dental crowns tmj Archives - Dr. Duane Delaune's Blog

Will Jaw Pain and Popping Recur with a New Bridge?

Posted on September 21, 2023 by AllSmiles.

I had jaw pain and popping with my last dental bridge and had to see a TMJ specialist to correct it. I got that bridge in 2001, so it is time to replace it. I relocated and switched dentists in 2014. Three weeks ago, I asked her about a new bridge, and she recommended a zirconia bridge. The pretreatment estimate includes a porcelain upgrade, which my dentist did not explain. I’ve had a billing issue in the past with this practice, so before I call, can you explain the porcelain upgrade? Is this related to my previous TMJ issues? Or should I be concerned that the jaw pain and popping will recur? Thanks, Hannah

Hannah,

We understand your concerns about a new dental bridge, especially if you’ve had TMJ concerns that required a specialist to resolve.

Will Jaw Pain and Popping Recur with a New Dental Bridge?

X-ray side-skull view of the temporomandibular joint (TMJ)

Get a second opinion to prevent or resolve temporomandibular joint (TMJ) complications

Jaw pain and popping will not recur with a new dental bridge if your dentist has advanced occlusion and bite training. A dentist with post-graduate occlusion and bite training understands how your teeth should meet when you close your mouth or chew. Also, the contact force between your teeth affects your facial and jaw muscles.

Are TMJ and Zirconia Crowns Related?

Online articles about zirconia crowns have varying opinions about how zirconia crowns affect your TMJ (jaw joint) risks. Your dentist must take accurate impressions of your mouth and ensure your bridge fits well and is in harmony with your lips and bite.

What Is a Porcelain Upgrade for Your Bridge?

The dental office’s terminology of a porcelain upgrade is not a term that dentists commonly use. You should call the office and ask for an explanation of the terminology. You can check the insurance company for their opinion on the upgrade if you have dental insurance. Your pretreatment estimate will help you anticipate out-of-pocket costs.

Although we are unsure of what “porcelain upgrade” means, below are possibilities:

Your dentist may be planning for premium crowns if the bridge affects your front teeth.
The framework for your crowns may be a more expensive metal or metal-free.

However, ensure your dentist gives you a thorough explanation before you agree to treatment. If you are uncomfortable with the answer, we suggest getting a second opinion from a dentist with TMJ training.

Metairie, Louisiana, dentist Dr. Duane Delaune sponsors this post. Learn more about TMJ symptoms and treatment.

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.

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.