Frequently Asked Questions

TMJD is a painful disorder of the TMJ. TMJD often leads to a wide range of uncomfortable and disabling symptoms commonly mistaken for other conditions, like ear pain, arthritis or sinus problems.

The most common cause of TMJD is a bad bite, or malocclusion, where your jaw is out of alignment. This leads to the constant stress of the muscles, nerves, and connective tissue of your jaw.

The most common TMJD symptoms include soreness of the jaw and teeth, as well as frequent, migraine-strength headaches. Sometimes symptoms also include frequent ringing in the ears (tinnitus), clicking or popping of the jaw, neck and back pain, and even pain and tingling in the arms or hands.

The only way to know for sure is to be examined by a neuromuscular dentist like Dr. George. If you have some combination of severe headaches and jaw or tooth pain, and your doctor cannot locate the cause or give satisfactory treatment, it is a good idea to see if you are suffering from TMJD.

Dr. George utilizes advanced state-of-the-art equipment to diagnose TMJD. This can include computerized instruments like the Myotronics K-7, a device designed to measure and track jaw and muscle information to gather critical information about your bite, electromyographic muscle analysis, and sonographic joint analysis in addition to the joint X-rays.

The TMJD treatment procedure is broken into three steps. First, Dr. George will seek to relieve your pain and symptoms over the short-term. Then she will stabilize your bite to prevent further damage to the TMJs and your teeth. Finally, she uses long-term treatment options to permanently correct your bite. She may use some combination of the following:

• Coronoplasty—In this process, she reshapes your tooth enamel to help slightly misaligned teeth fit better.
• Removable overlays—She may give you permanent orthotics that fit over your teeth to maintain bite alignment.
• Reconstruction—In this procedure, porcelain crowns are placed on teeth to make them higher and better-fitted to provide structural support for the jaw.
• Orthodontics—If your teeth are healthy, Dr. George may recommend Neuromuscular braces to move them into the correct position.

You should see rapid relief from symptoms, but the length of treatment depends on how the severity of the condition. When TMJD is caught early, most patients have a shorter course of treatment. If you suspect you have the symptoms of TMJD, please contact Dr. George today at 724-934-3422 to set up your initial consultation.

TMJD can become a serious problem when left untreated, leading to chronic pain, sleep apnea, depression, and anxiety. Often it is misdiagnosed and patients find themselves visiting multiple doctors getting no answers or relief.

TMJD pain can present itself in many ways. Some symptoms include aching pain in and around the ear, facial pain, locking of the joint, difficulty chewing and/or swallowing, headaches/migraines, neck pain, ringing in the ears, clenching, grinding, ear congestion, lose or tender teeth, and trouble sleeping.

While some treatments provide short-term relief from pain, they do not directly address the root cause of TMJD. The only way to permanently treat TMJD is through treatments that move teeth and jaw to the right position and align the bite. Dr. Alex will focus on treating the cause of TMJD symptoms with the goal of eliminating or reducing pain.

It can be both a medical or dental problem, depending on the root cause of it. For example, arthritis is a medical condition that can lead to TMJD while a misaligned bite is a dental problem that can cause TMJD symptoms.

TMJD can be diagnosed with dental X-rays, a CT scan, and an MRI to reveal problems with the jawbone, joints, and surrounding structures.

The root cause of someone’s TMJD is sometimes difficult to determine and can be caused by a number of factors, including genetics, injury, dental work, and other medical conditions. There is really no way to reduce your risk for TMJD, but there are things you can do to prevent and minimize the pain:

• Stick to soft foods and avoid sticky or chewy food
• Do stretching and massaging exercises
• Be mindful of the resting position of your jaw
• Reduce stress
• Correct your posture

If it’s a minor case or caused by stress, TMJD may go away on its own. However, serious cases of TMJD will likely need some type of therapy to resolve or reduce the problem.

When TMJD is left untreated, it can cause chronic pain, inflammation, and sleep apnea. Dealing with pain and fatigue can lead to depression, anxiety, and impacts one’s quality of life. TMJD can be like a roller coaster – sometimes symptoms can be calm and tolerable; however, if left untreated, they usually come back in time.

Tooth crowns are ideal for patients who have suffered some tooth damage or loss, or who require extensive restructuring of individual teeth.

Yes. Porcelain crowns are manufactured from a specially formulated dental ceramic material that is stronger and more durable than your natural teeth. They function just like regular teeth through chewing and speaking.

Your porcelain tooth crown procedure will be completed over the course of two office visits. During your first visit, your tooth will be fully prepared by removing of decayed tooth structure and preparing the surface to ensure a strong, permanent bond for your new porcelain crown. We will then take a custom digital scan of your tooth that we will use to create your tooth crown.

