TMJ Dentist Archives - Dr. Duane Delaune's Blog

Will I Need Braces for Inner Cheek Biting?

Posted on November 8, 2023 by AllSmiles.

I keep biting the inside of my right cheek when I chew. It happens if I eat something that requires much chewing, like chicken or an apple. It doesn’t happen with softer foods, though. Is this a dental issue that requires braces, which I cannot afford, or could it be a medical issue? I can’t imagine why it would be medical, but I don’t know. The problem began over a year ago, but it’s become more frequent. Thanks. Viviana from Tampa, FL

Viviana,

A cheek-biting habit may be related to dental concerns. A dentist can determine whether your teeth alignment is causing you to bite your inner cheek when you chew.

What Causes Inner Cheek Biting?

Factors that can cause inner cheek biting include anxiety, depression, distractions, compulsive behavior, or bite misalignment. Although occasional accidental cheek biting is not a concern, you should get professional help to identify the cause of a chronic habit.

Anxiety or depression – Cheek biting can become an emotional reaction to stress, anxiety, or depression.
Compulsive behavior – Body-focused repetitive behavior is related to conscious or subconscious habits, such as cheek biting, hair pulling, or skin picking.
Distractions – Reading, driving, watching TV, or talking while eating can distract you from chewing well, causing you to bite your inner cheek.
Teeth misalignment – Teeth misalignment from orthodontic concerns or restorative dental work can affect your bite or how your upper and lower teeth meet. Cheek biting can be a sign of a non-harmonious bite.

What Can a Dentist Do for a Cheek-Biting Habit?

Teeth misalignment can cause inner-cheek biting and TMJ issues

A dentist can examine your teeth and bite to determine whether they affect your check-biting habit or if you need to consult your medical doctor. If so, the dentist may recommend a mouth guard, orthodontics, or tooth restoration to correct your bite. If your bite is off, you may also experience TMJ-related symptoms, including jaw pain or stiffness, earaches, headaches, or neck pain. Schedule an exam with a dentist with advanced occlusion and bite training for an accurate diagnosis.

Dr. Duane Delaune of Metairie, Louisiana, sponsors this post. Read why Dr. Delaune’s patients consider him one of the best dentists in town.

Which Ceramic Crowns Can Hide a Dark Front Tooth?

Posted on August 15, 2023 by AllSmiles.

I have crowns on my front teeth. They are old and fused to metal. The front left tooth had a root canal in 2012, and the tooth is dark. Which ceramic crowns should I request to hide the dark tooth without making it evident that my front teeth have crowns on them? Thank you. Viviana from IL

Viviana,

We understand your concerns. We advise patients to focus on the dentist’s skill to restore their smile rather than the materials used. The riskiest thing you could do is to pick crown material and ask your dentist to use it. This could put the dentist outside their comfort zone, working with an unfamiliar material and producing an unattractive outcome. Remember, no material will guarantee a beautiful result unless the dentist is artistic.

Consider several reasons.

Which Ceramic Is Best for Front Teeth Crowns?

The best ceramics for front teeth crowns depend on several factors, including the condition of your teeth, whether they are discolored, and your dentist’s skill and preferences. We recommend searching for a dentist with advanced cosmetic dentistry training to determine which crowns will produce the most natural-looking results for your teeth.

All-ceramic crowns look natural

While it’s true that porcelain-fused-to-metal crowns don’t look entirely natural, many all-ceramic crowns can look so real that even a trained professional might be unable to tell they’re not your natural teeth.

Durable ceramics are plentiful

All-ceramic options are strong enough for your front teeth, so there is no need to worry about that aspect.

Your dentist’s artistic talent matters

Matching a dental crown to the natural tooth next to it is a challenge. Front teeth show when you smile, so achieving a match is vital to helping you feel confident about your smile. Find a dentist with artistic ability and advanced cosmetic dentistry training. Let the dentist choose a ceramic based on your case and the dentist’s experience and comfort level. Skilled cosmetic dentists collaborate with a master ceramist who understands ceramics and can achieve beautiful results.

Can a Dental Crown Hide a Dark Front Tooth?

If you have an underlying dark tooth, a dentist and ceramist must mask it with opaquer. One technique is to use a composite buildup material and then add the crown. However, some dentists prefer to instruct the lab ceramist to use an opaque layer in the crown instead. and then layer it with feldspathic porcelain for a natural-looking result.

Before choosing a dentist, you can schedule consultations with two or three advanced cosmetic dentists to compare your options and the dentists’ work. A trained cosmetic dentist will balance your bite to prevent TMJ concerns, ensuring your smile is healthy and attractive.

Before and after dark front teeth restored with dental crown photos from Metairie, LA, cosmetic dentist Dr. Delaune

Dr. Delaune’s patient

Dr. Duane Delaune of Metairie, Louisiana, sponsors this post. Read why Dr. Delaune’s patients consider him one of the best dentists in town.

Could My Bite Be Ruined for Life with These Crowns?

Posted on June 23, 2023 by AllSmiles.

I think my new crowns ruined my bite for life. My dentist shaved and burred my crown until I developed hives. I had an appointment last Friday about the hives on my lips and gums. I wonder if I am having an allergic reaction to the zirconia crowns. Do I need an allergist for this? I am asking about my bite and zirconia allergy. What can I do? Thanks for your help. – Emanuel from Morrisville, NC

Emanuel,

We understand your concerns and are sorry to hear about your frustrating experience.

Could Crowns Ruin Your Bite for Life?

Jaw pain, earaches, and other TMJ symptoms can occur if your bite is off.

When you find a dentist with advanced training in occlusion and bite, you will be relieved to know that your bite is not ruined for life. We recommend looking for dentists with in-depth study of occlusion and bite. When your bite is off, you feel the discomfort. It can also cause jaw pain, earaches, neck pain, and other TMJ symptoms.

