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Why Does One of My Three Dental Crowns Hurt?

Posted on by AllSmiles.

One of my upper left molars has been hurting for two months. My dentist thought the tooth might be fractured and covered it with the crown. It hurts even when I chew soft food. When I put pressure on the tooth with my finger, it feels better, but the pain returns when I lift my finger. This is so weird.

My dentist adjusted the crown, but the teeth still hurt. I’ve had other crowns with no problems like this. Is something wrong with my bite? What could be causing my tooth pain? – Thanks. Carlton from Gatlinburg, TN

Carlton

Thank you for your question.

Your description sounds like your bite is still off.

Why Does Your Dental Crown Hurt?

A poorly placed crown can push your teeth out of alignment and cause pain. Pain from decay or infection in your teeth will not improve if you push down on them, so decay or infection is not the problem. Either your gums or the crown is causing your symptoms.

close up of temporomadibular joint

Untreated concerns with dental crowns can lead to TMJ discomfort

If your dentist adjusts your bite correctly, you can clench your teeth and put pressure on them without discomfort. Your dentist might need to adjust other teeth, too. She may be hesitant about adjusting your teeth if she only worked on the tooth that has the crown. Sometimes small shifts in one tooth affect others, and adjusting adjacent teeth is the only way to align your bite correctly.

A misaligned bite can cause problems like these:

  • TMJ disorder
  • Headaches
  • Neck pain
  • Nighttime teeth grinding
  • Jaw pain

Get a second opinion if your dentist is unable to correct your bite. You can look for a dentist with advanced training in occlusion and bite.

 

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.

Should She Finish This Full-Mouth Reconstruction?

Posted on by writeradmin.

I went for years grinding my teeth without any intervention or knowledge that it was happening. I moved to a new city, which meant a new dentist. He was the one who told me about the grinding. I would explain why my jaw always hurt. I am wearing a night guard now, but he also suggested a full-mouth reconstruction. I was a bit nervous about that because I have a very sensitive mouth. I once had Zoom Whitening done and it was absolute agony. I did (and do) trust this dentist so I went ahead with the reconstruction. He’s finished the first half, which is the bottom arch. While it does make that part of my smile look much better, it almost looks too perfect. I liked the quirky look of my old smile. Plus, like the Zoom, the procedure was agony for me.  I’m no longer hurting, since he did the first half and I’m wondering now if it is necessary to finish. There is a color difference wtih my bottom teeth being whiter. If Zoom weren’t such a painful experience for me I’d just do that.  Do you have an opinion?

Katherine

Dear Katherine,

a woman smiling from the dentist chair with her dentist smiling beside her

You’ll need to bear in mind that I haven’t examined you, nor have I seen any x-rays. I can give you some generalities. I am not usually one to recommend half of a full-mouth reconstruction. In general, restorative material is harder on your teeth than natural tooth structure. That could cause a problem with your upper teeth, including increased sensitivity–something you definitely don’t need.

If not having the quirkiness bothers you, there is an easy solution for that. Most cosmetic patients want the perfect smile look. My feeling is your dentist and his ceramist would LOVE the opportunity to be more creative and add some quirkiness. You mentioned having some pain with the reconstruction. If the numbing medication isn’t working it is likely because with your sensitive teeth you have had enough bad experiences to give you dental anxiety. There is something about how the anxeity affects your body chemistry that causes it to interfere with the effectiveness of your medication. Oten, doing something as simple as using nitrous oxide before the procedure starts will relax you enough to enable the numbing medication to do its job.

All of that being said, if you feel the first half of your reconstruction has served the purpose you needed and all you truly want at this point is the whitening, you don’t have to use Zoom Whitening, which can be a tad strong for people with sensitive teeth. Instead, you can do home whitening trays. You will wear the gel at your convenience for as long as you can comfortably tolerate. You may find that a better solution for you. There are a variety of teeth whitening options.

This blog is brought to you by New Orleans Cosemtic 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.

 

 

Is Grinding my Teeth No Big Deal?

Posted on by writeradmin.

I mentioned to my dentist that my jaw hurts and I realized that sometimes I clench and grind my jaw. He said it is no big deal and not to worry about it, but my jaw hurts.  Is there anything I can do about it? It seems like a big deal from where I’m sitting.

Tracy

Dear Tracy,

Woman holding her jaw in pain

Grinding your teeth IS a big deal.

The first thing I’m going to say is you need to get a different dentist. This is not only a big deal, it is a HUGE deal. First, the pain you are experiencing alone is enough to do something about it. But, in addition, you are slowly grinding down your teeth. Eventually, you will wear them down to nubs. If that happens, the procedure to deal with that is a full mouth reconstruction. That requires getting a dental crown on every tooth. While proactive treatment will only bring in a couple of hundred dollars. A full-mouth reconstruction is a cost of $30, 000 or more. Plus, you are at a much greater risk to develop TMJ disorder.

There are a few things that can be done to help this. First, you’ll want to get out of pain.  Believe it or not, some Botox can help with this, as well as any migraines you may be experiencing as a result.

