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Why Do My Three New Crowns Hurt When I Chew?

Posted on by AllSmiles.

In early July, my dentists put crowns on my top left bicuspid and the two teeth behind it. After the second molar, I do not have any teeth because an oral surgeon pulled my teeth 14 years ago. All three teeth had old fillings and deep decay. Now that I have crowns, the teeth hurt when I chew. Because three teeth in a row have crowns, I’m unsure whether one or all teeth hurt.

When I put pressure on the crowns with my finger, they all hurt, but the pain could be referring. My dentist adjusted the crowns twice but said my bite was too aggressive when I chew. She said I should chew on the other side of my mouth until the inflammation calms down. That is not a solution for me. Should I ask my dentist for new crowns or get someone else to check out my crowns first? Thanks. Ennis from MD

Ennis,

Thank you for your question.

Dr. Delaune would need to examine your crowns and take x-rays for an accurate diagnosis, but we will provide general information that can help.

Why Do Your New Crowns Hurt?

close up of temporomadibular joint

TMJ issues can result from crowns that do not fit well

If your new crowns hurt when you chew,  you may be too high or have a tooth infection. What is the solution?

  • Adjust your bite – Lower opposing teeth can hit the upper teeth with more pressure than usual if your bite is too high. The repetitive force will irritate your teeth. Eventually, your jaw muscles and joints can become irritated and sore. Neck pain, earaches, or headaches may develop as TMJ disorder symptoms. If your dentist correctly adjusted your bite and the pain linger, you may have a tooth infection.
  • Check for tooth infection – An x-ray will reveal whether you have a tooth infection. The extent of your pain sounds like you may need root canal treatment. When an infection is challenging to detect, you may need a referral to a root canal specialist (endodontist).

Will You Need New Crowns After Root Canal Treatment?

You should not need new crowns after root canal treatment unless your current crowns are defective or contribute to discomfort. An endodontist can access your tooth pulp through the top of your crowns to perform root canal treatment and seal the crowns closed.

If you do not get satisfying answers from your dentist, schedule a second opinion with a dentist with advanced TMJ and root canal training.

 

Duane Delaune, DDS, an accredited cosmetic dentist of Metairie, New Orleans, sponsors this post.

 

Did Wisdom Teeth Removal Give Me TMJ?

Posted on by AllSmiles.

Woman with a hand on her jaw, perhaps needing a TMJ dentistEarlier this month, I had two impacted wisdom teeth removed, and I wonder if something about the procedure gave me TMJ. It’s been three weeks since my oral surgery, and the right side of my face, where the teeth were extracted, is still numb. It hurts when I try to open my mouth wide, and I have numbness on the side of my tongue. I called the oral surgeon’s office, and the receptionist quickly responded and said it takes time for the nerves to heal. I am still uncomfortable with the receptionist’s answer because she didn’t offer to ask the oral surgeon to return my call. She answered me too quickly. Before I call the office again, is the receptionist correct? Should I be concerned? Are any of my symptoms related to TMJ? Thank you. Joan from Colorado

Joan,

Thank you for your question.

Your lingual (tongue) nerve is near wisdom teeth; sometimes, it travels on top of wisdom teeth. It might be difficult or impossible for the most careful dentists or oral surgeons to avoid touching or damaging the nerve during impacted wisdom teeth extraction. The symptoms you describe are related to the nerves near wisdom teeth, not temporomandibular joint (TMJ) concerns.

After Impacted Wisdom Tooth Extraction, When Will the Nerve Heal?

When and if the nerve will heal after wisdom teeth removal depends on several factors:

  • Extent of damage – A bruised or stretched nerve could take a month or two to heal. A cut nerve is unlikely to mend, but some growth may occur over time. Expect a year or more of recovery time for a crushed nerve.
  • Sensation in your tongue – If your tongue feels numb and tingly, it may be that the nerve is repairing itself.
  • Inability to open your mouth – Swelling during the healing process can prevent you from opening your mouth. If the swelling does not improve or gets worse, you might have an infection in your muscle tissue, limiting how wide you can open your mouth. Your oral surgeon may prescribe antibiotics.
  • Microsurgery – Although nerve repair surgery is complicated, at times, it is possible. You can ask your oral surgeon if it is an option.

