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Who is the best implant dentist: a periodontist, an oral surgeon, or a general dentist?

A dental implant dentist sits alone next to an empty treatment chair in a dental practice.Can you clear something up for me?

I’m confused about who I should see to get a dental implant because I originally thought that there was just one implant specialist who does this kind of treatment. But wherever I look, I see periodontists, dentists, and oral surgeons all advertising implants. I’m trying to get a straight answer before I schedule a consultation, but no matter which practice I call, they all tell me they are the best choice for dental implant treatment. I don’t know who to believe.

— Stephen from Albany, NY

Dear Stephen,

The simple reason for your confusion is that there’s no dental implant specialty recognized by the American Dental Association. Here in the United States, you’ll find qualified specialists in nine areas of dental treatment, but dental implant treatment isn’t on the list.

This means that any dentist, periodontist, or oral surgeon who has learned how to place implants can offer the treatment, but there’s no such thing as a dental implant “specialist.”

Naturally, each doctor will explain why his or her unique training or qualifications make them the best candidate for placing your implants, but the choice is ultimately yours to make.

Depending on your individual case, you may even need to visit more than one doctor to complete your treatment from start to finish. For example, a periodontist might do an excellent job placing your implant, but they will refer you to a restorative dentist who will design and place your implant restoration.

Do your research on the training, qualifications, and patient testimonials and reviews of each dental implant provider you are considering. If you still can’t choose between them based on your research, try asking each of them these questions:

  • How many patients have you treated with dental implants?
  • How many dental implants have you placed?
  • How many of them have failed? (Note: dental implants are highly predictable and successful, so failures are rare, and a provider will recall the few, if any, cases of implant failure they’ve observed in their career.)
  • How long have you been placing dental implants?
  • How much time have you logged studying the dental implant procedure?

A doctor’s answers to these questions can help you find out if he or she is the right provider for your dental implant treatment.

This post has been published on behalf of Owasso dental implant dentist Dr. Heng Lim.

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How do I find a legitimate neuromuscular dentist?

I’ve had a teeth-grinding habit for as long as I can remember. It got to the point where I had crowns on all of my teeth by the time I was in my mid-twenties. But they weren’t placed correctly and I’ve ground them down, as well. The crowns didn’t look that great to begin with, but now they look even worse because they’re so flat. So obviously, I’d like to replace my crowns and make my teeth look better, but that’s only the beginning of my problems.

Years of grinding my teeth and wearing down my crowns have left me with a painful TMJ that clicks and an uneven bite, so I started visiting a so-called “neuromuscular dentist” for treatment with an orthotic device. As it turns out, he wasn’t a specialist like I thought he was, and the treatment didn’t help. If anything, it made my bite much worse as I now have an open bite and my crowns have worn down even more. I went to an orthodontist to see if braces could correct my bite, but he said I would need the help of a prosthodontist.

A woman in a yellow shirt smiles as she reclines on a white sofa. She is happy and free of TMJ pain because of seeing a qualified dentist for full-mouth reconstruction.
Freedom from TMJ pain is possible!

Right now, I’m trying to find the right doctor to help me because my case is so complicated. Should I see a cosmetic dentist who can make my teeth look better? Or start with a prosthodontist who can fix my bite?

I’ve gotten so many recommendations and I have no idea where to begin. After all the pain and disappointment I’ve experienced, I’m not even sure if I can trust anyone.

— Rhoda from Akron, OH

Dear Rhoda,

It’s easy to feel overwhelmed and discouraged when trying to correct dental problems that you have struggled with for many years. It’s even worse when you’ve gone to multiple dentists for help only to have your hopes crushed.

Not all dentists who claim to treat TMJ problems are truly qualified to do so, which is something you personally and unfortunately experienced. On the other hand, dental specialists like prosthodontists who are capable of creating a balanced bite are not always concerned with providing the most esthetic finish.

So it’s understandable that you may feel torn between visiting two different dentists seeing as you need to accomplish two objectives.