The next thing you’ll want to do is protect your teeth. While it is easy enough to notice when you’re grinding your teeth during the day. While you’re sleeping is when most of this likely occurs. I suggest you have a nightguard made. This will protect your teeth from grinding and clenching while you sleep.

However, I don’t think your dentist is the best one to handle this.  I’d like you to see a dentist with TMJ training. They can help get to the root cause of all this and solve the source of the problem.

This isn’t something that is taught in general dental school, so you’ll want a dentist who has invested in post-doctoral training. For instance, Dr. Delaune did advanced training in TMJ Disorder through the well-respected Dawson Academy.

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

Finding a Cosmetic Dentist on Yelp!?

Posted on by writeradmin.

I have chipped a few of my teeth due to teeth grinding. I’m going to get a smile makeover and am thinking of dental bonding because they’re likely less expensive than porcelain veneers. I am aware they take an expert cosmetic dentist. I’ve been going through Yelp! and found two in my area with very high ratings. Is there something else I should be looking for to help me choose between the two?

Jennifer

Dear Jennifer,

before and after dental bonding

It is great that you are trying to do research for you cosmetic dentist but I don’t think Yelp! is the way to go for this particular thing. It is a great resource for finding a decent dentist, but based on the research I’ve done, it doesn’t appear their algorithm judges based on the types of procedures. So they may have a lot of high ratings, but it has nothing to do with their ability to do beautiful cosmetic work. Those high rankings could be simply because they are a friendly office.

Before we go into a better way to find a great cosmetic dentist, though, I want to go over your procedure. You said you wanted a smile makeover which I’m assuming you mean to cover the tooth the way porcelain veneers would. Dental Bonding is much better for small amounts of work, like fixing a chipped tooth (as the images above show).

If you’re looking to cover the tooth the way porcelain veneers do, you will find that it will end up costing you more. Dental bonding is done freehand, which would take forever over larger surfaces. In fact, very few dentists will even do it. So depending on what you’re going for, you may want porcelain veneers.

Whichever procedure you choose, you will need to get a nightguard. This will protect your new dental work from the grinding you do at night. Without that, it will damage your veneers or bonding just like it did your natural teeth.

Choosing Your Cosmetic Dentist

There isn’t a recognized specialty in cosmetic dentistry. That makes it hard for patients to know who is good and who isn’t. One way to help with this is to go to the mynewsmile.com website. This is run by an expert cosmetic dentist who is retired from practice. He screens dentists who want to be listed for their training, technical skill, and artistry. A dentist can’t just pay to get listed on his site.

Any dentist recommended there can give you a gorgeous smile and are among the top cosmetic dentists in the country.

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

What causes receding gumlines

Posted on by writeradmin.

I see that some of my teeth have gumlines that are receding. I’m fairly good at my oral hygiene. I brush twice a day and floss once. What could be causing this? Is there a way to fix it?

Candace

Dear Candace,

Woman covering her mouth with her hands

I’m glad you wrote. I can tell you care about your teeth a great deal and do your best to take care of them. There are a few reasons you could be dealing with receding gums.

  • Gum Disease

If plaque or food gets trapped under your gums, it is not only an irritant but can cause the teeth to become loose. I don’t know who your dentist is but most dentists check for this at each of your cleanings and checkups. Some discount clinics, though, will skip this step. You can call your dentist and ask how your gums looked at your last checkup or just go in for another one.

  • Brushing too Aggressively

If you are super aggressive about brushing and using a hard-bristled toothbrush. I always recommend to use a soft-bristled brush. It does a great job and is safer for your gums.

  • Bruxism

This is when you grind or clench your teeth. This can cause notches on your teeth at the gumline. When that does happen, it will cause your teeth to recede. This is also dangerous for your teeth. A simple nightguard, which your dentist can custom fit to your bite, which will protect your teeth. Without that, you will end up grinding your teeth down to nubs, which will require every tooth in your mouth to be crowned. That is known as a full mouth reconstruction and can cost you up to $60k.

Repairing Receding Gums

There is gum surgery which can be done to repair your gums. Periodontists do the surgery. Some dentists do it as well. A few, including Dr. Delaune, invest in further training to learn the pinhole technique.

Unlike traditional gum grafting surgery, this requires no scalpels or sutures. It’s worth looking into.

This blog is brought to you by New Orleans 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.

Protecting Lumineers

Posted on by writeradmin.

I’m considering getting a smile makeover with Lumineers. Can you tell me how hard they are to take care of?

Marilyn

Dear Marilyn,

Advertisement with Lumineers including a woman smiling and a single veneer being held by a tool

It’s great that you’re getting a smile makeover. However, I want to caution you against choosing the brand. Instead, you should carefully choose the dentist and let them choose the brand.

While some dentists place Lumineers. Others prefer different brands. What you want is an expert cosmetic dentist who knows the pros and cons of each brand and can create a stunning smile for you.

Caring For Your Lumineers

Whatever brand of porcelain veneers you get, there are things that are important for you to know to keep them in great shape.