You can schedule a second opinion because your dentist cannot adjust your bite. If you are distrustful about a new dentist trying to adjust your bite, you can schedule a consultation first to meet the dentist, ask questions, and explain your anxiety.

Could You Be Allergic to Zirconia Crowns?

It is possible to be allergic to zirconia crowns, but we have no confirmed cases reported. If a zirconia allergy is causing your reaction, you would have reacted when you got the crowns—before your dentist began grinding on them. You may be experiencing burning mouth syndrome, which can occur after stressful dental appointments.

Grinding down super-strength zirconia crowns is challenging. Feeling the pressure from the grinding repeatedly can increase anxiety for almost any patient.

We hope you get a lasting resolution that relieves your anxiety. Your hives may improve, too. If they do not, we suggest scheduling an appointment with your medical doctor.

Metairie cosmetic dentist Dr. Duane Delaune sponsors this post. Read details about how Dr. Delaune strives to provide some of the best dental care in Metairie.

Is It Safe to Get a Tooth Filling at 7 Months Pregnant?

Posted on March 21, 2023 by AllSmiles.

Is it safe to get a tooth filling replaced if I am seven months pregnant, or should I leave it alone for now? I have a tooth filling from October 2022 for a small cavity. The tooth has become sensitive to heat and cold. My dentist said I needed a root canal and crown at my last dental visit. I prefer to switch out the filling and not be stuck in a dental chair near the end of my pregnancy. The sensitivity is worsening, and I am concerned about tooth pain during my delivery, making me even more miserable. I’m beginning to clench my teeth from the anxiety. I’m trying to break the habit because it will only worsen things. Is it safe to get a filling replaced? – Thank you. Yasmin

Yasmin,

Thank you for your question. We understand your concerns about your oral health, baby, and comfort during a dental visit. If you have a tooth infection, it will worsen without treatment.

Is It Safe to Get a Tooth Filling During Pregnancy?

According to the American Dental Association (ADA) is safe to get diagnostic, preventive, and restorative dental care throughout pregnancy. The ADA recommends the second trimester as the most favorable time for dental procedures for the following reasons:

First trimester – Many women experience nausea and vomiting, creating challenges in a dental chair.
Second trimester – You may feel better physically and more comfortable sitting in a dental chair.
Third trimester – The baby’s weight may cause discomfort or lightheadedness during a dental procedure.

Why Is Your Tooth Sensitive?

A tooth infection can cause sensitivity in a tooth with a filling. During the procedure, something may have irritated your tooth, such as lingering decay or irritation from dental tools or materials.

Dental X-rays During Pregnancy

Teeth clenching can lead to TMJ concerns

A dental x-ray will reveal your tooth’s condition with minimal radiation exposure. A tooth infection can spread to other teeth, your jawbone, and even your bloodstream.

If you are skeptical about your dentist’s care, we recommend getting a second opinion to determine the cause of your tooth sensitivity and what is required to relieve it. It will give you peace of mind and help you stop clenching your teeth, which can lead to more toothaches and jaw pain.

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

I’m So Tired of My TMJ Ear Pain

Posted on December 10, 2022 by AllSmiles.

I am so tired of my TMJ ear pain. I’ve had sharp, shooting ear pain on and off for the past three years, and it’s getting worse. In 2019, I saw a massage therapist, which seemed to help, but I moved during Covid and have not gotten back on track. My therapist then recommended self-exercises and warm packs on the sides of my mouth. I’m beginning to have neck pain at night for the past month.

Sleep is challenging because I also snore and know my sleep quality must be poor. I only have a dog at home, so no one is here to tell me how badly I store, but my dog doesn’t leave the room at night. Yesterday morning, I was talking with several colleagues, and the topic of sleep apnea came up. One person said they got good results from wearing a mouthguard at night. I’ve tried that before, but it didn’t seem to help. Are there alternatives? Thank you. Josiah from UT

Josiah,

We are sorry to hear that you’ve been suffering from TMJ symptoms and ear pain. We hope that our response will help you find relief.

What Causes TMJ Ear Pain?

The jaw joint is near the ear canal, so TMJ inflammation can affect your ears, causing pain or ringing (tinnitus). An ENT specialist or dentist trained in diagnosing and treating TMJ disorders can determine if TMJ or another condition is causing your ear pain or ringing.

What Is the Treatment for TMJ?

TMJ treatment depends on the cause and severity of your condition. After an examination, a TMJ dentist will explain treatment options, which may include:

Anti-inflammatory medication
Applying moist heat to the area
Custom night guard to minimize the effects of clenching and grinding your teeth
Eating soft foods
Relaxation techniques
TMJ stretches and exercises

Are Sleep Apnea and TMJ Related?

Studies show that sleep apnea and TMJ disorders are related. According to a 2019 article published in The Journal of Craniomandibular & Sleep Practice, when the jaw joint malfunction contributes to

Teeth grinding
Headaches
Ear pain
Sleep disturbances

Request a Consultation with a TMJ Dentist

If you are experiencing TMJ symptoms, schedule an exam with a dentist with post-graduate training in diagnosing TMJ disorders. After a comprehensive exam, the dentist will explain how you can get relief.

In Metairie, Louisiana, Dr. Duane Delaune has been diagnosing and treating TMJ cases for decades. Visit his website to read about his training.

Why Do My Three New Crowns Hurt When I Chew?

Posted on September 30, 2022 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?

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 May 30, 2022 by AllSmiles.

Earlier 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 March 28, 2022 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?

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 January 7, 2022 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.

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 September 30, 2021 by AllSmiles.

My 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.