Although you spoke with a receptionist, call the office again and ask to talk with the oral surgeon, leave a message for him to return your call, or schedule a follow-up appointment. The surgeon will have more insight into your treatment options.

Metairie, Louisiana dentist Dr. Duane Delaune sponsors this post.

What’s Causing Radiating Ear Pain After a New Dental Crown?

Posted on by AllSmiles.

In August, my dentist replaced a crown on my bottom right molar that is just beneath my ear. Within two weeks, I started feeling pain that radiates into my ear. Before my dentist replaced the crown, I had a little discomfort and a mild earache. It is much worse now. It feels like my bite is off, too. Two weeks ago, dentist took a quick look at the crown and said the problem is probably from a salivary gland stone. He told me to follow-up with my medical doctor. I have an appointment next week. But doesn’t it make sense that if the pain increased, it has something to do with the tooth or my new crown? Thank you. Gerald from Detroit

Gerald,

Thank you for your question.

Your dentist’s explanation about a salivary gland stone sounds like a quick excuse. It is not a reasonable explanation for the symptoms you describe.

What Is a Salivary Gland Stone?

A salivary gland stone is a hardened mineral or calcium deposit that forms in a salivary gland. Larger stones can block saliva flow.

If you had pain from a salivary gland stone, it would be in the soft tissue. And it would not radiate in your ear. Some salivary glands are under the tongue, and one is in the middle of each cheek. A stone may cause pain and swelling and get worse when you eat. Also, the stone would show up in an x-ray.

What Is the Cause of Radiating Ear Pain After a Dental Crown?

close up of temporomadibular joint

A poor-fitting crown can lead to TMJ issues

If you have a toothache and radiating ear pain after getting a new dental crown, your dentist should check the crown and tooth. The dentist should also check your bite and balance it as needed. Otherwise, in addition to the ear pain, you can begin to experience temporomandibular joint (TMJ) issues, including headaches, neck pain, and jaw stiffness.

It is time for a second opinion with a dentist who has advanced training in occlusion and bite (the way your upper and lower teeth meet when you close your mouth or chew). The dentist will check your tooth for decay or damaged tooth pulp and ensure your crown fits correctly.

 

Dr. Duane Delaune, an cosmetic dentist in Metairie, Louisiana, sponsors this post.

New Crowns Affect My Speech and Make My Neck Hurt

Posted on by AllSmiles.

My dentist placed four new crowns on my front teeth. Two crowns got rid of a gap between my center front teeth, and my dentist added two more crowns to even out my smile so the center teeth would not look too large. Since getting the crowns, my mouth does not close correctly, and I have trouble pronouncing some words, like words that begin with “tr.”

Also, my mouth and lips are dry, and I have some neck and jaw pain. I’ve had the crowns for three months, and despite my dentist’s adjustments, I see no improvements. I prefer to go back to my gap because the crowns are so uncomfortable.

My dentist asked me to give him more time, But I am unsure what we are waiting for. So far, I do not have another appointment scheduled with him. What are my options? Thank you. Edgardo from TX

Edgardo,

Your description is a problem that requires the attention of a dentist with advanced training in occlusion and bite. Dentists who study occlusion and bite understand proper jaw function and how your upper and lower teeth should meet when you close your mouth or bite down.

When Dental Crowns Cause Speech Issues and Pain

When a dentist places new crowns, you begin to experience speech issues and neck and jaw pain, so closing your gaps is not the issue. Usually, the problem is that your dentist opened your bit too far.

Several issues can create a bite that opens too far:

  • Crowns are too thick
  • Crowns are too long

Symptoms from Poor-Fitting Crowns

Poor-fitting crowns can prevent proper mouth closure and neck and jaw pain.

