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They anesthise you before with a injection it looks scary and causes a bit discomfort but doesn't hurt much after that u wouldnt feel a thing i had a root canal a couple of months ago the only frustrating part was my root canal took multiple appointments to finish so the wait was the only annoying part but overall its a bit discomfortable but not painful

Yes, I use the scanner for sleep appliances as well. It's a fabulous scanner. Congratulations on the purchase. You will love it.

depending on the specific cause of the ringing but many do resolve with treatment

​@@dr.agathabisthis could be the best news I've heard EVER. I know every body is different so no promises made, but I was really needing some hope. I've just started treatment for TMJ relief and have high hopes. Thanks doc!!!

Not sure what you mean. Are you asking if you are "not a clencher" should you get a regular night guard and what do you mean by 'regular'? Because it's not about the "night guard" as much as it is about the design of the night guard.

I don't understand what you mean. What's confusing?

I can't comment without knowing your particular situation, whether you are truly a clencher or if there is a tooth grinding component (meaning is there any tooth wear), and what are the occlusal contacts on your appliance. There are many factors that play a role on the choice of design and if you are truly a clencher then the contacts in the front may be a good choice but there are a lot of other factors that are important to consider.

I am 53 and clench mostly but sometimes grind. I do have TMJ where my jaw clicks. He gave me an upper night guard that has a thicker front it is a full night guard goes all the way to the back. Should I just get a regular night guard?

Yes, this happens a lot with bruxism devices as well if not fitted properly. It's a good think you caught it right away!

Hi, soft night guards encourage clenching so there are a couple of points to make based on what you are saying. Ideally, it would be great if you could get a hard-acrylic night guard, however, since you have a soft one, let's focus on the one you have. if you find that your teeth don't align, it's possible that you are not biting evenly on the night guard you have. If there are teeth that are NOT touching, so NOT in contact with the night guard, then these teeth can shift, tip, or over-erupt. If you are only feeling your far back teeth are touching, check for the following: (1) are the very back teeth included in the nightguard? Meaning: is the nightguard covering those teeth? If not, then likely they have over-erupted. (2) Are the far back molars OUT of contact with your nightguard? If the molars you are referring to do NOT touch the night guard when other teeth do, then it's also likely they have over-erupted. If all of the above is not the case, then it's possible that you are clenching in certain areas on your night guard causing it to bend resulting in tooth movement. That's part of the reason I am not a fan of soft guards. Anyways, check all that and message me back.

@@dr.agathabis Dr. Agatha, thank you so much for your thoughts. The following is my observation: (1) My very back teeth are not included in the night guard because my dentist has used a pair of scissors to cut away the part of the nightguard covering the 4 molars (2 molars in upper left, 2 molars in upper right) after I told him the far back molars are touching each other in daytime. So the far back 4 molars are NOT included in the nightguard now. (2) As the far back molars are not included in the nightguard, my upper and lower far back molars are out of contact with each other. I can feel a gap between my far back upper and lower molars. (3) My dentist recommended to wear a nightguard because he thinks my teeth are wearing with signs of grinding and he saw that I have torus developed near upper lateral incisor. May I know if you mind sharing your thoughts please? Shall I stop wearing the nightguard now? Thank you so much for your time, Dr. Agatha.

@@azumaegg Ok so I need to know when the back part of the night guard was cut off. So here are questions that can help narrow this down: (1) when did you notice the back teeth touch when you bite down? So when did you notice the bite change? (2) when did the dentist cut off the back part of the nightguard?

Dr. Agatha, thanks for your reply: (1) I started wearing the nightguard on 5 Aug 2024. The nightguard at this point is NOT cut yet, covering all my upper teeth. I wore this nightguard from 5 Aug to 19 Aug 2024, for two weeks. On 19 Aug 2024, that's 2 weeks after wearing the nightguard, I started feeling my bite changed, and so with my dentist's permission, I stopped wearing the night guard. It took me 3 months to have my bite gradually moved back to its original position. On 25 Nov 2024, I finally feel that I regained the original bite. (2) On 25 Nov 2024, however, my dentist asked me to visit him him again as he would like to check my progress and to encourage me to wear the nightguard again. I told him everything and it's on 25 Nov 2024, he cut off the back part of the nightguard. Then I wore the cut-off nightguard for three nights (25, 26, 27 Nov 2024), and my nightmare of weird bite of my back molars happened again. Even in daytime, after I have taken off my nightguard, I feel my bite is different now. A million thanks, Dr. Agatha. Any thoughts will be much appreciated.

