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Cosmetic Dentistry Frequently Asked Questions
Provided by Dr. David Dooley of Chicago


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I don't want anybody to know I've had my smile done. Will this look natural?


While every case is unique, LVI trains dentists to use techniques that help create the most natural smile possible. A style for your smile will be determined, taking into account your lifestyle, facial proportions, gender, age, complexion, hair and even eye color.

Most often, our patients hear questions like: "Have you changed your hair style?", or "Have you lost weight?" Their friends know something is different - they just don't know what .


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How quickly will I be able to complete my treatment?


Most aesthetic procedures, from simple bonding to a complete smile makeover, can be completed in as little as one to three visits (but may vary depending on the complexity of each case). Our doctors are trained to work efficiently, keeping you in the office for the shortest time possible.

For example, a smile makeover often involves placing veneers or crowns on the top eight to ten teeth. In the first appointment, you and the doctor will discuss what you want your smile to look like.

In the second appointment, the doctor will carefully prepare your teeth and place temporary veneers. This appointment typically lasts 2-4 hours total.

In the final appointment, your new teeth will be placed, polished and adjusted. Again, the appointment will take around 2-4 hours.

The total time from start to finish? Less than a month, and sooner if necessary. Soon you'll be smiling with confidence!


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How will my temporaries look?


Often, the difference is so dramatic that you'll feel like your new smile is already complete. However, temporaries are just that - temporary. They are not meant to replace natural teeth. It is important for you to go to your final restoration appointment when scheduled to ensure the procedure goes as smoothly as possible.


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How long will my new smile last?


Today's materials are actually stronger than natural teeth, and are far more resistant to wearing and breakage. With regular checkups and care, your smile should last for many, many years.


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What kind of questions should I ask when looking for a cosmetic dentist?


Obviously, training and commitment to continuing education are of paramount importance. Just like medicine, dentistry changes significantly over the years, and your dentist must keep up. LVI trained dentists have experience and training from the prestigious Las Vegas Institute. Ask your LVI dentist how they would design your new smile. What is their protocol, and how will you know if you will like the smile before it becomes final? Don't be afraid to ask questions.


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I've always been afraid of the dentist. How can I feel more comfortable?


LVI teaches dentistry techniques that will make your procedure surprisingly comfortable. By working quickly and using advanced technologies, they are able to be very conservative in your treatment, allowing you to heal more quickly.

There are also several options from sedation dentistry to sleep dentistry. LVI dentists are trained to listen to your specific needs in order to allay any fear and make your visit as pleasant as possible. Ask your dentist what they can do to make you feel more comfortable with options like sedation dentistry.


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How will a new smile change my life?


It is not uncommon for the patients to cry with joy, hug their dentist, or even kiss them! Patients tell us they are filled with self-confidence, they feel more outgoing, and they simply can't stop smiling!

Shy patients are often transformed into social butterflies. Professionals tell us of greater career success. Older patients look and feel decades younger. Sounds impossible, but it's true. Think about how a new or improved smile would change your life.


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Will my insurance pay for these procedures?


Unfortunately, most dental insurance has a maximum annual benefit of $1,000 to $2,000 dollars depending on your coverage. Since insurance companies are in business to make money, they allow only the least expensive possible treatment - not necessarily the treatment that is best for your dental health.

Most cosmetic treatment is considered elective and not covered by insurance. Your dentist will do everything possible to maximize your insurance benefit, but be prepared to pay for the treatment with alternate finances. There are many financing options available, so ask your dentist what the best option is for you.


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What are my payment options?


Most dentists accept checks, credit cards, or offer a third party financing option. These financing companies allow you to make the payments for your new smile out over time, making the payment fit comfortably into your monthly budget. Ask your dentist how best to accomplish your treatment and financial funding.


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What is the end result?


A new, beautiful smile will dramatically affect your life. Aside from the aesthetic benefits, most patients find that a nice smile also increases their confidence and cheerfulness. This, in turn, improves their interactions with friends, co-workers and romantic partners. It's no secret that most people find a nice smile to be quite attractive.

Additionally, a nice smile has health benefits, too. Missing teeth, for instance, contribute to your risk of gum infection. Improving your smile won't just increase your social life, it'll also contribute to your overall dental well-being.