  • Lip incompetence – When your lips cannot close naturally without effort, it can lead to dry mouth. And as saliva production decreases, bacteria breeds And black buildup leads to tooth decay.
  • Jaw and neck pain – Upper and lower teeth that do not meet cause jaw strain. Repeated stress results in neck and jaw pain.

Get a Second Opinion for Your Dental Crowns

Schedule an appointment with a dentist who has advanced training in occlusion and bite. Your neck and jaw pain should resolve with new crowns that fit well. Otherwise, if your symptoms continue, the National Institutes of Health’s brochure on temporomandibular joint (TMJ) disorder recommends conservative treatment. A dentist may recommend a custom split to wear and night and help your jaw relax.

Duane Delaune, DDS, an cosmetic dentist of Metairie, New Orleans, sponsors this post.

Before-and-after dental crowns photo

Crowns that fit well prevent speech issues and jaw and neck pain.
Photos are of Dr. Delaune’s patient.

 

Did dental treatment cause my TMJ symptoms?

Posted on by AllSmiles.

Woman with a hand on her jaw, perhaps needing a TMJ dentistMy teeth were in horrible shape, so my dentist placed eight temporary crowns on my lower almost two weeks ago, and since that time, I have had terrible jaw pain. I am scheduled for four porcelain veneers in a month. Although I do not like taking pain meds, I take ibuprofen twice daily. I deal with the pain the rest of the time. My dentist is out of town through next week due to a death in his family. Is my pain normal, or should I schedule an appointment with another dentist? I am worried that my bite is off and causing me to develop what feels like TMJ. – Thank you, Karla, from KY

Karla,

Thank you for your question.

You have had extensive dental work on your lower teeth, so we understand that you are pretty uncomfortable. What you describe does not sound unreasonable for reconstructing your teeth. Preparing eight teeth for crowns requires keeping your mouth open for an extending period.

Did Dental Treatment Cause TMJ?

Your jaw muscles can become sore and stiff during and after long dental sessions. Other than taking ibuprofen, you can apply moist warm towels to the sides of your face. Continue to rest your jaw and avoid foods that are chewy or sticky. Rest your jaw as much as possible. The symptoms you describe should be only temporary and not require TMJ treatment. Not all jaw pain is related to TMJ.

Other TMJ symptoms include:

  • Earaches
  • Ringing in the ears
  • Neck pain
  • Headaches
  • Jaw locking, popping, or clicking

Your dentist has probably arranged another dentist for on-call emergencies. If your pain worsens or lingers, call the dental office, and ask about arrangements your dentist may have for follow-up care.

 

Duane Delaune, DDS, a cosmetic dentist of Metairie, New Orleans, sponsors this post.

My Mouth is Collapsed

Posted on by writeradmin.

I have always had problems with some teeth grinding. I wear a mouth guard at night as a result. That is the only time I feel like people can see my teeth and my jaw even hurts less. When I am not wearing it, my jaw hurts, you can’t see my teeth even when I smile, and I’m having trouble pronouncing some letters. My dentist is suggesting porcelain veneers. I just want to make sure I understand all my options. Is this the way I should go?

LeeAnn

Dear LeeAnn,

Woman holding her jaw in pain

I want you to be very careful here. While porcelain veneers could improve the appearance, if your dentist has artistic skill with cosmetic work, it will not solve the pain your are in. It sounds like your bite has collapsed as a result of the teeth grinding. This is going to lead to TMJ Disorder, which will put you in even more pain.

The solution in a case like yours is to have a full-mouth reconstruction, which means putting a crown on every tooth in order to build your bite back into the right position. However, this is the single most advanced procedure in general dentistry. It is not taught adequately in dental school. You will need a dentist who has invested a lot of post-doctoral training in both TMJ Treatment and Reconstructive Dentistry.

If this is done incorrectly, you will end up in more pain than before. In your position, I would look for a dentist who has significant training in one of the following institutions.

  • The Pankey Institute
  • Dawson Academy
  • The Las Vegas Institute for Advanced Dental Studies

The first two are located in Florida. The last one is (obviously) located in Las Vegas. They will have the knowledge necessary to make sure when they do build up your bite, they do it correctly.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

Form AND Function with TMJ Treatment

Posted on by writeradmin.