During your second visit, Dr. George will place your crown and make any necessary adjustments. We will then use a special permanent bonding cement to affix your new crown

When properly cared for and maintained, your new porcelain crown can last more than ten years. Patients should practice good dental hygiene and brush and floss their crown regularly as they would with a natural tooth to extend the life of the restoration. Be sure to schedule regular checkups with Dr. George to have professional cleanings and so that she can make sure your crown is still in good shape.

Porcelain veneers are bonded to the front surface of your tooth while a dental crown covers the entire tooth. Crowns are typically thicker than veneers. Veneers, commonly known as the “Hollywood Smile” are an ideal choice if you want to improve the look of your teeth. Crowns can also change the way teeth look, but are used when there is significant damage to the existing tooth.

Porcelain crowns are a great option to restore damaged or missing teeth. They are strong, durable, natural-looking, and made to match the shade, size, and shape of your surrounding teeth.

The average cost of a porcelain crown or restoration is 2000-2500 per crown.

Injury, teeth grinding (bruxism), pressure from a misaligned bite, and poor dental habits are some of the most common causes of damaged porcelain crowns.

The tooth is prepared by Dr. Alex by removing a small amount of your enamel to create space for the veneer or crown to adhere to the tooth. then take a digital impression of the teeth and place temporary veneers or crowns.

No, when done correctly, porcelain crowns should feel comfortable and fit your bite just like your natural teeth. While some discomfort is normal for the first few days as you recover from the procedure, your dental crown may need some adjusting if it still feels uncomfortable after a week or two.

Cosmetic dentistry can make a patient look more youthful and improve their overall facial appearance. The result is improved self-confidence, a better quality of life, and improved oral health.

This depends on a number of factors, including the condition of your natural teeth, the aesthetics you want to achieve, your budget, and your comfort level with treatments. Finding the right cosmetic procedure starts with a consultation with Dr. Alex or by requesting a Smile Virtual consult.

Although very rare, side effects of cosmetic dental treatments can include sensitivity to anesthesia, inflammation and irritation at the treatment area, tooth sensitivity, headaches, bleeding gums, and jaw pain.

Cosmetic dental treatments can work for just about everyone who wants to improve the appearance of their smile. Some patients do require more extensive treatments to correct bite alignment and crooked teeth to help cosmetic treatments last longer.

Some of the most common causes of tooth discoloration are tobacco use, coffee, tea, and certain foods. There are also situations where people have permanent staining or discoloration on their teeth from antibiotics as a child called tetracycline staining.

Porcelain veneers, often referred to as “the Hollywood smile”, is one of the most common cosmetic dental procedures and something Dr. Alex creates often.

Our full mouth reconstruction procedure begins with a personalized consultation where we learn about your dental health issues, goals, concerns, and any symptoms you may be experiencing. During the consultation, we conduct a thorough assessment of the health and function of your mouth and use the latest dental technology to provide us with a full perspective on the condition of your teeth and jawbone. After gathering and analyzing the information, we map out a customized treatment plan that caters to your specific needs and can best achieve your goal of a beautiful, healthy smile.

The length of time it takes for a full mouth reconstruction varies depending on the type and amount of treatments needed. The average time from start to finish is 2-3 months.

A full mouth reconstruction is ideal for patients who have:

• Missing teeth
• Gapped teeth
• Tooth decay
• Damaged teeth
• Worn teeth from injury or grinding
• Short teeth
• TMJD symptoms
• Misaligned bite
• Collapsed face
• Disproportionate facial features
• Premature aging

There are many reasons why a patient may require full mouth restoration. Generally speaking, people who have several dental conditions that impact the way their teeth and jaw function are good candidates for full mouth restoration. However, people who simply want to look better but are not necessarily experiencing pain or discomfort are excellent candidates. We can discuss whether a full mouth reconstruction is right for you.

Full mouth reconstruction procedures involve crowns and veneers to achieve a beautiful, white, straight smile.

No, occlusal equilibration involves reshaping the teeth, so they fit together nicely. It does not address the timing of sideway movements, which is why DTR Therapy is so effective at identifying friction and stress in the jaw. DTR also utilizes EMG to allow proper tracking of the jaw muscles.

No, DTR Therapy doesn’t hurt, and no anesthetics are needed. DTR Therapy can eliminate pain caused by TMJD symptoms.

DTR Therapy is done in a comfortable and relaxed environment with Dr. Alex, one of the few dentists in the world who is certified to complete DTR Therapy. We use Tekscan and EMG technology to provide us with accurate measurements of a patient’s bite and identify contacts that may be leading to hyperactive muscles, breakage, and TMJD symptoms.

DTR Therapy works by:

• Measuring pressure, timing, and muscle activity.
• Making accurate micro-adjustments with the data gathered.
• Achieving a better-balanced bite and more functional bite activity.