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Common Cosmetic Dental Problems


Have you ever been embarrassed by your smile? Do you feel that your teeth are too crooked, or not white enough? Do you have missing or broken teeth? If you've ever been self-conscious about your teeth, you know how difficult life can be sometimes. A problem with your smile can make it difficult to face the world.

Fortunately, modern cosmetic dentistry has advanced to the point where virtually all dental problems can be at least improved, if not fixed outright. If you've ever been embarrassed or self-conscious about the appearance of your smile, cosmetic dentistry is for you. An LVI-trained cosmetic dentist can help fix your smile, and even brighten your outlook on life!

An improved smile can lead to improved confidence. A smile you're happy with is a smile you'll use more often. Most patients find themselves becoming more outgoing and cheerful after undergoing cosmetic dental procedures. Life is better when you have a wonderful smile!

There are a host of reasons why patients find themselves unhappy with their smile. Genetics, accidents and poor dental care can all contribute to dental problems.

Here are some of the most common problems which cosmetic dentistry can fix:

* Gaps between teeth
* Broken teeth
* Chipped teeth
* Misshaped teeth
* Crooked teeth
* Misaligned teeth
* Stained and discolored teeth
* Short and worn teeth
* Cracked teeth
* Jaw problems, including headaches.

These problems present themselves in a variety of combinations and strengths. Additionally, dental problems can add up -- missing teeth, for instance, can lead to gum disease and infections. There are more than cosmetic reasons as to why the above dental problems should be addressed.

However, cosmetic dental improvements alone can add wonderful benefits to your life. Only a qualified cosmetic dentist can properly diagnose and treat these dental problems. A brighter, healthier smile can be right around the corner.
If you live in the Chicago area, contact Dr. Dooley today. He is a graduate of the Las Vegas Institute for Advanced Dental Studies, and, as such, is specially trained in a full range of cosmetic dentistry services. He offers affordable financing options, too -- there's simply no reason to live with a damaged smile. Contact us today -- a better smile is right around the corner!


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Cosmetic Dentistry


Cosmetic Dentistry is an umbrella term that includes a variety of different elective procedures designed to improve the appearance of your teeth, as well as correct a variety of jaw and jaw alignment problems.

Cosmetic dentistry is a specialized branch of dentistry. As such, not all dentists are cosmetic dentists. Cosmetic dentists have undergone specific, additional training at cosmetic dental academies, such as the Las Vegas Institute for Advanced Dental Studies.

Here is a list of the most common cosmetic dental procedures:

* Teeth (or tooth) whitening. This is also called "bleaching"
* Composite and porcelain veneers
* Dental implants (to correct missing teeth)
* Dental bonding
* Dentures
* Dental bridges (to replace missing teeth)
* Tooth contouring and reshaping (for more minor changes)
* Dental fillings (metal fillings are rarely used. Rather, fillings are now matched to the color of your teeth)
* Dental crowns
* Dental caps
* Root canals
* Cosmetic gum surgery (used to correct a "gummy smile")
* Accelerated orthodontics (such as braces you wear for only a few months)

In some cases, a combination of several procedures may be used to correct a problem. Each mouth is different, and only a qualified cosmetic dentist can determine what will work best for you.

There are very few dental problems that cannot be corrected by through cosmetic dentistry. And, in some cases, they can be treated in just three appointments.


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Choosing a Cosmetic Dentist


Cosmetic dentistry is a science. But all dental problems are unique to the structure of the individual patient's mouth. And there are a myriad of different cosmetic dental procedures which are available. The success of many of these procedures depends upon the skill of the cosmetic dentist applying them. So, in a way, cosmetic dentistry isn't just a science, it's an art!

This is why you want a dentist who absolutely specializes in cosmetic dentistry. Unfortunately, not all dentists are trained in cosmetic dentistry. The American Dental Association does not yet issue special certifications or licenses indicating which dentists are cosmetic dentists and which are not. The dentist you go to for twice yearly check-ups is probably not going to be the same dentist you go to for cosmetic enhancement.

