I am a mess. I had been grinding my teeth for years. Apparently, my dentist knew this and never mentioned it until my teeth were down to nubs. He crowned the worn teeth, but now I am in constant pain. Plus, I’ve worn those down as well. I don’t know how to stop doing that because I didn’t realize I was doing it to begin with. I went to get specialist help but learned there isn’t a specialist in this. It has been suggested I see a prosthodontist, but I’m worried the teeth won’t look good. Do I have to choose between functioning pain-free teeth and a pretty smile?

Amelia

Dear Amelia,

I’m sorry you’ve been put through this. Plus, I hope you don’t mind saying I think you need to find a better dentist. This one doesn’t seem to have your best interests at heart. He knew you were grinding your teeth and never provided you with the simple tool to protect your teeth to keep from wearing them down.

Then he let you do it again with your dental crowns. I’m sorry, but that is like standing there watching a blind person walk off a cliff, charge them for the hospital bill and repairs, then watching them do it again. How were you supposed to know you were grinding your teeth, let alone what would help? He’s the professional.

Yes, a prosthodontist will typically have more training in treating TMJ Disorders than your average dentist, but as you mentioned not many of them are artistic. They are passionate about the technical aspects and don’t really care about appearance-related issues.

What you need is a dentist who is passionate about form and function; one who has invested in both TMJ training as well as cosmetic training. I promise they exist. They’re not as much of a unicorn as it might seem at the moment.

Finding a Great TMJ Dentist Who Can Create Beautiful Smiles

You’ll need to begin with the TMJ training. It will not matter how beautiful your smile is if you are in too much pain to share it. Here are some institutions which have great TMJ training. You’ll want to find a dentist who has trained with one of them.

• The Dawson Academy
• The Kois Center
• The Pankey Institute
• The Las Vegas Institute of Advanced Dental Studies

From there, you’ll look to see if any of them have great cosmetic skills. The best are AACD accredited. These are hard to find. Dr. Weiss is one of six accredited dentists in the whole of Pennsylvania. If you can’t find one, that doesn’t mean it’s hopeless. Many great cosmetic dentists are on their way toward accreditation. I would look at their smile galleries to see what type of results they get. Just makes sure it is images of their actual work and not just stock photos.

One other thing. You need to get a nightguard. This is like a sport’s mouthguard, but is custom-fitted to your bite. It will protect your teeth from the grinding you are doing while you sleep.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Micahel Weiss.