Dwight Romriell

The primary limiting factor for immediate placement of an implant is the amount of infection in the bone. If it can be cleaned out the implant can be placed that same day.

Most jaw surgeries use both CT and MRI images to plan the surgery. Often, the surgery is coordinated with an orthodontist to finish the bite in the best position they can.

Crowns can be used to close the gap between teeth when braces is contraindicated.

A crossbite should be treated at the earliest possible time to incorporate the correction in the bite with the growth of the patient for the greatest long term stability.

The most effective home cleaning is done with a combination of first flossing between the teeth followed by brushing with a sonic toothbrush. Brushing with any brush is better than not brushing at all; although, studies have shown using a sonic brush has proven to be most effective.

The teeth become sore as the teeth begin to be moved by the invisalign trays

A crown that has come loose can be re-cemented if the tooth has not decayed underneath the loose crown.

I have treated misaligned jaws for more than 30 years. There are 2 forms of jaw misalignment. 1st and most common is the misalignment of the teeth which is typically treated by an orthodontist. 2nd form of jaw misalignment is due to misalignment of the jaw joints. The jaw joints are referred to as the TMJs or temporomandibular joints. Only a very few dentists are competent in diagnosing and treating misaligned jaw joints. Jaw joint surgery is very uncommon and should only be a last resort.

TMJ surgery should only be a last resort following all other options. In the past 1,00 TMJ patients I have successfully treated, only 6 patients have needed TMJ surgery. Treatment options following following TMJ surgery are very limited and have very poor outcomes. Visit the American Academy of Craniofacial Pain.

Surgical treatment of a TMJ disorder in today's world is uncommon. I have treated thousands of TMJ disorders for more than 30 years and I see less than 1% of the patients that will require TMJ surgery. The comfortable functional outcomes of TMJ surgeries is very poor and should be only a last resort.

The skill of the dentist and the laboratory determine the appearance and outcome of the appearance and quality of crowned teeth. Particularly with front teeth don't take the cheap route and receive less than what is expected. Ask on facebook who has had a positive outcome with crown on front teeth.

A good pain management medication is a combination of 800mg of Ibuprofen with 1000mg of Tylenol taken three times each day, but not for more than two weeks. This combination is more effective than taking codeine medication.

I have treated TMJ disorders for more than 30 years. Less than 1% of my patients have needed TMJ surgery, and should only be a last resort after treatment by a competent TMJ dentist. Check out The American academy of Craniofacial Pain.

Only a few oral surgeons do TMJ surgeries. The standard of care is to provide conservative treatment prior to even considering TMJ surgery. Surgery should be a last resort. Visit The American Academy of Craniofacial Pain.

My practice is primarily treating TMJ disorders, which I have done for 40 years. Some dentists are competent in diagnosing a TMJ disorder; unfortunately, only a very few dentists are actually competent in treating a TMJ disorder. For a dentist with exceptional knowledge and skills in the treatment of a TMJ disorder, I suggest one search the American Academy of Craniofacial Pain for a listing of trained doctors.

No! Most teeth having crowns placed on them do not and will not have root canals.

Untreated decay will become more severe to the degree the nerve will die, abscess, and the tooth may be lost.

In my office the process of taking a CT scan using an Icat machine takes less than 10 minutes. The actual scan with my machine takes only 24 seconds.

It is not unusual to have more than one root canal treatment in a single day.

TMJ is the jaw joint. Download a free consumer guide on my landing page at my web site www.theTMJsleepcenter.com Unfortunately there is a great deal of misinformation available on the web causing further frustration. I have successfully treated more than 5,000 patients suffering with a TMJ disorder. The temporomandibular Joint is the jaw joints immediately in front of your ear. TMJ is its name of the jaw joint. TMJ is not the diagnosis. just as knee or shoulder is not the diagnosis for a knee or shoulder disorder. Unfortunately "TMJ" is commonly the over simplified diagnosis and the treatment is under stated with laughable treatment suggestions when critically analyzed make little sense.
Seldom is the pain or symptoms in the jaw joint itself. The condition has been called The "The Great Imposter" because the symptoms lead one away from the cause rather than pointing directly at the jaw joint condition itself. Commonly my patients have been to see their ear doctor, the eye doctor the headache doctor, and maybe even to their dentist. Few dentists will provide meaningful information and may lead one away from the jaw joint being the cause of their pain and frustratiion. The symptoms usually involve the jaw muscles in the face (masseter) and the side of the head (temporalis) causing pain or aching. The symptoms can include facial pain, ear pain ringing dizziness, ear pressure, eye pain, headaches, reduced ability to move the jaw, increased and lasting pain when holding the mouth open for a dental appointment, jaw fatigue when chewing or a long day of talking, and many other symptoms. Very few patients have all of the symptoms; although, all will have several of the symptoms. The TMJ condition is usually the result of an injury often occurring many years earlier. Very surprisingly the symptoms seldom occur soon after the injury. I have a cat scan in my office and acquire images of the jaw joints and take a detailed history followed by an extensive hands on examination. The ability of the jaw to move properly is of great value to me in making a diagnosis and determine the appropriate treatment. The normal jaw opening should be 45-50mm and the ability to slide to the side should easily be 12-15mm each direction. Wearing a night guard is rarely the appropriate solution and unfortunately is by fat the most common prescribed treatment.