Fortunately, dentists who specialize in cosmetic dentistry are easy to find. Cosmetic dentists obtain additional training and certification from cosmetic dentistry organizations and universities. For cosmetic dentistry procedures, you want a dentist who has taken courses at, or belongs to, a cosmetic-dentistry-specific organization such as the Las Vegas Institute for Advanced Dental Studies, the American Academy of Cosmetic Dentistry, PAC-Live or the American Society of Dental Aesthetics. By looking into the credentials of a specific dentist you are assured that your cosmetic dentist has training in the most up-to-date, safest cosmetic dentistry procedures available.

How do you find a cosmetic dentist? There are four initial steps that will put you on the right track:

1. Ask your friends and family for references.
2. Ask your dentist and/or doctor if there's anyone he or she recommends.
3. Check with the aforementioned accredited cosmetic dentistry organizations:
* Las Vegas Institute for Advanced Dental Studies
* American Academy of Cosmetic Dentistry
* P.A.C.-Live
* American Society of Dental Aesthetics
4. Refer to directories, commercials, web sites and other advertising.
(This step should only be used as a very basic starting point as, obviously, the information contained within can be biased towards the person or organization being advertised.)

Once you've found a cosmetic dentist you feel will be right for you, there are several steps you can take to insure that he or she is a qualified professional:

1. Check with the dental licensing board in your state. (This varies by state -- an internet search regarding the medical licensing board in your state is the best place to start.)
2. Check for any medical malpractice suits filed with the clerk of the county or circuit court in the area(s) where your cosmetic dentist has practiced. At minimum, consider three medical malpractice judgments against a doctor within five years to be a warning sign.
3. Verify credentials and training. Typically, you want a dentist who is exclusively a cosmetic dentist, or at least one who devotes the majority of their practice to cosmetic dentistry. Ask your dentist questions about how long they've been practicing cosmetic dentistry, what organizations they belong to, what specific cosmetic dentistry training they have (not just dental training), and ask to see some before and after photos of previous patients.
4. Ask the dentist how many times he or she has performed the specific procedure(s) you want done, and what the rates of complication are.
5. Ask the dentist for references.

If any of these steps result in what you feel is an unsatisfactory answer, it's probably safer to continue your search elsewhere.


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Cosmetic Procedures/Treatments


The most important thing to remember is that cosmetic dentistry is a specific branch of dentistry, and not all dentists are qualified to perform cosmetic dental procedures. Before undergoing any procedure, make sure your dentist is a qualified cosmetic dentist. He or she should have specific cosmetic-dentistry-specific training, and should belong to at least one cosmetic dental organization such as the American Academy of Cosmetic Dentistry, PAC-Live or the American Society of Dental Aesthetics. The Las Vegas Institute for Advanced Dental Studies is generally considered to be the preeminent cosmetic dentistry school in the United States - if your dentist is a graduate of LVI, you can be assured that you're in good hands.

The type of cosmetic dental procedure required depends entirely upon the needs of the individual patient. From chips to gaps to stains to a myriad of other dental problems - each patient's mouth and dental condition is different. Only a qualified cosmetic dentist can help you explore your options. There is no such thing as a routine procedure.

However, while each procedure is unique to the individual, all cosmetic dental procedures are safe and, in the hands of a professional cosmetic dentist, virtually error-free and painless. That great smile you've always wanted really is literally only weeks, or even days, away.

Tooth whitening is one of the most common cosmetic dental procedures, and there is definitely a benefit to having your teeth whitened under the supervision of a cosmetic dentist as opposed to over-the-counter methods. A qualified cosmetic dentist - such as an LVI-trained dentist - is able to give you teeth which are whiter, more even and more natural than an over-the-counter product can ever achieve. Tooth whitening is a relatively simple and inexpensive procedure - involving either in-office laser-based treatments or at-home bleaching trays - and the benefits of working with a professional cosmetic dentist far outweigh any perceived ease of over-the-counter products.

Most other cosmetic dental procedures revolve around damaged, misaligned and crooked teeth. There are several options to repair a "broken smile" and, again, the procedures applied depend upon the individual patient's specific needs. However, the most common categories of repair typically involve the placement of veneers, bridges, dental bonding and dentures. These - generally - cover and/or replace damaged teeth. For more extensive repair, instant orthodontics is a popular option. Like regular orthodontics - but faster - instant orthodontics is a great, expedient way to repair misaligned teeth.