I had a serious problem with my bite when I started grinding my teeth. I’d ground them down to nubs. He put crowns on each of my teeth. However, I don’t think he did them right because now I have a slanted bite both upper and lower, plus a crossbite. I feel I’m in worse condition than I was before. I decided then to go to a neuromuscular specialist. He put me in an orthotic for a little over two years, which opened up my bite. Now my crowned teeth are ground completely down to nubs. Again, I am in worse condition than I started. I also learned that there isn’t a neuromuscular specialist, which makes me feel I’ve been swindled. I am out a fortune and in horrible pain. I didn’t even talk about how bad the crowns looked to begin with but both of them said I could have a healthy bite and a decent smile, but it would never be a Hollywood smile. I wasn’t asking for a Hollywood smile, but rather, I was looking for a natural-looking smile.  This one looks like beige-ish chicklets. Is the bite even fixable at this point? If so, can it look like a normal smile?

Madeline

Dear Madeline,

a woman holder her jaw from TMJ pain

You have been through a lot with dentists. Though you were thinking rightly in wanting a neuromuscular dentist, as you have discovered, there isn’t a recognized specialty in neuromuscular care, though it does actually take a significant amount of post-doctoral training in order to do it well. You are dealing with a serious case of TMJ Disorder at this point, even more so than when you started treatment.

I will say right off the bat, though you will need a tall order in a dentist, you will not have to choose between form and function. You will need a dentist with expert post-doctoral training in both TMJ Disorder and Cosmetic Dentistry. Both have to be post-doctoral because what is taught in general dental school isn’t enough for your situation.

Look on the mynewsmile.com website. These dentists are prescreened for their technical skill and artistry. They cannot pay to be listed on the site, they actually have to have the skills needed.  Once you have found all the dentists listed on that site within a reasonable driving distance to you, that is when I’d like you to look a their TMJ training AND experience

How to Find a Qualified TMJ Dentist

There are several schools that have great TMJ programs. Here are some of them:

  • Dawson Academy
  • Kois Center
  • Las Vegas Institute of Advanced Dental Studies
  • The Spear Insititute

While there are others, these are among the best schools.

This blog is brought to you by New Orleans Cosmetic Dentist Dr. Duane Delaune.

 

 

Her Dentist seems negligent

Posted on by writeradmin.

I wanted to get some advice. I had a check up not too long ago and everything was great. However, recently I’ve been having pain in my lower back teeth. It is hard to describe. It feels a bit like someone is pulling on the teeth and then letting go. I have never had a cavity before so I don’t know what that feels like. Could it be from that? I’m not grinding my teeth when it happens, so I don’t think it is from that. Have you heard of this before?

Olivia

Dear Olivia,

a woman holder her jaw from TMJ pain
Teeth grinding can lead to serious problems

My first concern is that your dentist doesn’t seem to have addressed your teeth grinding. This is quite serious. You can actually end up grinding your teeth down to nubs. In addition, it can lead to TMJ problems by throwing off your bite.

This is such a simple thing to fix I don’t understand why your dentist hasn’t dealt with it. Wearing a simple nightguard can save you tens of thousands of dollars. Once your teeth get ground down to nubs, you are looking at a $30,000 full-mouth reconstruction.

There are some dentists who will only look at things like cavities and ignore other issues. such as TMJ Disorder, gum disease, and occlusion. All off those are important.

I’m going to recommend you get a second opinion from a dentist who may be more thorough than your current one. As for the pain you are experiencing, bear in mind I haven’t examined you or seen any x-rays. I’m just going by your description.

It doesn’t sound like a cavity to me. Based on what you’ve said, two possibilities come to mind. The first is gum disease. That’s a big deal because by the time you start feeling pain, there is usually significant bone loss, which could lead to you losing your teeth. I want you to get that evaluated as soon as possible.

