It seems today that every dentist is a cosmetic dentist. This represents a fairly recent phenomenon. Since cosmetic dentistry is not a specialty recognized by the American Dental Association, how does one determine who's good, and who's not?
Below are four criteria that I would recommend using in your selection of a cosmetic dentist:
- EDUCATION: There are many continuing education courses offered in cosmetic dentistry, and most of them are quite good. A cosmetic dentist must be dedicated to expanding his learning and increasing his knowledge through regular participation in these courses. This is a critical component of a cosmetic dentist's development of his or her own philosophy and technical expertise.
- EXPERIENCE: While education is extremely important, it is of little relevance if not used in practice. The more cases a cosmetic dentist completes, the more capable that professional becomes in visualizing results, anticipating challenges, and knowing which techniques will produce the optimum result for the client. Cosmetic dentistry is extremely technical, and a clinician's skill set develops over time.
- LAB SUPPORT: Most cosmetic dental cases involve the fabrication of a porcelain crown and/ or veneer. These items are made in a dental laboratory by specially trained personnel. This dental laboratory technician, or ceramist, is responsible for translating the cosmetic dentist's specific information on your case into a well-crafted and natural-looking product. In this sense, the ceramist is a true artist. In order to achieve a high level of proficiency, this individual must have benefited from the experiences of completing many cases. Ideally, the cosmetic dentist should have the same highly skilled ceramist complete all of his or her cases. This scenario would result in consistently beautiful results. In order to achieve this, the cosmetic dentist must have an established relationship with a high-quality dental laboratory.
- REFERENCES: A cosmetic dentist should be able to provide a list of clients on whom he or she has completed cosmetic procedures. This is the best way for a potential client to gauge the patient's experience with their cosmetic dentist and their degree of satisfaction with the final product.
Hopefully, these guidelines will help in the process of selecting the cosmetic dentist who is right for you
If you experience ongoing pain in the area near your ear, your jaw or the muscles on the side of your face, possibly accompanied by a clicking or popping sound or restricted jaw movement, you may be suffering from TMD — an abbreviation for Temporomandibular disorders. Sometimes people incorrectly use the term TMJ to refer to these problems, when in fact TMJ is the abbreviation for the temporomandibular joint — or jaw joint — itself. So while you definitely have a TMJ (two of them in fact), you may or may not have TMD.
TMD, then, describes a group of conditions characterized by pain and dysfunction of the TMJ and/or the muscles surrounding it. It's not always so easy to figure out exactly what's causing these symptoms, but the good news is that most TMD cases resolve themselves with the help of conservative remedies that you can try at home. In fact, it's important to exhaust all such reversible remedies before moving on to anything irreversible, such as bridgework or surgery.
The two TMJs that connect your lower jaw, the mandible, to the temporal bone of the skull on either side, are actually very complex joints that allow movement in three dimensions. The lower jaw and temporal bone fit together as a ball and socket, with a cushioning disk in between. Large pairs of muscles in the cheeks and temples move the lower jaw. Any of these parts — the disk, the muscles or the joint itself — can become the source of a TMD problem. If you are in pain, or are having difficulty opening or closing your jaw, a thorough examination can help pinpoint the problem area; then an appropriate remedy can be recommended.
Causes of TMD
As with any other joint, the TMJ can be subject to orthopedic problems including inflammation, sore muscles, strained tendons and ligaments, and disk problems. TMD is also influenced by genes, gender (women appear to be more prone to it), and age. Physical and psychological stress can also be a factor. In some cases, jaw pain may be related to a more widespread, pain-inducing medical condition such as fibromyalgia (“fibro” – connective tissues; “myo” – muscle; “algia” – pain).
Signs and Symptoms of TMD
Clicking Sounds — Some people with TMD hear a clicking, popping or grating sound coming from the TMJ when opening or closing the mouth. This is usually caused by a shifting of the disk inside the joint. Someone standing next to you might even be able to hear it. Clicking by itself is actually not a significant symptom because one third of all people have jaw joints that click, studies show. However, if the clicking is accompanied by pain or limited jaw function — the jaw getting “stuck” in an open or closed position, for example — this would indicate TMD.
Muscle Pain — This can be felt in the cheeks (masseter muscles) and temples (temporalis muscles), where the two big pairs of jaw-closing muscles are located. If you feel soreness and stiffness upon waking up in the morning, it's often related to habits such as clenching and/or grinding the teeth at night. If you have this type of nocturnal habit, a custom-made nightguard should be very helpful in decreasing the force applied to your teeth, which will in turn allow your muscles to relax and relieve pressure on your jaw joints. Other self-care remedies are discussed below (please see Relieving the Pain).
Joint Pain — Pain that's actually coming from one or both jaw joints technically would be described as arthritis (“arth” – joint; “itis” – inflammation) of the TMJ. Radiographs (x-ray pictures) show that some people have arthritic-looking TMJs but no symptoms of pain or dysfunction; others have significant symptoms of pain and dysfunction but their joints look normal on radiographs. There is no cure for arthritis anywhere in the body, but medication can sometimes help relieve arthritic symptoms.
Relieving the Pain
Once you have been examined, a strategy for treating your condition and managing your pain can be developed. Sometimes a temporary change to a softer diet can reduce stress on the muscles and joints. Ice and/or moist heat can help relieve soreness and inflammation. Muscles in spasm can also be helped with gentle stretching exercises. Non-steroidal anti-inflammatory medications and muscle relaxants can also provide relief.
Other Treatment Options
Severe TMD cases may require more complex forms of treatment, which might include orthodontics, dental restorations like bridgework, or minor procedures inside the joint such as cortisone injections or lavage (flushing) of the joint. It's rare for major surgery ever to be necessary in a case of TMD. Again, it's important to try the wide range of conservative, reversible treatments available, and give them enough time to work as they almost always prove effective. The first step is an examination at the dental office. To learn more about available treatment options, view this Chart on TMD Therapy
TMD – The Great Impostor This “chameleon” of dental disorders manifests in a variety of ways, including joint pain, sinusitus, ear pain, tooth and headaches. Dear Doctor magazine examines the causes of TMD, its signs and symptoms and what can be done to treat this common disorder... Read Article
Seeking Relief From TMD TMD, or Temporomandibular Disorders, is an umbrella term for various painful conditions that affect the jaw joints. There are different treatment approaches to TMD problems, but not all are based on science. It's important to be up on the latest information and to be an educated consumer. In this comprehensive article, Dear Doctor magazine provides state-of-the-art information and guidance on what you should know, whom you should see, and what you should ask... Read Article