Cosmetic dental repair is about more than just vanity. An improved smile can increase your confidence, your happiness and your life overall. Also, a nicer smile is a healthier smile. Gaps and misaligned teeth increase your risk for bacterial infection and tooth loss. Cosmetic dentistry won't just improve your smile, it will also improve your health.

If you have a "broken smile" contact a qualified LVI-trained dentist today. A dazzling, healthier smile is easier, more affordable and available sooner than you think! Cosmetic dentistry - it truly is something worth smiling about!


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Smile Makeovers


Only you know what you don't like about your smile, and only a qualified cosmetic dentist knows how best to help you. A cosmetic dentist is different from a regular dentist - while both have been to dental school, only a cosmetic dentist has undergone specific training in the field of cosmetic dentistry. Be sure and ask questions - a professional cosmetic dentist belongs to cosmetic dentistry organizations such as the American Academy of Cosmetic Dentistry, PAC-Live or the American Society of Dental Aesthetics. Also, a qualified cosmetic dentist has received additional training beyond regular dental school, such as the Las Vegas Institute for Advanced Dental Studies, one of the nation's premier schools for cosmetic dentistry instruction.

A "smile makeover" is any cosmetic dental procedure - or combination of procedures - used to improve your smile. It can be something as simple as at-home tooth whitening to something as complex as veneers, bridges and instant orthodontics. Each individual's needs are different. A qualified cosmetic dentist will help determine what procedures are best for you!

Tooth whitening is a procedure many people undergo. It's safe, easy and economical - and, under the supervision of a properly trained cosmetic dentist, produces results which are natural and beautiful. But tooth whitening is just the beginning. Crooked teeth can be straightened. Missing teeth can be replaced. Misaligned teeth can be straightened. Virtually all smile problems can be corrected!

Additionally, thanks to procedures such as instant orthodontics, most tooth problems can be corrected much faster than you'd ever think. What used to take years now only takes months, or even weeks!

There are very few dental problems which can't be corrected by modern cosmetic dentistry, and there are even fewer reasons to not undergo them. Cosmetic dentistry is safer, easier, more effective and more affordable than ever before! A beautiful new smile is the first step to creating a beautiful new you. And aside from the improved confidence and happiness which accompanies a new smile, there are also wonderful health benefits - a new smile helps prevent tooth loss, infection and disease.


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Instant Orthodontics


When most people think of orthodontics, they think of an expensive, time-consuming procedure involving braces, head-gear and other embarrassing appliances. But that is no longer the case!

Instant orthodontics accomplishes the same results as traditional orthodontics, but in much less time and with no awkward appliances. Straight, even teeth can be yours, and in only a matter of weeks!

What exactly is instant orthodontics? It's when thin, ceramic shells of material - called veneers - are placed over the front surface of your teeth. They're very natural looking, and are colored to fit in alongside your natural teeth - under the guidance of a professional cosmetic dentist, your new veneers will be virtually indistinguishable from real teeth. Plus, your new teeth will be just as durable as real teeth. There's really no downside.

The typical Instant Orthodontic process involves four procedures over the course of about a month. The first appointment is an initial consultation with your cosmetic dentist. The procedure will be explained to you and a timetable will be determined. The second procedure is where the mold is made - the mold is used to create the veneers. During this second procedure, your teeth will be lightly shaved down (to accommodate the additional thickness of the veneer) and a mold is created. This mold is then sent to a dental laboratory. After approximately two weeks, you'll return to the dentist and the veneers will be bonded to your teeth. This is a relatively complicated process, and can take several hours. The final appointment is a follow-up appointment to insure the veneers have bonded properly.

When it's all over, you'll have straight, even, natural-looking teeth! No braces, no head-gear and - most importantly - almost no wait.


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Porcelain Veneers


If you have crooked, chipped misaligned, discolored or otherwise damaged teeth, veneers are an excellent remedy. Veneers are thin shells of ceramic material which are permanently bonded to the front surface of your teeth. They're custom-made and custom-colored; when placed by a qualified cosmetic dentist, veneers are virtually identical to natural teeth.

Plus, not only do veneers look like real teeth, they act like them, too. Veneers are considered a conservative alternative to crowns, and they can be applied to both the top and bottom teeth.

