TMJ Dentist Archives - Page 2 of 2

Dental Crown Feels Uncomfortable

Posted on May 8, 2021 by Annmarie Worthington.

I had a dental crown placed on an upper tooth. I think it was made too big because it hits the bottom teeth before any other teeth do which is causing some pain. My dentist said it is just that I am not used to it and to give it some time. I have and it still bothers me. Would it damage the crown to ask him to file it down?

Casey

Dear Casey,

A porcelain crown being placed on a tooth

When a dentist says, “Give it time. You’ll get used to it,” that is code for “I don’t know what is wrong or how to fix it.” Here is the thing. You should not have to get used to a dental crown. When it is done properly, it is completely unnoticeable, just like your natural teeth. You don’t go around thinking something is off about one of your teeth unless there is a problem. With a crown, if you are noticing it there is a problem.

Occlusion between upper and lower teeth is both complicated and important. Without the teeth meeting together in the right position, you will not only have pain when you chew, but you could end up with TMJ Disorder, which is a problem with the moveable joint in your jaw. If your bite throws that off, you will have a whole host of problems.

A dentist should know how to make adjustments to the crown. He should start by having you bite down on some bite registration paper, which will tell him what parts are hitting where. From there he can make the adjustments. If he does not know how to do that, ask for a refund so you can get this done properly by a prosthodontist who has more training in reconstructive dentistry. They will know how to fix the problem.

This blog is brought to you by San Antonio Dentist Dr. Tostado.
Click here to learn about our holistic dental care.

A Collapsed Bite

Posted on March 7, 2021 by Annmarie Worthington.

I would like to see if there is a way to fix my smile. I am thinking it might need porcelain veneers, but thought I’d check first. When my mouth is in repose you cannot see my teeth at all. Even when I am smiling, I have to sort of force my lips to make my teeth show. It’s very embarrassing to me. At night I wear a mouthguard because of pain in my jaw from clenching and my face and mouth both feel and look better when I do. Are veneers my best option or should I look at something else?

Kaelyn

Dear Kaelyn,

Woman covering her mouth with her hand

I am very glad you wrote now, before you had any work done. It is all too often that people end up writing after they went to the wrong dentist to get this fixed and their mouth is now a disaster. Based on your description, it sounds like you have combining factors of some TMJ disorder along with a collapsed bite.

Porcelain veneers alone will not fix this. You will need at least some dental crowns to help open up your bite. However, you are looking at a very advanced procedure. This is one of the toughest cases a dentist can do and it will take some advanced, post-doctoral training. I want you to look for a dentist with full-mouth reconstruction experience.

You may want to look for a prosthodontist. They have more advanced training in dental reconstruction and will make sure your bite is in proper alignment throughout the procedure.

This blog is brought to you by San Antonio Dentist Dr. Gilberto Tostado.

Will Zirconia Crowns Resolve My Jaw Pain?

Posted on February 12, 2021 by AllSmiles.

I am beginning not to trust my new dentist. I am getting a four-crown, zirconia dental bridge. I looked at the dentist’s estimate, and it includes a porcelain upgrade. The dentist did not mention anything about a porcelain upgrade to me, so before I call the office, will you please explain what this is? I want to compare her answer with yours. On a second matter, my last bridge was not zirconia, and I had lots of jaw pain and TMJ issues that finally got corrected. Are zirconia crowns less risky for TMJ? Thank you. Len

Len,

Unfortunately, your dentist would need to explain what he means by a porcelain upgrade. The terminology is not standard to the dental profession but is a term your dentist uses.

Below are several possibilities.

Your dentist is using a more expensive type of porcelain for your dental bridge.
If the bridge is for front teeth, the charge could be for premium esthetic treatment to ensure your crowns and bridge look like natural teeth and match surrounding natural teeth. It is common for a dentist to charge more for front-tooth crowns than crowns in the back of your mouth.
Perhaps a more expensive type of metal will be used as the framework for your crowns.
It could be terminology for a metal-free bridge. You mentioned that you will receive a zirconia bridge, which is metal free.
Maybe your dental insurance plan restricts how much your dentist can charge for a bridge. Using a term like porcelain upgrade could be your dentist’s way of recouping some of the expense.