The first DTR visit is 90 minutes. We then schedule the patient 1 week later and then monthly visits for about 2-3 months. It all depends on the severity of the case and how well the body heals.

No, Dr. Alex needs to examine the jaw and teeth to determine if you are a candidate.

The type of orthodontics Dr. Alex offers will more than likely change your face to look more balanced, youthful, and proportionate.

Yes, facial growth orthodontics can improve your jawline, defining and repositioning it to a more attractive position.

The length of the treatment varies by case. While some may see significant improvement within 3 months, others may need to wait 6 months to a year before orthodontics begin to shift the teeth and facial structure.

Facial growth can impact bite alignment and how teeth are positioned. Proper face and jaw growth are interrupted by things like mouth breathing, improper tongue posture, and even pollution in urban areas.

When the “damage” happened as a child, and these problems aren’t addressed, what typically happens is an underdeveloped jaw and one or both jaws recessed.

Unlike traditional braces, which push and pull the teeth to achieve a straight smile, facial growth orthodontics considers the whole physiological development of the jaw and face. The primary goal is to support the growth of the top jaw to its proper size. The lower jaw then follows and begins to function properly.

Facial growth orthodontics can be used for treating and correcting:

• Poor Sleep
• TMJD pain
• Facial pain
• Facial asymmetry
• Crossbites
• Underbites
• Overbites
• Migraines and headaches
• Premature facial aging
• And more

Facial growth orthodontics is a non-surgical method that stimulates jaw and face growth. At Pittsburgh Dentist, we offer:

• Fixed Growth Guided Appliance (FGGA) – A fixed appliance is often used to treat adults with an underdeveloped upper jaw. An FGGA expands the arch without needing to extract teeth, expanding the jaw on an axis from front to back.

Removable Growth Guided Appliances (RGGA) – This method is ideal for children who are still waiting for their adult teeth to come in. It helps develop a child’s airway and addresses the inability to properly close and open the mouth.

The average time is 2-3 years.

Proper retention and tongue placement are needed to prevent teeth from shifting after treatment. Myofunctional therapy is a very important part of treatment – if it’s not practiced, you are prone to have your teeth shift after braces or in general.

Myofunctional therapy focuses on correcting improper functions of the tongue and facial muscles by teaching individuals how to engage and strengthen the muscles. Therapy helps place the tongue and orofacial muscles in the appropriate position.

Orofacial Myofunctional Disorders occur when the development of the dentition and the alignment of the teeth and jaw are interrupted, which can be due to a number of different factors. When a patient has had orthodontic work, relapse may occur if we don’t correct the myofunctional disorder, and the patient may need a second round of orthodontic work.

While the most apparent sign that your child might need orthodontic treatment is crowded teeth or gaps between teeth, other less obvious signs include airway issues, snoring, or grinding at night.

Dental crowding, gaps, missing teeth, protruding teeth, and jaw growth problems are some of the most common orthodontic issues in early childhood. Over time, these issues can develop into other problems such as TMJD symptoms, sleep apnea, an uncomfortable bite, and asymmetrical facial features.

Our teeth grow in synchronicity with our tongue, cheek, and jaw muscles. Our teeth don’t develop on their own, but rather in synchronicity with the natural movements of the tongue, cheek, and jaw muscles. This is often the reason why crooked teeth lead to asymmetrical facial features and issues like TMJD.

The ideal age for controlled arch orthodontic treatments is when a child has lost all of their baby teeth and has all of their adult teeth grown in. While controlled arch orthodontics can work for any age, early intervention is best to help prevent dental issues into adulthood.

An open bite, crossbite, crowding, deep bite, underbite, and facial asymmetry are some early warning signs of a bite problem in children.

Yes, space can be created to make sure there is more room for the teeth to erupt.

We require orthodontic records using a CBCT and a radiology report. We need to confirm that the bone and teeth are healthy to undergo orthodontics.

Yes, you can see your general dentist for routine cleanings – it will not interfere with care.

These treatments are designed for both adults and children. For children, it provides early intervention to guide growth and prevent future issues. For adults, it can correct underlying problems to improve a smile and overall health.

By gently expanding the dental arches and guiding proper jaw development, our approach creates more space in the mouth and throat. This helps to reduce airway obstruction, which can lead to easier breathing and a significant improvement in the quality of your sleep.

A key goal of our approach is to create enough space for all of your teeth to fit properly. This comprehensive method often eliminates the need for extractions, which is a common requirement in traditional orthodontic treatments.

You can expect a beautifully straight and functional smile, enhanced facial harmony, and a healthier life. Patients often report reduced jaw pain, fewer headaches, and a significant improvement in breathing and sleep quality.

While our approach is more comprehensive, the treatment timeline is highly individualized. The focus is on achieving long-term health benefits and a stable foundation, and the process is meticulously planned to be as efficient and comfortable as possible.