  • Make sure your hygienist understands cosmetic dentistry: Not all hygienists are familiar with cosmetic work. It is important during your checkup and cleanings that your hygienist doesn’t use anything like a Prophy Jet or acidulated fluoride. Either one of these will damage the glazing and cause your veneers to pick up stains.
  • Keep up with your home care: Being stain-resistant doesn’t mean you can get away with not taking care of your teeth. You’ll have to brush regularly as well as floss. Some dentists recommend you use Supersmile toothpaste, which is specifically designed for cosmetic work.
  • Protect your teeth from grinding: If you grind your teeth, you’ll want to make sure you get a night guard. Consistent grinding can cause your veneers (and natural teeth) to chip. A night guard protects them.

Finding that Expert Cosmetic Dentist

Cosmetic dentistry isn’t a recognized specialty. Because of that, any dentist can call themselves a cosmetic dentist regardless of their skill level. There are countless cosmetic dentistry horror stories by patients who’ve thought they were getting a gorgeous smile with a qualified cosmetic dentist only to leave heartbroken and disappointed with the results.

Because of that, Dr. Hall, who runs the mynewsmile.com website, decided to make a recommended list of skilled cosmetic dentists. He screens them for both technical training as well as their artistry. Anyone he recommends can give you a gorgeous smile you’ll be thrilled to share with the world.

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

does tmj mean surgery?

Posted on by writeradmin.

I’m 27 years old and have been dealing with a significant amount of jaw pain. I did some research online and it sounds like I may have TMJ. Everything I read says the treatments for this are jaw reconstruction or having all your teeth re-made. That sounds terrifying to me. In fact, I’m a little too scared to see a dentist about it in case they say that is what I need. Are there any other options? What happens if I just don’t treat it and just deal with the pain with medications?

Morgan

Dear Morgan,

close up of temporomadibular joint
TMJ disorder has various causes and solutions

Before you panic, let me assure you there are many causes and solutions for TMJ Disorder. As you can see from the image above, your TMJ joint is similar to your knee joint. It has movable parts and a disc which serves as a buffer. There are also lots of muscles that help with the various movements requisite to good jaw function. This is known as the temporomandibular joint (hence the TMJ).

Treatments like full-mouth reconstruction or jaw surgery are for the most severe cases, usually after years of going without treatment or a tragic accident. It doesn’t sound like that is what you’re dealing with.

The first step to any treatment is a diagnosis of what is causing the problem in the first place.

Two Causes for TMJ Disorder

One common cause for this is pressure you’ve put on the jaw joint. This is done through clenching your jaw or grinding your teeth. This often happens without a patient even realizing it because they do it in their sleep.

If you get treatment for this early on, before too much damage is done, there is no invasive treatment. It can often be handled simply by wearing a night guard to protect your teeth and add some cushion to assist with the pressure on your jaw.

Another cause is misalignment of your bite. Our teeth shift over time. It could be that yours have shifted in a way that has caused pressure on your jaw.

In some cases, this can be fixed with orthodontics such as Invisalign. Other, more severe cases, will require a full-mouth reconstruction. This latter treatment can also happen if you don’t get teeth grinding under control and your teeth get worn down to nubs.

Full-Mouth Reconstruction

With this procedure a dentist has to crown all of your teeth. This is either because they are too worn down from grinding or your bite is so far out of alignment this is necessary to repair it.

This is quite an advanced procedure and would require a dentist with significant training in TMJ Disorders as well as cosmetic dentistry.

Look for a dentist who trained at one of the following:

  • Dawson Academy
  • J.D Pankey Institute
  • The Las Vegas Institute of Advanced Dental Studies

This will take care of their TMJ qualifications. To find out if they’re also a great cosmetic dentist, go to the mynewsmile.com website to see if they’re recommended . They pre-screen cosmetic dentists for both their technical skill and artistry.

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

Custom mouthpiece for grinding because of meds?

Posted on by writeradmin.

My dentist is trying to convince me to get this custom-fitted device to sleep with. He says I’m grinding my teeth because of the medicine I take. First, wouldn’t I know if I happened to be grinding my teeth and second, can medicines really make you do that? Does it even matter?

Clark

Dear Clark,

custom-fitted trays
Custome-fitted mouthpiece’s will protect your teeth.

I promise your dentist isn’t trying to pull one over on you. Everything he said is based in fact. Most patients doen’t realize they are grinding their teeth, because it happens at night while they’re sleeping.

The Consequences of Grinding and Clenching

Griding and clenching your teeth is known as bruxism. When you do that habitually, whether intentionally or not, your teeth begin to wear down. In some cases, I’ve seen them worn down to nubs and the patient had to have all their teeth crowned. This is known as a full-mouth reconstruction and is very costly.

In addition to wearing down the teeth, you can also end up chipping or even cracking them . Cracked teeth will also have to be crowned in order to save them.

A nightguard protects your teeth from the force of these motions. Even though you likely won’t be able to stop doing them, your teeth won’t bear the consequences.

Be on the Lookout for TMJ Disorder

With constant motion of your jaw in grinding, you’re in danger of another kind of problem. You could wear down your temporomandibular joint, leading to TMJ disorder.

Here are some symptoms to look out for:

  • Jaw Pain
  • Clicking in the Jaw
  • Migraines, especially in the morning

If any of these pick up, you’ll want to see a dentist who has some special training in TMJ.

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