And yes, to be sure about it, you should call the office and ask for an explanation. You can also ask if the office is willing to send you an e-mail or something in writing that explains the service.

Are TMJ and Zirconia Crowns Related?

Diagram of the temporomandibular joint and surrounding structures

Temporomandibular joint (TMJ) dysfunction can be minimized with crowns that fit well

Although you may read articles online with varying opinions about zirconia crowns and how they affect TMJ risks, your dentist is responsible for ensuring that your new bridge is in harmony with your bite. If your dentist has advanced training in occlusion and bite, you should not experience recurring TMJ problems. You must also be diligent about wearing a custom nightguard if you grind your teeth while you are asleep.

Dr. Gilberto Tostado of San Antonio, TX, sponsors this post.

I needed a root canal but my dentist overlooked it

Posted on October 8, 2020 by AllSmiles.

In August, my dentist put a crown over one of my upper right molars. The tooth was cracked and had an old silver filling in. The dentist had problems getting my tooth numb, so it felt like electric shocks when she was drilling.

When the dentist checked my bite with my crown, I told her that it was uncomfortable and hurt to bite down. She adjusted the crown twice while I was there. And when I still wasn’t happy with it, she told me to give it a couple of weeks. It hurt to floss around the crown. I gave it a couple of weeks, and nothing improved. In mid-October, I called the office again, complained, and insisted on a new crown. My dentist adjusted the crown instead and started talking about two more crowns that I needed.

I declined getting two more crowns until I knew that the first one was okay. My dentist asked me to wait two more weeks after adjusting to the crown. Shouldn’t a crown fit correctly when I leave the dental office? Anyway, the crown still wasn’t right, so I had another appointment with my dentist. She removed the crown and said I need root canal treatment. I am wondering if this is an issue my dentist should have noticed before placing a crown. Now she says that the tooth has a periapical abscess.

My dentist has not offered a refund or admitted that she misjudged the condition of my tooth. I want to get a refund before switching dentists. Do you have any advice? Bronwyn from Tennessee

Bronwyn,

Although Dr. Tostado would need to examine your tooth and see your x-rays for an accurate diagnosis, we will explain what we can, based on the information you gave us.

A cracked tooth with an old filling

When a tooth cracks, it often needs treatment in addition to a crown. If a tooth has internal damage, putting a crown over it won’t make the injury go away.

A cracked tooth is t risk for root canal treatment.
Some sensitivity after getting a crown is normal, but it shouldn’t linger. And you should not feel pain.
A crown that is made and placed well will blend with your bit without you noticing it.
Your dentist should have told you that you might need a root canal in the future.

Based on your conversation with your dentist, it seems that she was more concerned about completing all your dental work rather than getting it right.

But getting a refund, I think, is going to be tricky in your situation. To do that, you would need

Can You Get a Refund from Your Dentist?

It is possible to get a refund from your dentist if you can prove that your dentist didn’t meet the standard of care that she promised. You have several ways to try to get a refund. Although you may not have a case against your dentist for wanting to continue treatment with two more crowns, your new faulty crown might give you a good chance.

A lawsuit – A lawsuit requires that you can prove your dentist’s negligence. Your description sounds like your dental was negligent, but the details you gave us aren’t enough to determine if she is liable. A malpractice or consumer rights attorney can decide that for you.
Complain to the dental board – Although you can file a complaint, the Tennessee state dental board might consider your case as a dental procedure that went bad. Although it seems that your dentist doesn’t know how to adjust your bite, she did not drastically deviate from protocol.
Online reviews – You can tell your dentist that you will leave negative online reviews about your experience. Check her current online reviews. If they are mostly positive, a negative review will concern her. Otherwise, it might not have an impact.

Periapical Abscess and Root Canal Treatment

A periapical abscess is a collection of pus at your tooth root that results from an infection. It means that the pulp—living tissue, vessels, and nerves—inside the tooth is dead. Dead nerves inside a tooth mean that you won’t feel any pain inside the tooth from root canal treatment.

