BRENTWOODDENTAL & TMD
TMD / TMJ FAQs
TMJ / TMD causes what symptoms?
Symptoms that are common include:
- Ear, jaw, jaw joints, and face muscles pain or tenderness
- Headaches
- Temple aches
- Throat discomfort
- Opening the jaw causes pain
- Chewing discomfort
- Pain in the neck, shoulder, back, and arms
- The sensation of the joint 'locking'
- Clicking, popping, and grating noises
What causes TMJ / TMD?
TMJ / TMD is a chronic, degenerative disorder that requires immediate and long-term treatment. TMJ / TMD can be caused by various factors, including trauma to the jaw or TMJ. Arthritis, bruxism (teeth grinding), or neck problems could all be blamed.
Is surgery required to treat TMJ / TMD?
Surgery is not a first-line treatment and should only be considered if all other, more conservative options have failed to relieve and manage your symptoms.
Non-surgical methods are intended to relieve pressure on the TMJ / TMD, reduce pain, and allow you to resume normal chewing, talking, yawning, and swallowing activities.
What is the best treatment for TMJ / TMD?
ULF-TENS (Ultra Low-Frequency Transcutaneous Electrical Neural Stimulation), a method for relaxing your muscles with gentle massage, is the first step toward symptom reduction. ULF-TENS also helps alleviate pain by stimulating the production of endorphins, a natural analgesic. We then use a combination of modern neuromuscular procedures to gently and safely return your bite to its ideal position. Finally, we will discuss several ways to manage your TMJ / TMD in the long term for joint health and pain relief.
TMJ, TMD & Headache FAQs
What does it mean if my jaw joint clicks or pops when I open my mouth?
A clicking or popping jaw joint means you have a TMJ problem that should be evaluated, and it is likely to get worse without treatment to stabilize it. The noise usually comes from the cartilage disc inside the joint shifting out of its normal position. Dr. Holmes can assess the popping to determine the type of displacement and the right course of treatment.
I already have a bite splint, so why isn't it relieving my TMJ symptoms?
Your splint may not be working because an accurate diagnosis was not established before it was made, or because the design or instructions were not right for your specific problem. Generic or universal splint designs are not recommended since a splint should be custom fabricated based on your diagnosis. Other physical problems may also be contributing to your pain, and Dr. Holmes can determine why your current treatment has not worked.
Can a TMJ problem cause my headaches or migraines?
Yes, TMJ problems often cause or worsen what are described or diagnosed as migraines. Other disorders or conditions can also be a factor, so a proper and thorough evaluation is needed to find the true cause. Dr. Holmes excels at finding answers to these kinds of questions.
Why does my bite feel wrong, like there's no comfortable spot for my jaw?
This feeling is usually caused by unstable jaw muscles, an internal jaw joint disorder, or a combination of both. It is a recognized sign of a TMJ/TMD problem. Dr. Holmes can evaluate your bite and jaw joints to find the source of the discomfort.
Can braces fix my TMJ problem?
Orthodontic treatment can sometimes be a good option to correct your bite and tooth alignment, but it should never be used before an accurate diagnosis of your TMJ problem is established. Treating the bite without first understanding the joint disorder can lead to the wrong approach. Dr. Holmes determines the diagnosis first before recommending any treatment path.
Can neck or ear pain actually be caused by a TMJ problem?
Yes, disorders of the neck and ear can refer pain to the jaw joint and surrounding areas, and the reverse can also happen. Dr. Holmes has tests that can determine the true source or sources of your pain. This helps separate a TMJ issue from other causes of head, neck, or ear discomfort.
Will my TMJ disorder just go away on its own if I wait it out?
No, a TMJ disorder will not go away on its own. Symptoms may temporarily diminish, but without proper treatment and stabilization the problem will degrade over time. Our office recommends getting it evaluated rather than putting it off.
Is TMJ/TMD just a psychological or stress related problem?
No, TMJ/TMD is a true physical ailment and not something that is only in your head. Stress can make the underlying physical problem worse, but it is not the root cause. Dr. Holmes treats the physical joint and muscle problem directly.
What are trigger points and can they cause my headaches?