That’s why seeing another neuromuscular dentist could actually be a step in the right direction for you. Your case does sound complex, and you will get the most comprehensive care in the hands of a dentist who has experience in full-mouth restoration and TMJ treatment.

But it’s clear from your last experience with a so-called “neuromuscular dentist” that he did not know what he was doing. There is not currently a recognized specialty for TMJ treatment or neuromuscular dentistry, so it can be a challenge to find a professional who is truly qualified.

However, there’s no need to choose between two different dental specialists, or to choose between function and appearance. A dentist with the proper training and experience in neurologic or physiologic dentistry and cosmetic dentistry can relieve your pain and restore your teeth at the same time with beautiful lifelike crowns.

The next step for you is to locate a dentist near you who truly knows what they are doing and is equally passionate about function and appearance. Start by searching for dentists in your area who advertise their expertise in TMJ treatment and can show proof of their cosmetic skills in an online smile gallery. For example, the Las Vegas Institute for Advanced Dental Studies is a respected post-graduate program that trains dentists in TMJ treatment and neuromuscular dentistry.

We hope this information helps you locate the right treatment provider, Rhoda.

This post was published on behalf of Owasso TMJ dentist Dr. Heng Lim.

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My new crown doesn’t feel right. What should I do?

I just got a new crown on a back tooth, but it feels odd when I bite down on it, like it doesn’t quite line up with the other teeth. 

I asked my dentist if he could trim it down so that it fits better, but he checked it and said I just need more time to get used to the sensation. It’s been two weeks at this point, and it’s still bothering me. 

Is it normal for a crown to feel “off” like this?

— Stefanie from Tulsa, OKA woman is frowing in pain and touching the side of her face with her hand because her dental crown doesn't feel right. A dentist experienced in full-mouth reconstruction can help her get relief.

Hi Stefanie,

First of all, it’s not normal for a crown to feel “off.” A crowned tooth should feel so normal that you forget the crown is even there. If your bite started to feel uncomfortable after you got the crown, then this suggests that your crown may need to be adjusted.

So why would your dentist tell you to ‘just get used to it?’

Well, designing a dental crown so that it fits perfectly in line with the opposing teeth is not a simple task. It requires a certain skill set and may even take multiple attempts to create a natural-feeling crown. Most dentists can design crowns that adequately restore individual teeth, but relatively few dentists are experts in creating crowns that help harmonize the entire bite.

“Occlusion” is the scientific term for the way your upper and lower teeth fit together when you bite down. If your dentist does not feel that they are an expert in occlusion science, then he might tell you to ‘just get used to it’ if he can’t find an obvious problem.

On the other hand, a dentist with advanced post-graduate training in restoring balanced occlusion could help you get a more comfortable bite. The Las Vegas Institute for Advanced Dental Studies, for example, is a respected institution that teaches dentists how to improve the function and balance of the bite.

Does this mean that you should visit a new dentist? 

Not necessarily. If your bite just feels slightly “off” but you don’t experience any pain when you bite down on your new crown, then you may indeed get used to the sensation if you give it a few months. You can stay with your original dentist as long as you are confident he has your best interests at heart.

Keep in mind, however, that an unbalanced bite has the potential to cause complications down the road. Too much pressure on one tooth could cause bone loss around that tooth, or an unbalanced bite could even lead to TMJ pain. Adjusting your crown could help that tooth feel better and eliminate your risk of such complications, but it sounds like your current dentist doesn’t know what further adjustments can be made. 

If you are ready to seek more advanced help, then use this opportunity to search for a new dentist who has the qualifications and experience necessary to balance out your bite. A dentist who is skilled in full-mouth reconstruction and in adjusting occlusion can safely adjust your crown. 

You may also want to visit such a skilled professional the next time you need a new dental crown. Search for a dentist near you who has advanced training from a post-graduate dental institution and ask them for a second opinion.

This post has been published on behalf of Owasso dentist Dr. Heng Lim.

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