@@azumaegg ok great. Thanks for the detailed info. Basically it's one of 2 possibilities: (1) Your original (not-cut off) night guard did not have contact with opposing back teeth so they over-erupted as a result. Then when you stopped wearing it, you pushed them back in, regaining your original position. But once the back part of the nightguard was cut, the back teeth were not touching on the nightguard while other teeth were, and so they over-erupted again. (2) The soft night guard causes you to clench, putting uneven pressure on teeth resulting in some over-erupting and others being pushed in. In either case, in order to correct this and prevent this from happening again, you would need to get a new night guard that creates EVEN bite pressure on ALL teeth. Ideally a hard-acrylic. Hope this helps.

No, you can get one for either arch. The bottom one is thinner and also doesn't interfere with tongue space during sleep. Tongue against roof of mouth is very important for good sleeping, so I typically prefer lower nightguards.

You don't need teeth to live so you always have that choice. But clearly, you have never had topical anesthetic applied prior to injection - that makes a big difference.

@@dr.agathabis I clearly have had topical anesthetic, and the injection still hurts. You feel pressures and you feel anesthetic stinging you. It gets even worse depending on where the anesthetic goes. Youll obviously claim youre one of these magic dentists that never hurts anyone and your injections are painless and that everyone who comes to see you thinks its like going to Narnia, it isnt and it never will be. And also, maybe look after your teeth so you dont need someone drilling them over and over might be a better idea anyway? Never had any fillings at 38, only 2 extractions (which hurt like hell), so the less time spent wth people like you the better.

For me it's the "horse needle" used here thats the issue. You might want to find a dentist that uses something called "The Wand" because this goes at a very slow rate - now that is truly painless.

@@LiamWalsheliamskitchen A much better alternative, i agree.

@jamesdenny5078 also worth mentioning that in the video she's using Carbocaine Plain, which is not known to sting.

The time depends on what needs to be done; each case is very different so it's impossible to say how long without seeing the patient

I am not sure if you mean "disc" perforation or other perforation but and TMJ issues, especially those involving any kind of perforation are complex and requires a tailored approach. There’s no one-size-fits-all solution for TMJ issues.

Thank you for sharing your experience. Based on your symptoms, it sounds like your jaw alignment might be contributing to your tinnitus, dizziness, and ear pressure. Overbites and TMJ dysfunction can sometimes cause these issues. Since your ENT, MRI, and neurologist evaluations were clear, you may benefit from consulting a dentist or TMJ specialist experienced in jaw alignment and joint health. They can assess your bite, jaw position, and joint function to explore treatment options tailored to your needs.

Hi Emma, I am located in Oakville, Ontario, Canada. You can check out my website at www.smilesbybis.com for details

Thank you for sharing! If your new appliance was made to protect your teeth, it should help reduce wear on your bottom teeth. Be sure to follow up with your dentist if you have any concerns or if it doesn’t feel comfortable. A proper fit is essential for it to work effectively

very good comment; thank you!

Hi and thank you for your words. You can email me at agatha@smilesbybis.com or call my office at (905)338-6684

Thank you for your question! Using a Fox plane is a great way to ensure the proper orientation of the occlusal plane. To use it effectively, position the Fox plane on the occlusal surfaces of the wax rim (or teeth) and adjust it until it’s parallel to the interpupillary line for frontal alignment and the Camper's plane (ala-tragus line) for lateral alignment.

not teeth grinding but the jaw position that can result from the tooth wear from teeth grinding

thank you so much!

​@@dr.agathabis What can be done to fix the hearing loss?

yes, I will be doing that video in the new year

if you don't have any tooth wear, you are likely a clencher. Take a look at your front teeth and if they don't seem worn, it's likely more clenching.

Thank you! the slide is measured on the anteriors so the difference in incisor position from CO to on initial contact. I am actually making a video on how to measure this so stay tuned. I will be uploading it shortly.

Great 👏​@@dr.agathabis

agatha@smilesbybis.com

😂

best advice I can give you is practice practice practice. Like anything, you will get better as you do more scans. Do some on yourself or a friend for additional practice.

Treatment depends on many factors, which is why those who treat it (like myself) need to see the patient in person to find out where the jaw position is in 3 dimensions and what is causing it to move back. The treatment would then vary on the reason the jaw is not in the correct position. So there is not "single cure"; rather it requires a person-specific approach.

​@@dr.agathabis What kind of doctor should I visit if my jaw click and it's locked closed?? Physiotherapist or chiropractor? Please help

@@Hankaspirit neither. Only a dentist who is specialized in TMJ treatment

@@dr.agathabis Thank you 🙏.

Thank you for the positive comment! Much appreciated.