Trigger points are areas that are the actual source of pain, even though the pain itself may be felt somewhere else in your head. Dr. Holmes is able to determine if you suffer from this condition and treat it accordingly with highly successful therapies.
How long does a therapeutic injection appointment for headache pain take, and is there downtime?
This service is quick, often less than 10 minutes, and requires no recovery period. The procedure involves a few tiny injections that block nerve impulses to the targeted muscles. This decreased muscle activity helps reduce pain issues such as headaches as well as the appearance of wrinkles.
Why would a dentist like Dr. Holmes be a good choice for therapeutic injections instead of going elsewhere?
Dr. Holmes has advanced training to administer this treatment, and as a dentist he is very familiar with the anatomy of the face and head, allowing him to administer treatment with exceptional accuracy and precision. He can also give you this treatment during your normal six month exam and dental cleaning visit, saving you time and an extra trip. He knows where, when, and how much to administer for the best results.
Should therapeutic injections be the first treatment I try for my headache pain?
No, these injections should not be used as a primary treatment option for headache pain before a TMJ diagnosis is established. Most patients have an underlying occlusal or joint problem that should be corrected first to get the best results from this treatment. Dr. Holmes uses this option with success because he evaluates the TMJ diagnosis before recommending it.
Cosmetic Dentistry FAQs
What are dental veneers made of?
Dental veneers are thin shells usually made of porcelain or resin. They are custom created and shaped in a high quality dental laboratory before our office bonds them to the front of your teeth. Because they are made of tooth colored materials, they match the natural appearance of your smile.
What smile problems can veneers fix?
Veneers can correct slightly crooked teeth and improve the look of misshapen teeth. They can also whiten severe staining and discoloration, close unwanted spaces and gaps, repair broken, chipped, cracked, or worn teeth, and correct teeth that are too small or too large.
Will veneers look natural?
Yes, veneers are designed to look natural because they are made of tooth colored materials like porcelain and resin. Our office will help you select a shade of porcelain or resin that is natural yet radiant, so no one will even notice you have veneers.
Can veneers fix chipped or cracked teeth?
Yes, veneers can repair broken, chipped, cracked, or worn teeth. Our dentists bond these thin shells to the front of your teeth to give your smile a beautiful, uniform appearance.
Can veneers close gaps between my teeth?
Yes, veneers can close unwanted spaces and gaps between teeth. They are a versatile way to help your smile look its best while addressing other cosmetic concerns at the same time.
Where are veneers made?
Your veneers are custom created and shaped in a high quality dental laboratory. Our dentists then bond these to the front of your teeth to give your smile a beautiful, uniform appearance.
What causes teeth to become stained or discolored?
Your teeth can become stained from drinks like tea, soda, wine, or coffee, as well as highly or darkly pigmented foods like berries. Tobacco use, plaque and tartar deposits, certain medications like tetracycline, fluorosis, trauma to the teeth, and aging can also cause discoloration.
Why didn't my over the counter whitening kit work?
Over-the-counter whitening kits can leave you with disappointing results, which is why many patients turn to professional teeth whitening instead. Our office offers a teeth whitening system designed to help you achieve the bright smile you desire.
Can trauma to a tooth cause discoloration?
Yes, trauma to the teeth can result in grey, white, or brown spots. This is one of several factors, along with staining from drinks, tobacco use, plaque and tartar, certain medications, and fluorosis, that can affect your tooth color.
Does fluoride affect tooth color?
Yes, fluorosis, which is excessive fluoride ingestion, is one of the factors that can cause your teeth to become discolored. Our office offers professional teeth whitening to help brighten your smile if you are unhappy with your tooth color.
Can certain medications stain your teeth?
Yes, certain medications, including tetracycline, can contribute to staining and discoloration of your teeth. If you are unhappy with your tooth color, our office offers a professional teeth whitening system to help brighten your smile.
What is cosmetic dental bonding used for?
Cosmetic dental bonding is commonly used for small cosmetic changes such as improving the appearance of chipped or discolored teeth. It is also used to close gaps between teeth, change the shape of a tooth or make it appear longer, protect an exposed tooth root due to gum recession, and as an alternative to amalgam (silver) fillings.
