I’ve been battling with TMJ problems for the past couple of years. Mostly, my jaw is just sore in the morning and it fades away as I go about my day. I know I should be wearing a night guard. My dentist told me I needed one and I still haven’t gotten it. But, here’s the thing – I had a crown done about two weeks ago and it didn’t feel right from the start. I mentioned it to my dentist and he made some adjustments, but I could still feel it hitting the tooth above it first. My dentist said he’d adjusted it as much as he could and that I will get used to it. My TMJ pain is even worse than usual since getting the crown. Could the two be related? — Marcella
Making sure the teeth come together properly requires intricate knowledge of the jaw and anatomy. When there are bite problems, like those caused by an ill-fitting crown, it can certainly exacerbate an existing TMJ issue or even cause one to start.
Unfortunately, a lot of dentists fail to realize this and they don’t take additional training to ensure they’re getting it right. Some will just make repeated adjustments to their work until a patient stops complaining, and others will reduce the restoration down so much that it doesn’t connect with the tooth it bites against at all.
The bottom line is that yes, you need to get your night guard made. Your TMJ problems are going to progress until you get the nighttime grinding under control. However, the crown is probably contributing to the problem right now and it needs to be corrected. It’s not a matter of getting used to it. Although you may become accustomed to biting incorrectly or moving your mouth differently so that it doesn’t bother you so much, it will still put undue stress on your joints. Keep working with your dentist to get it corrected. If you hit a point where it’s not getting resolved and he’s unwilling to help, get a consultation with another dentist who specializes in TMJ issues and understands occlusion.