Veneers are not false teeth; they only cover the front surface of teeth. They can cover chips, breaks, gaps and stains.

Applying veneers usually takes about a month. First, there is an initial appointment, where your dentist will cover the procedure. Then, during the second procedure, a mold is taken of your teeth. This mold is then sent to a dental laboratory, where the veneers are custom made for your mouth. The veneers are then placed during the third procedure.

It's important to note that placing veneers is as much of an art as it is a science. That's why it's important to have a qualified cosmetic dentist - one who is specially trained in cosmetic dentistry - when undergoing this procedure. When veneers are placed they are colored so they match the surrounding teeth. The quality of the color matching depends largely upon the skill of the cosmetic dentist doing the procedure.

That's why it's important to choose a dentist who is specifically trained in cosmetic dentistry. A cosmetic dentist has additional skills above and beyond those of a regular dentist - he or she will belong to a cosmetic dentistry organization such as the American Academy of Cosmetic Dentistry, PAC-Live or the American Society of Dental Aesthetics. Also, he or she will have graduated from a cosmetic dental school, preferably the Las Vegas Institute for Advanced Cosmetic Dentistry, the nation's premier cosmetic school.

Once your veneers are placed, you can expect a mouth of natural-looking, beautiful teeth which blend in with your regular teeth. With no more cracks, breaks, gaps or stains you'll find your confidence increasing and your smile appearing more and more. Veneers are a pleasant, quick and cost-effective way to create a winning smile!


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Implant Dentistry


Roots. Although you can't see them, a solid root structure is instrumental in maintaining healthy teeth. Damaged roots cause tooth rot, decay and - in extreme cases - total tooth loss.

A dental implant is a substitute for a tooth root. Implants are an anchor for replacement teeth. The implant is inserted into the jawbone, and then the false tooth - also called a "pontic" - is then attached.

Implants are made of titanium, which fuses well with bone (this process is called osseointegration). The final result is a strong support structure which, in most cases, will hold your pontic to your jaw for the rest of your life.

There are three different types of dental implants. One, called a root form implant, is a screw type of implant which is inserted directly into the jawbone, under the gums. The second, called a plate form implant, is very similar to a root form implant. The only difference is that a plate form implant is set directly on top of the jawbone, under the gums. This type of implant is used when the jawbone is too narrow or short - a condition usually caused by disease.

If the jawbone has undergone severe deterioration, the third type of implant must be used. Called a subperiosteal implant, it is basically a custom-made, artificial jawbone. Creating this implant is an intricate, surgical procedure. Fortunately, most patients do just fine with either a root or plate form implant.

Once your implant is installed, the artificial tooth - or teeth, in some cases - are installed. These teeth are not dentures, and are not removable. Rather, they are permanently attached, and behave just like real teeth.


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Tooth Whitening


A nice, white smile is a wonderful way to face the world. Not only do most people find a nice smile attractive, you'll also find yourself becoming more outgoing and confident. A nice, white smile is more than just a cosmetic addition - it will also add numerous other tangible benefits to your life. It's easy to see why tooth whitening is one of the most popular cosmetic treatments people receive.

Many people try over-the-counter tooth whitening products, but the results are nowhere near as good as what can be accomplished via a cosmetic dentist. Over-the-counter products produce a uniform look which - in most people - creates a very unnatural look, one which is much too bright.

A qualified cosmetic dentist, however, can achieve a natural look.

There are two basic methods a cosmetic dentist can use to whiten your teeth. One is an in-office treatment, such as BriteSmile. A special gel is applied to your teeth, and then a laser is used to activate the gel, which then whitens your teeth. This procedure is quick and easy - it usually takes only one treatment! Only a qualified cosmetic dentist can apply the gel properly - just the right amount must be used to create a natural look.

The second type of professional whitening method is an at-home procedure. A custom-made mouth tray is created for you. Then, at home, you place a special gel into the tray. Depending on the degree of whitening required, you'll wear the gel-filled tray either all night, or for a few hours each day, for a length of time that's determined by your dentist.

Only a qualified cosmetic dentist can determine which procedure - and, more importantly, which strength of procedure - is right for you. The end result is beautiful, bright, stain-free smile - but not one which forsakes a natural look.