How does cosmetic bonding work?
A tooth colored material called resin is applied to the affected area of your tooth and then quickly hardened with a special light that bonds the material to your natural tooth. The procedure does not take long and can often be done in just one dental visit.
How long does cosmetic bonding take?
Cosmetic bonding does not take long and can often be accomplished in just one dental visit. The resin is applied to the tooth and hardened quickly with a special light.
Can bonding protect an exposed tooth root from gum recession?
Yes, cosmetic dental bonding can be used to protect the exposed root of a tooth caused by gum recession. It is also used for fixing chipped or discolored teeth, closing gaps, and changing the shape of a tooth.
Is bonding an alternative to silver fillings?
Yes, cosmetic dental bonding can be used as an alternative to amalgam (silver) fillings. It uses a tooth colored resin material that is hardened with a special light to bond to your natural tooth.
Can bonding change the shape of a tooth?
Yes, cosmetic dental bonding can change the shape of a tooth or make it appear longer. It is a common procedure also used to fix chipped or discolored teeth and close gaps between teeth.
What is the Snap Smile Simulation?
Snap Smile Simulation is a service where our office uses Snap Cosmetic Simulation Software to show you how you will look with your new smile. We take a picture of your current smile and then show you what your new smile will look like.
How do I get a smile simulation before treatment?
As part of your consultation with Dr. Holmes, you will receive a complimentary smile computer simulation. Our office will take your picture and then text or email you what you could look like, so you can show your friends and family how great your smile will be.
Can I share my smile simulation with family?
Yes, after your picture is taken, our office will text or email you the simulation of your new smile. This lets you show your friends and family how great your smile will be before you even begin treatment.
CEREC Crowns, Implants & Dentures FAQs
How long does it take to get a CEREC crown?
You can get your permanent crown in about 90 minutes while you wait, since our office fabricates it right in the office with a 3D printer. There is no need for putty impressions or a temporary crown while a lab builds your permanent one. This means you do not have to miss work more than once.
How experienced is Dr. Holmes with CEREC crowns?
Dr. Holmes has completed more than 10,000 CEREC crown cases. This experience lets our office offer same day crowns fabricated right in the office. You receive a custom made, permanent crown without the wait typically associated with lab made crowns.
What situations call for a dental crown?
You might need a crown to cover a discolored or misshapen tooth, to support a tooth with a large filling, to cover a dental implant, or to support a worn out, cracked or broken tooth. Our office offers several types of dental crowns and can even custom color your crown to match adjacent teeth. This way your new crown matches the rest of your smile.
What are dental bridges made to do?
Dental bridges are false permanent teeth used to fill the gap left by missing teeth. They are usually anchored to the adjacent healthy teeth with cement and resin or metal bands. Our office offers fixed, cantilever, and resin bonded bridges, and the type suitable for you depends on the quality of your teeth, the position of the gap, and the condition of the teeth on either side of it.
What determines the cost of a dental bridge?
The cost of a dental bridge can vary depending on the material used and the position of the bridge placement. Different types of dental bridges are available across a wide budget range. Contact our office to set an appointment and learn more about which option fits you.
Why is a 3D image needed before getting a dental implant?
A 3D image lets our office get a better picture of your existing bone mass before placing a dental implant. You should never get a dental implant without having a 3D image completed first. Our office uses CEREC 3D technology to place and restore implants right in the office.
What makes someone a good candidate for dental implants?
A good candidate for dental implants has healthy gums and enough bone in the jaw to support the implant. If your jawbone is too thin or soft to properly anchor an implant, you may need a bone grafting procedure first, or a sinus lift if there is not enough bone height in your upper jaw. Our office will help determine if you are a good candidate for this treatment option.
What happens during the healing process after implant placement?
After the titanium implant is placed surgically in the jawbone, healing typically takes a few weeks to a few months. During this time the implant actually fuses with your natural jawbone in a process called osseointegration, creating a stable foundation for the crown. Once this is complete, an abutment is placed on top of your gumline for the crown to attach to.
What is an abutment in implant dentistry?