After root canal treatment, a dentist must ensure the crown fits well to avoid TMJ issues

But an upper molar tooth is more challenging to treat. An endodontist (root canal specialist) can treat your tooth, and you won’t need an extraction. If you ask a dentist to extract the tooth, you will need to replace it. Otherwise, your teeth will begin to drift, disrupt your bite, and possibly cause TMJ (temporomandibular joint) issues. TMJ symptoms affect more than your teeth. Symptoms can include:

Earaches
Headaches
Jaw stiffness, clicking, or pain
Neck pain
Dizziness
Painful talking, yawning, or chewing
Tinnitus (ear ringing)

Our Recommendation

It seems that you are uncomfortable with your dentist. We recommend that you get a second opinion from a dentist with advanced training in occlusion and bite. The dentist will understand how to achieve harmony between your teeth so you can speak and eat comfortably.

And you may need a referral to a root canal specialist to save your tooth and avoid the need for a dental implant or partial denture.

We wish you the best. Please let us know the results.

Gilberto Tostado, DDS, of San Antonio, TX, sponsors this post.

Why Did My Jaw Hurt After My Dental Appointment?

Posted on August 7, 2020 by AllSmiles.

Hi,

I recently had my teeth prepared for several temporary crowns and several porcelain veneers placed on my lower teeth. I am looking forward to when my porcelain crowns come in, but ever since my appointment, my jaw has been aching. I cannot get through the day without taking over the counter pain killers, and wish I had something stronger. It usually hurts worse later in the day, and I need to take something to ease the pain before bedtime.

It’s been several days since my appointment, but my jaw pain hasn’t let up. Is this normal? Do I need to go back to my dentist? I really hope it stops soon.

Mayumi, from Gadsden, AL

Hi Mayumi,

There usually is residual pain after long appointments, as your mouth has been through a lot. You will likely have pain or discomfort for one or two weeks after the surgery. Preparing that many teeth for crowns and veneers requires the mouth to be open for much longer than you’re used to.

To make yourself more comfortable, you can call your dentist and ask if there is anything else you can do. The pain is likely temporary, so it should not be TMJ or TMD. Over the counter pain killers are OK to take, and try to rest your jaw as much as possible. You can also use heat from warm towels to help your jaw relax.

This blog post is brought to you by San Antonio TMJ dentist, Gilberto Tostado, of 5 Star Dental Group.

Are My TMJ Problems and Diabetes Related?

Posted on July 3, 2020 by AllSmiles.

Hi there,

I have been having jaw pain for months. I tense my jaw when I’m stressed, and I grind my teeth at night. My dentist made a night guard so I would stop grinding, but still no relief. I have tried cold compresses and ibuprofen to reduce the pain and inflammation, but still nothing. My dentist also ground down some teeth, as a misaligned bite was likely causing TMJ pain. Still no help.

My insurance has not been covering this, so I am out a lot of money and no closer to finding an answer to my pain. I feel like my dentist has given up, as his latest idea is that my diabetes is responsible for my pain. Is that correct? He knew I had diabetes when I first walked into the office, so why did it take him so long to mention a link between the two?

Since he thinks it is linked to my diabetes, he says there is nothing he can do for the pain. It is interfering with my daily life; I can barely eat or sleep because of the pain. What can I do? Or will I be in pain for the rest of my life?

From Alphonse, in Columbus, Ohio

Hi Alphonse,

You are correct, your temporomandibular joint, or TMJ, is likely the cause of your pain. However, if your dentist knew you were diabetic, he should not have prescribed you ibuprofen, as it is contraindicated for diabetics, meaning you could be at higher risk of side effects.

Diabetes can cause oral health problems, such as dry mouth, which can lead to gingivitis. It can also cause diabetic neuropathy, or nerve damage to your nerves near the surface of your skin. This usually affects a patient’s feet but can affect other parts of your body, and very rarely affects your face.

Despite the link between the two, there are still ways to options. If your dentist is not willing to treat your pain, you should seek a second opinion. A dentist more skilled in treating TMJ will likely be able to provide you some relief.

This blog post is brought to you by San Antonio TMJ dentist, Dr. Gilberto Tostado, of 5 Star Dental Group. Please note that TMJ is not a specialization or certification, but dentist who pursue continuing education courses pertaining to TMJ will call themselves TMJ dentists or TMJ specialists.