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Dental Crowns


A dental crown is a device which covers a tooth. Its function is to either strengthen a decayed tooth, repair a broken tooth or improve the cosmetic appearance of a tooth.

A crown is similar to both a veneer and a filling. The differences between the three are technical - only a qualified cosmetic dentist can determine which is the best choice for you specific needs. If you have broken, decayed or otherwise damaged teeth, please contact Dr. Dooley for a consultation. He is a graduate of the Las Vegas Institute for Advanced Dental Studies, and is expertly trained in all forms of cosmetic dentistry. He'll be able to determine if crowns are right for you.

There are three types of crowns - porcelain, gold and porcelain fused-to-metal crowns. Porcelain crowns look like real teeth, but they are not as durable as gold crowns. Gold crowns are very strong but, because they're gold, they are used only in areas of the mouth where they won't be visible (typically the back of the mouth). Porcelain fused-to-metal crowns have a metal substructure. They're used when porcelain crowns will not work. Porcelain fused-to-metal crowns have a slightly noticeable metal sub-structure - a dark line which appears, over time, near the gumline.

Only a qualified cosmetic dentist can determine which type of crown is appropriate for your individual needs. However, each crown is placed in the same type of way. A mold is first taken of the decayed tooth, then that mold is sent to a dental laboratory, where the crown is made. The crown is then fitted atop the damaged tooth with dental cement.

The cement used affects the color of the tooth. Matching the color of the crown to the color of the surrounding teeth is as much of an art as it is a science, which is why it's so important to find a dentist who is expertly trained in cosmetic dentistry.


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Dental Bridges


Missing teeth are more than just cosmetically unappealing. Missing teeth also significantly increase the risk of disease and decay in your other teeth and gums. Additionally, missing teeth can affect your speech. If you have any missing teeth, please see a qualified cosmetic dentist - such as Dr. Dooley - right away.

The most common way to fix missing teeth is to install a dental bridge. A dental bridge is a false tooth. It's attached to the mouth in a special way - it's attached between two of your natural teeth via two porcelain crowns. The false tooth - which is also called a "pontic" - is suspended between the two crowns. The two crowns act a bridge, holding the pontic in place.

Dental bridges are not dentures and, as such, dental bridges are not removable. There are several different types of dental bridges - they differ mainly in the way that they are installed - and only a qualified cosmetic dentist can determine which is right for you. Also, only a qualified cosmetic dentist - such as a graduate of the Las Vegas Institute for Advanced Dental Studies - can properly match the color of your bridge to that of the rest of your mouth. That's why it's so important to choose a dentist specifically trained in cosmetic dentistry, such as Dr. Dooley.

Missing teeth lead to more dental problems than almost any other cosmetic dental-related problem. If you have any missing teeth, you should contact a dentist right away. A healthier, more pleasing smile is available, and sooner than you may think!


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Dental Bonding


Dental bonding is one of the most common cosmetic dental procedures around. It's used to correct a wide variety of tooth problems, such as cracks, decay, gaps, discoloration and chips. In fact, almost all minor dental problems can be at least helped by dental bonding.

So what is dental bonding? It's a tooth-colored resin which is applied to your teeth. It's analogous to putty. The resin is applied to your teeth - filling in gaps, covering up cracks, etc. - and then the resin is hardened with a special light.

Unlike most other cosmetic dental procedures, bonding does not require that a mold first be made. Bonding is typically done in just one office visit. It's painless, quick and relatively inexpensive.

Bonding is best suited for small cosmetic changes.

Only a qualified cosmetic dentist can determine if bonding will be effective for you.


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Natural-Looking / Metal-Free Fillings


The days of noticeable metal fillings are gone. Cosmetic dentistry has advanced to the point where fillings can now be matched to the color of your teeth and thus be virtually invisible.

Fillings are used to treat cavities. If you suspect you have a filling - i.e., you have tooth pain, especially when exposed to cold - you need to see a dentist as soon as possible. Untreated cavities lead to prolonged pain and an increased risk of further tooth decay.

If you do have a cavity, metal-free fillings, generally speaking, are for you. They're used in almost all instances where metal fillings once were. Additionally, if you currently have metal fillings, you, in most cases, can have those metal fillings replaced by metal-free fillings.