A second possibility is from the tooth grinding. You are likely doing it at night when you aren’t aware it is happening, but the pain you’ve described can happen even when you aren’t grinding your teeth. I mentioned earlier the nightguard. That would be another very important issue to deal with.

This blog is brought to you by New Orleans Dentist Dr. Duane Deluane.

full mouth reconstruction disaster

Posted on by writeradmin.

My dentist has been fixing my teeth because of my teeth grinding. He said I’ve been grinding them for years. Now they need to be repaired. He’s using crowns and bridges. When he did the temporaries they fit sort of okay. Some of the teeth weren’t fitting together okay but he said he would straighten that out with the permanent ones. The permanent ones are in, but it doesn’t feel right. Some of them aren’t touching each other and some are touching in some spots and not others. Is that normal? I know teeth vary. The problem is it hurts when I’m chewing and I’ve been getting pretty bad migraines. What do you recommend?

Joseph

Dear Joseph,

man grabbing the side of his jaw in pain

If I am understanding you correctly, the first thing I suggest you do is find another dentist. You said he told you that you’ve been grinding your teeth for years. In all that time, did he mention it to you or did he wait until they were down to nubs?

If he knew it and didn’t mention it, that is gross negligence. He could have saved your teeth from this procedure by providing a simple nightguard for you. This is a device you wear, similar to a sports mouthguard, which is custom-fitted to your bite and protects your teeth from the grinding, which mostly happens while you are asleep.

Because he didn’t do that, you are spending thousands of dollars on a full-mouth reconstruction, instead of what could have been a couple of hundred bucks.

Plus, you told me the temporaries weren’t occluding well either. He said he’d fix that with the permanents, but that isn’t how it works. The permanent crowns and bridges are patterned after the temporary ones. He had to fix those first.

You Need a TMJ Dentist

A full-mouth reconstruction is extremely advanced. It is something well beyond the skills of someone who simply graduated from dental school. It takes advanced TMJ training.

Some of the better schools are:

  • The Dawson Academy
  • The Las Vegas Institute of Advanced Dental Studies
  • Texas Center for Occlusal Studies
  • The Pankey Institute

In your place, I would get a refund and then find a dentist who has studied at one of these institutions. You can find them by doing a search for a TMJ Dentist online, then look at their bios to see where they did their post-doctoral training.

Bonus points if they are also a mynewsmile.com recommended cosmetic dentist, then you’ll know they can also create a beautiful smile.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

solving a collapsed bite

Posted on by writeradmin.

I’m trying to find out what to do about my smile. I hate it. You can never see my teeth when my mouth is at rest. Actually, they’re almost impossible to see all the time. Even smiling my hardest you can barely see them. There is also almost constant jaw pain. When I wear a nightguard, it does help things feel more normal, but obviously I can’t wear that all the time. I want a smile I can be proud of. I was thinking of porcelain veneers but wanted to get all my options before deciding.

Margot

Dear Margot,

Woman covering her mouth with her hands

You don’t have to spend your life ashamed of your smile. I will say, though, I’m very glad you wrote before seeing a dentist. Too many would make things worse instead of better. It sounds like you’re dealing with a collapsed bite, along with complications from TMJ. Disorder This will take a dentist with advanced post-graduate training in a variety of skills.

Porcelain veneers aren’t the best option for you. You’ll need a procedure that will build up the teeth. This should be done with dental crowns, but it has to be done in a very specific way.

This should start with a provisional restoration. Once that is successful, the permanent restoration should be built from it. However, this isn’t easy. Successful will mean your teeth show under normal circumstances, your jaw doesn’t hurt, your speech is normal, and you love how they look.

You will need a dentist who has advanced training in restorative dentistry, neuromuscular dentistry, as well as cosmetic dentistry. That is a tall order.

See what dentists have advanced TMJ Training in your area, then check to see if they’re listed on the mynewsmile.com website. These dentists have the cosmetic training to create beautiful smiles. Combined, it will cover all the aspects you need.

This blog is brought to you by New Orleans Dentist Dr. Duane Dellaune.