An abutment is the piece placed on top of your gumline once the implant has fully fused to your jawbone through osseointegration. The crown, implant supported bridge, or denture is then attached to the abutment to complete the procedure. This is the final step after the implant has healed in place.
What are the advantages of implant supported crowns?
Implant supported crowns look and function like your original teeth and do not require surrounding teeth to be compromised to sustain a bridge. They also conserve bone and prevent the sagging of facial and dental muscles. No extra care is required beyond basic dental care such as flossing.
Why do traditional dentures eventually lead to bone loss?
Traditional dentures sit in the mouth on top of the gums, so there are no tooth roots to anchor and stimulate bone growth or strengthen the jawbone. This leads to bone loss, receding gums, and changes in the shape and profile of your face, as well as periodontal disease. Dentures also often need to be resized and can cause sores in the mouth from friction.
How does an implant supported bridge differ from a traditional bridge?
A traditional dental bridge is connected to two natural teeth on either side of the gap, which are shaved down and fitted with crowns to anchor the bridge. Since it sits on top of the gum line with no tooth root stimulating the jawbone, the bone can eventually disintegrate, causing the bridge to slip. An implant supported bridge is instead anchored by two dental implants, preserving the natural teeth and preventing bone loss and slippage.
What problems can an ill fitting denture cause?
An ill fitting denture can slip, cause sores in the mouth from friction, and impair your ability to speak clearly. It may also need to be resized over time. Our office offers alternatives such as implant retained or implant supported dentures for patients dealing with these issues.
What are my options if I have multiple failing or missing teeth?
If you have an ill fitting denture or multiple broken, abscessed, failing and missing teeth, your choices include traditional removable dentures, implant retained dentures (snap on dentures), or implant supported dentures and bridges. Our office can help you determine which option fits your situation.
What is the difference between conventional and immediate dentures?
Conventional dentures are made and inserted after the remaining teeth are removed and the tissues have healed. Immediate dentures are inserted right after the remaining teeth are removed, so you do not have to be without teeth during healing. However, immediate dentures may need adjustment to fit properly once your gums shrink during healing.
What is a removable partial denture made of?
A removable partial denture fills in the space left by missing teeth using replacement teeth attached to pink or gum colored plastic bases connected by metal framework. It attaches to your natural teeth with metal clasps or precision attachments. Precision attachments are nearly invisible but often require crowns on your natural teeth for a precise fit, and generally cost more than those with metal clasps.
General & Preventive Dentistry FAQs
How often should you schedule a dental cleaning and exam?
You should plan to visit for a cleaning and exam about every six months. If it has been longer than that since your last visit, our office encourages you to contact us to schedule your next appointment. Regular visits help you and your family maintain healthy, beautiful smiles.
What happens during an oral cancer screening?
An oral cancer screening is a careful examination of your entire oral cavity for any abnormal cell growth. Dr. Holmes checks your lips, gum tissue, the inside lining of the cheek, tongue, palate, throat and tonsils for any abnormality. Sometimes a visual exam alone is not enough, so our office may suggest additional tests such as a blue dye test or a dental examination with light.
Why is oral cancer screening important?
Oral cancer screening matters because cancer of the mouth can be treated successfully when it is found early. Regular dental checkups make this possible, and the screening itself is a painless, simple examination. If a wound or cyst is found, a simple biopsy can detect abnormal cells, and in 90% of cases proper treatment leads to a cure.
What are the signs you might need a dental filling?
You may need a dental filling if you have extreme sensitivity to hot and cold foods and drinks, a constant toothache, jaw pain, or bad breath. These symptoms can mean tooth decay is present. During a check up our office can determine whether you need a filling, and an x-ray may be taken to find out how much damage there is.
Are tooth colored fillings available at your office?
Yes, our office provides tooth colored fillings made from porcelain or composite resins. They match the color of your teeth so they look natural in your mouth, and they also keep your mouth mercury free.
What symptoms suggest you might need a root canal?
You might need a root canal if you have tender or swollen gums, extreme sensitivity to hot and cold temperatures, discoloration of the tooth, or a severe toothache. A root canal repairs and saves a tooth that is badly decayed or infected. Without treatment, the tissue around the tooth can become infected and abscesses can form.