In addition to being less noticeable, and therefore more cosmetically pleasing, metal-free fillings are also less conductive of heat and cold. Also, metal-free fillings take less time to harden than traditional fillings - so you'll be out of the dentist's chair sooner!


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TMJ / Neuromuscular Dentistry


Temporomandibular Joint dysfunction is pain which develops around the jaw and its associated muscles. TMJ disorder can make speaking, chewing, swallowing and facial expressions strained and uncomfortable.

This chronic pain, as well as other TMJ complications, makes TMJ the third largest health problem in the United States. Approximately 40 percent of all chronic pain syndromes are concentrated in the head and neck areas. Fifteen percent of TMJ disorders are genetic; 85 percent are acquired. Some estimates suggest that 20 percent of all Americans possess some symptoms of TMJ.

The temporomandibular joint is located directly behind the ear. It consists of two bones -- the skull bone and the jawbone. Between those two bones is a disc called an intra-articular disc, which acts as a type of shock absorber. As the mouth opens and closes, the disc moves and glides along, both forward and backward, always staying in position between each bony structure. The disc provides for smooth, quiet movement and acts as a cushion against the heavy forces generated by strong jaw muscles.


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TMJ / Neuromuscular Dentistry FAQs


What is TMJ?
Temporomandibular Joint dysfunction is a chronic pain which people get in and around their jaw muscles. Some estimates place it as the third largest health problem in the United States.

The TM joint consists of two bones - the skull and the jawbone. There is a disc between those two bones which acts as a cushion. If that cushion malfunctions misaligns in some way, either due to genetics or other causes, pain results. The pain can be either constant or it can be more pronounced as the mouth opens and closes.

What are the symptoms?
There are many symptoms. Some of the more common ones are headaches, ear ringing, sore teeth, numbness in the arms and hands, and general pain the face, neck or shoulders.

TMJ is hard to self-diagnose. If you have symptoms you believe are TMJ related, it's best to see a medical professional for an accurate diagnosis.

Why would I see a cosmetic dentist about TMJ?
A cosmetic dentist - especially one trained at the Las Vegas Institute for Advanced Dental Studies - understands the symptoms of TMJ, because TMJ is often the result of jaw and jaw alignment problems.

Also, a cosmetic dentist can determine if TMJ is NOT caused by alignment problems. Sometimes TMJ can have a totally different origin - it can be the result of a neurological condition, for example, or an accident. If that's the case, your doctor will be able to refer you to a more appropriate medical specialist.

In short, a cosmetic dentist is a good place to start the process of diagnosing TMJ because if the pain is the result of an alignment problem, a cosmetic dentist can treat that. If the pain is not the result of an alignment problem, a cosmetic dentist can help you determine where else to go for help.

What is the treatment?
The treatments of TMJ are as varied as the causes. Cosmetic dental specific treatments can involve something as simple as mouth guards to something as complex as extensive orthodontics. It all depends on the severity of the TMJ. Only a qualified cosmetic dentist can properly determine the appropriate treatment.

Dr. Dooley has trained at the Las Vegas Institute for Advanced Dental Studies. TMJ is a condition that should be looked at by someone trained in the intricacies of the disorder. Please contact Dr. Dooley today for a consultation. Start feeling relief sooner!


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TMJ / Neuromuscular Dentistry - Common Symptoms


Only a medical professional can properly determine if you have a TMJ disorder. However, there are numerous symptoms which can be exhibited both singular or in combinations.

-Headaches / migraines -- including dull, aching pain around the ears, face, temples, neck, back of head, back of eyes and shoulders.

-General facial pain

-Neck and shoulder pain

-Ringing in the ears -- including hearing loss, ear stuffiness, congestions and ear pain.

-Sensitive or sore teeth

-Jaw pain, including difficult or painful chewing, and difficulty opening and closing the mouth. Also, jaw pain which is more prevalent in the morning or late afternoon.

-Numbness or tingling in the arms and/or hands.

-Jaw clicking, popping or grating.

-Ear ache without an ear infection.

-Limited jaw movement, including locking of either the open or closed jaw.

-Sensitive teeth when no dental problems can be found.

