Frequently Asked Questions

Here are some of the most frequently asked questions from our dentistry patients. If you have any questions / concerns that are not answered here please click here to contact us and we’d be more than happy to answer them!

What is TMJ?

TMJ is the acronym for temporomandibular joint(s). The TMJ is located just in front of the ear, where the jawbone connects to the skull on either side of the head.

What is TMJD?

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.

What causes TMJD?

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.

What Are the Symptoms Of TMJD?

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.

How Do I Know If I Have TMJD?

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.

How Does Dr. George Diagnose 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.

How Is TMJD Treated?

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.
How Long Will My TMJD Treatment Take?

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.

Is TMJD a serious problem?

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.

What does TMJD pain feel like?

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. 

How do you permanently treat TMJD?

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.

Is TMJD a medical or dental problem?

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. 

How is TMJD diagnosed?

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

How can I reduce my risk for TMJ disorder?

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
Can TMJD go away on its own?

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.

What happens if TMJ disorder is left untreated?

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.

What are the benfits of porcelain tooth crowns?

Porcelain crowns are a natural, strong, and durable tooth replacement option for patients who have suffered serious damage to the visible portion of their teeth. Porcelain crowns can help return strength and structure to teeth that have been damaged by tooth decay, injury, tooth grinding or TMJD, giving form and function back to the mouth.

Who is a candidate for porcelain crowns?

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

Are tooth crowns strong enough to withstand normal use?

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.

How long will the dental crown procedure take?

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

How long will my porcelain crowns last?

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.

What is the difference between a porcelain veneer and crown?

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.

Are porcelain crowns good?

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.

What is the actual cost of a porcelain crown?

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

What can damage porcelain veneers or crowns?

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

How is a tooth prepared for a porcelain veneer or crown?

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. 

Will the porcelain crown feel any different?

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. 

What is cosmetic dentistry?

Cosmetic dentistry focuses on improving the appearance of teeth, gums, bites, and overall smile. 

What are the benefits of cosmetic dentistry?

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.

Which cosmetic procedure is right for me?

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

Are any side effects associated with cosmetic dental treatments?

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. 

Do cosmetic dental treatments work for everyone?

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. 

What causes tooth discoloration?

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. 

What is the most common cosmetic dental procedure?

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

What is full mouth reconstruction?

A full mouth restoration involves a series of treatments to improve the overall aesthetics of your teeth. The procedures are customized to you and completed in stages.

What can I expect from a full mouth reconstruction?

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. 

How long does it take for full mouth reconstruction?

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.

Who needs a full mouth reconstruction?

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
How do I know if full mouth reconstruction is right for me?

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.

What procedures are involved in reconstruction?

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

What is DTR Therapy?

Disclusion Time Reduction (DTR) Therapy uses the latest in Tekscan and EMG technology to identify where friction and stress are causing facial muscles to hyperfunction. By using digital occlusal analysis data to evaluate muscle activity, we can accurately determine and measure contacts that are over-engaging. These movements are what can lead to hyperactive muscles and TMJD symptoms. 

Is DTR Therapy the same thing as equilibration?

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. 

Does DTR Therapy hurt?

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

Does my insurance cover DTR Therapy?

DTR Therapy is typically not covered by insurance. We are able to submit to your dental insurance and if there is any coverage, they will reimburse you directly. Some insurance plans may cover a portion of the DTR Therapy procedure. Be sure to check with your insurance whether your coverage includes DTR Therapy.

What can I expect with DTR Therapy?

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.
How long does it take for the full procedure?

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. 

Is everyone a candidate for DTR therapy?

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

What is facial growth in dentistry?

Facial growth orthodontics involves the use of appliances that are either fixed or removable. These appliances put light pressure over a nerve in the palate, stimulating upper jaw growth or remodelling and creating micro-trauma that forces the body to form new bone and soft tissue in the entire mid-face/nasomaxillary region.

Does face growth orthodontic treatment change your face?

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

Can facial growth orthodontics improve jawline? Will my jawline become more defined?

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

How long do facial growth orthodontics take to change your face?

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.

Why is growth important in orthodontics?

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. 

What can facial growth orthodontic treatment be used for?

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
How does facial growth orthodontic treatment work?

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.

How long does facial growth orthodontic treatment last?

The average time is 2-3 years.

How can I prevent my teeth from shifting after treatment?

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.

What is myofunctional therapy?

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.

What are some facial development issues I should be aware of with my child?

A few facial development issues to be aware of in children include asymmetry of the face, ears that stick out, and a gummy smile.

What are some signs my child might need orthodontic treatment?

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.

What are some of the most common orthodontic problems encountered in early childhood?

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.

Why is growth important in orthodontics?

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.

What is the ideal age for controlled arch orthodontic treatments?

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. 

What are some early warning signs of a bite problem?

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

Can my child’s tooth alignment change after their treatment ends?

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

What are the factors that you require before any orthodontic treatment?

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.

Should I see my general dentist while I have braces?

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