How many visits does a root canal take?
Root canal treatment can be done in one visit or more, depending on how much infection is in the pulp. Dr. Holmes will take x-rays and perform an exam to diagnose the issue and create a treatment plan before beginning.
What steps are involved in a root canal procedure?
During your root canal, Dr. Holmes numbs the tooth to reduce discomfort and removes the infected nerve or pulp. The canals are then cleaned, shaped and sealed, and a permanent filling is placed on top.
Who should wear a custom fitted sports mouth guard?
Anyone who plays sports or engages in athletic activity, whether competitive or not, can protect themselves by wearing an athletic mouth guard. Hundreds of thousands of Americans a year sustain dental injuries during competitive play, and many of those injured are children. Our office offers custom, form fitting mouth guards to patients of all ages.
What injuries can a custom mouth guard help prevent?
A custom mouth guard cushions the blows from direct contact or an awkward step that can cause broken teeth, fractures in the jaw, gum lacerations and injuries to your lips or tongue from your own teeth. Research also suggests properly fitting mouth guards reduce the forces that can cause concussions and neck injuries. The ADA estimates mouth guards prevent approximately 200,000 injuries per year in high school and college football alone.
What is the benefit of getting a mouth guard made by a dentist rather than buying one at a store?
When Dr. Holmes creates your mouth guard, our office can make sure it is tightly fit to your teeth for maximum protection. We use digital x-ray technology to make sure the guard protects your teeth, gums, lips, tongue and cheeks. Mouth guards are also available in different colors and designs.
What are the warning signs of gum disease?
Signs of gum disease include swollen, red, or tender gums, and gums that bleed easily when you floss or brush. Gum disease, also called periodontal disease, is caused by bacteria in plaque and tartar that build up on the teeth and inflame the gum tissues. If untreated, it can lead to a receding gum line, bone loss, and tooth loss.
Is gum disease linked to other health problems?
Yes, research has shown that untreated periodontal disease is connected to several health complications. These include heart disease, stroke, diabetes, high blood pressure, pregnancy complications, and respiratory conditions. Our dentists and dental team will work to restore the health of your smile if you have gum disease.
What treatments are available for gum disease?
Our office offers a number of periodontal treatments, including scaling and root planing, which are deep cleaning treatments. If you believe you may have gum disease, our office encourages you to contact us as soon as possible to schedule your visit. We are dedicated to helping you keep your smile healthy.
What can cause a toothache?
A toothache, which is pain in or around a tooth, can be caused by tooth decay, an abscessed tooth, a tooth break, chip or fracture, bruxism or grinding teeth, infected gums or gingivitis, or a filling that has become damaged or loose over time. Call our office today if you are experiencing a severe toothache.
What symptoms accompany a toothache?
A toothache can cause pain that is sharp, throbbing, or constant, along with swelling around the tooth and gums. You might also experience fever, headache, nausea, or a foul taste in your mouth. Our office can offer same day appointments whenever possible if you are in pain.
What happens when you come in for a toothache appointment?
Our office will bring you in for a focused examination of the impacted tooth or area of your mouth. This includes an x-ray of the area and a thorough examination by our doctor. After the exam, Dr. Holmes will give you a treatment plan on how to fix the problem.
How does a snore guard appliance work?
A snore guard is a small oral appliance used only during sleep that prevents your jaw and tongue from dropping back into the throat and closing off your air passage. Keeping the airway open greatly reduces snoring. Each appliance is custom fitted to you, and fitting is quick and painless, taking only a few minutes.
New Patient FAQs
What should you expect during your first visit to Brentwood Dental & TMD?
You can expect a warm welcome from the front office team, an introductory conversation about your needs and concerns, and a full mouth examination that includes an oral cancer screening. You will also receive low radiation digital X-Rays and, if no major issues are present, a thorough dental cleaning. Afterward, Dr. Holmes will review your X-Rays with you and discuss any recommendations for your dental health.
What should you bring to your first dental appointment?
