their work.<\/p>\n
And yes, it is tricky to find where your natural bite is supposed to be. But this is part of the training of dentists who have real expertise in treating TMJ disorders. That’s going to be\u00a0your key – finding\u00a0a dentist who first of all\u00a0knows what they are doing\u00a0but also cares how your end result is going to look.<\/p>\n
I would recommend that you see Dr. Susan Petruska in Pittsburgh. She is a former professor of prosthodontics at the University of Pittsburgh School of Dental Medicine, but she is also accredited in cosmetic dentistry. There is also a dentist in her office who has been through the training in neuromuscular dentistry at the Las Vegas Institute for Advanced Dental Studies – a recognized leader in training dentists for treating TMJ disorder<\/a>. We list her on our Pennsylvania Cosmetic Dentists page.<\/p>\n Dr. Hall<\/p>\n