-Depression

Only a qualified medical professional can properly diagnose TMJ dysfunction. The above symptoms manifest them in a variety of ways and combinations. If you have any of those symptoms, or similar ones, it's best to see your dentist or doctor.


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TMJ / Neuromuscular Dentistry - Causes of TMJ


Any disturbance between the teeth, muscles and joints in the jaw can trigger neurological impulses, which in turn can cause painful TMJ dysfunction.

Additionally, stress can trigger pre-existing conditions.

Some of the causes of TMJ include:

-Improper bite

-Tooth and jaw misalignment

-Trauma / head injury

-Excessive yawning, or other periods where the mouth is open too wide for prolonged periods of time.

-Clinching or grinding of teeth

-Loss of teeth, especially the back molars

-Cervical traction involving the head, jaws and neck

-Compromised tongue position

-Upper airway constriction

-Poor posture

-Arthritis

Additionally, there are some dental-specific causes of TMJ. They are:

-Crowded teeth

-Narrow arches

-Crossbites

-Unlevel bite planes

-Gumline tooth erosion

-Generalized tooth sensitivity

-Enamel cusp fractures

-Porcelain crown fractures

-Deep overbite


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TMJ / Neuromuscular Dentistry - How to Diagnose


There are five main diagnostic techniques:

* Postural examination
This exam searches for imbalances in the body's mechanics and posture. Posture affects the relations of the lower jaw to the cranium, which can contribute to TMJ problems. Chiropractic care, physical therapy or massage therapy may be recommended in this case.
* Craniocervical Examination
This is an evaluation of the planes of the skull and cervical ranges of motion of the head.
* Limited Neurological Examination
TMJ can be caused by nerve or brain damage. This exam is a screening process used to detect such damage.
* TMJ Examination
This exam tracks the range of jaw movement, including the velocity, smoothness, muscle coordination and crossover patterns of the jaw, skull and neck.
* Muscle Palpation
This exam checks for tenderness and inflammation in the head, neck and shoulders.

These exams use various techniques for diagnosis -- including both physical and visual exams as well as X-rays.


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TMJ / TMD / Neuromuscular Dentistry Treatment


In most cases, TMJ involves resting and/or balancing the joint. If symptoms occur only infrequently, the treatment may be something as simple as warm, moist compresses. In more complex cases, a mouthguard may be created in order to reposition the jaw, relieving stress on the muscles and teeth.

This mouthguard is called a neuromuscular orthosis and is usually worn full-time. It creates balance between the teeth, muscles and joints. Usually, it worn anywhere from three to nine months, and may be used in conjunction with chiropractic care, physical therapy or massage therapy.

After that first procedure, a second procedure is then undertaken. This second procedure attempts to permanently stabilize the temporomandibular joints in one of several ways:

-A semi-permanent split -- this is a metal neuromuscular device which is worn in the mouth, sometimes for years.

-Comprehensive orthodontics -- In an effort to pull the teeth into the appropriate position, orthodontics devices may be worn for anywhere from a few months to a few years.

-Reconstruction -- There are numerous cosmetic dental techniques that can fix a variety of alignment problems. Although some of these procedures can be expensive, they can also be quite effective. From sedation dentistry to porcelain-ceramic technology, your entire dental landscape can be improved, and usually in less time than you'd think!

TMJ/Neuromuscular dentistry - Choosing a Neuromuscular Dentist

A neuromuscular dentist has specific, additional training above and beyond a normal dentist. However, some causes of TMJ require treatment from a doctor, and are beyond the scope of dental work.

A TMJ-trained dentist is often the perfect place to start, however. If the TMJ is the result of a tooth-related alignment problem, your dentist will be able to discuss your treatment options. If your TMJ is the result of other problems -- such as a neurological disorder -- your dentist will be able to refer you to a qualified medical professional.
Dr. Dooley has trained at the Las Vegas Institute for Advanced Dental Studies. TMJ is a condition that should be looked at by someone trained in the intricacies of the disorder. Please contact Dr. Dooley today for a consultation. Start feeling relief sooner!


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David Dooley, DDS
Colonial Dental Group

Office Address:

1775 Glenview Rd.
Suite 107
Glenview, IL 60025
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