Bring your completed Dental History and Patient Information forms, your dental insurance card if you have one, and a list of current medications with dosages. These help our office prepare for your visit and give Dr. Holmes a full picture of your health before your exam.
How early should you arrive for your first appointment?
You should arrive 15 minutes before your scheduled appointment time. This gives you time to bring in your completed forms, insurance card, and medication list before your exam begins.
Can a child be seen without a parent present?
No, a parent or guardian must accompany all patients under 18 years of age. Please plan to stay with your child during the visit so our office can address any concerns together.
Do you need to tell the office about medical conditions before treatment?
Yes, you should alert our office if you have a medical condition that may be of concern prior to treatment, such as diabetes, high blood pressure, artificial heart valves or joints, rheumatic fever, or joint replacement. This information helps our office plan your treatment safely.
Should you mention medications you are taking before your appointment?
Yes, you should let our office know if you are on any medication, including heart medications, aspirin, or anticoagulant therapy. You should also mention if you require medication such as antibiotics prior to dental cleanings.
Does the first visit include X-rays?
Yes, your first visit includes necessary low radiation digital X-Rays as part of the full dental exam. These help Dr. Holmes evaluate your teeth and gums fully before discussing recommendations with you.
What happens after your dental exam is finished?
After the checkup, Dr. Holmes will meet with you to discuss your X-Rays and recommendations for improving your overall dental health. If additional treatment is needed, you will receive a treatment plan and an estimate, and our office will schedule your next appointment.
What payment methods does Brentwood Dental & TMD accept?
You can pay with cash, debit cards, or most major credit cards including VISA, MasterCard, Discover, and American Express. Our office offers these options to make paying for your care as smooth as possible.
Does Brentwood Dental & TMD accept dental insurance?
Yes, traditional dental insurance is welcome and accepted, and our office will gladly file all insurance claims on your behalf. Our office can also file both medical and dental insurance for TMJ cases and treatment, so call our office for an insurance consultation.
Will dental insurance cover all of your treatment costs?
Not necessarily. Dental insurance is designed to help reduce your out of pocket dental expenses, but it generally does not cover all dental expenses, so you should expect some out of pocket cost at the time of service.
How does insurance reimbursement get determined?
Reimbursement levels are determined by your insurance provider and generally do not take up to date regional data into account. There is no regulation governing how insurance companies set these levels, and they are not required to disclose how they determine them.
Will insurance guarantee payment for your claim?
No, insurance companies do not guarantee payment on claims. They reserve the right to make payments based on their own estimation of usual and customary rates.
What does the office do to help you with insurance claims?
Our office will file your insurance claims, track them, follow up on delayed claims, and help with insurance family plans. Our office will also provide digital dental X-rays and a written diagnostic report if your insurance company has questions about your services.
Is patient financing available for dental treatment?
Yes, our office offers patient financing options, including interest free CareCredit Healthcare Financing, to help you with your dental care needs. This financing is subject to approval.
What should you bring to the office regarding insurance?
You should provide our staff with your insurance information when you call so our office can handle the insurance process for you. You should also bring your identification card and your insurance card with you to your visit.
What technology does Dr. Holmes use to take X-rays?
Dr. Holmes uses low radiation digital X-rays that use 90 percent less radiation and provide immediate images to help quickly diagnose hidden problems. Our office also uses 3D Cone Beam Digital X-Rays to get a full 3D, high resolution view of your jaw and bone structure for treatment planning.
Can you get a crown in a single office visit?
Yes, with CEREC Single Visit Dentistry, Dr. Holmes can make your crown in one office visit, so there is no need to come back a second time or wear a temporary crown. Dr. Holmes has completed more than 10,000 CEREC Crown cases.
Do fillings have to look metallic?
No, our office uses tooth colored restorations so you do not need a mouth full of metal when you get fillings. These restorations are natural looking and help your teeth keep their natural look and feel.
What are the office hours and location for Brentwood Dental & TMD?
Our office is open Monday through Thursday from 7:00 a.m. to 4:00 p.m. We are located at 5120 Virginia Way, Ste C13, Brentwood, TN 37027, just a few minutes south of Nashville.
