Category Archives: TMJ

Should my crowns touch my other teeth?

Hello,

I have had several crowns, and I was recently fitted for two new crowns. One of them is going to be a porcelain crown and the other gold. The upper rear and adjacent molars are the two teeth that I’m referring to. The end product is leaving a gap of at least one millimeter or so from the bottom teeth which also have crowns on them. I was under the impression that they should touch the opposing teeth. Was this done correctly? I’d like to know because I think I need to have another one done on the other side.

– David in Pennsylvania

David,

To answer your question, yes, a dental crown should touch the opposing tooth. So much goes into the study of how teeth come together. This study is called occlusion and is very in depth. There are many factors that dictate precisely how and where crowned teeth touch.

Another important factor to consider is how the upper and lower teeth come together in regard to how your jaw and bite function. A properly aligned jaw should have all your teeth touching at the same time when you clench your jaw. There are two patterns of occlusion when moving your teeth from side to side. The first is called canine-protected occlusion where only your canine teeth are touching. The canines are designed to handle the additional sideways stress because they have longer tooth roots.

The other pattern of occlusion for side to side movement is called group function. This means that when you grind your teeth sideways, all of the posterior teeth touch evenly because they are sloped similarly.

You may or may not have heard about a test that a dentist can use to check your bite. A thin plastic strip is placed between your back teeth. The strip is very thin, approximately 0.05 millimeters thick. Basically, wherever the strip is placed on the back teeth, you should be able to keep the strip in place while the dentist tries to remove it. Your bite should hold it in place.

Even if your back teeth are touching, they still may not be touching correctly. In turn, this could throw your bite out of alignment. This is serious because it is one of the factors involved with TMJ disorder.

This post is sponsored by Newton, MA cosmetic dentist Ultimate Aesthetics.

Related link: TMJ therapy

Have you heard of a dentist wanting to place a crown on each tooth?

I am an adult that wore braces as a teen. I thought this took care of my misaligned teeth. But the other day the dentist told me that my bite was off and that he wanted to place a porcelain crown on every single tooth. Do you know if this is appropriate? I want a smile that looks nice but this sounds extreme to me.

– Linda in New Jersey

Linda,

That is a very aggressive treatment plan, especially with the dentist stating that your bite is off. If you had a major problem with the way your jaw was functioning, then a full mouth restoration may make sense. It is difficult to interpret what his reference to your bite being off is really addressing without actually seeing your case firsthand. Truthfully, everybody has a bite that is off in some way or another.

That said, TMJ disorder is a very serious condition that can cause your teeth to be worn down, as well as painful headaches. Sometimes when a TMJ dentist is treating this condition, porcelain crowns may be placed on each tooth. But again, a full mouth restoration is extremely complex. If this is the situation you are in, you need to make sure the dentist if very well trained in post-graduate courses in TMJ. There are specialized institutes like the Pankey Institute or the Las Vegas Institute that are nationally known for treating TMJ. Another treatment that is a more of a typical first step is a removable splint to test a new bite alignment. At that point if the problem is not remedied, crowns may be the next step.

It sounds like it may be beneficial to seek the opinion of at least one other dentist, specifically one that is experienced in treating TMJ.

This post is sponsored by Newton MA cosmetic dentist Ultimate Aesthetics.

My dental implant bridge isn’t aligned correctly.

Hello,

I recently had some dental work done to replace four of my bottom right teeth. I ended up having a new implant bridge, using two dental implants. The problem is that when I bite down, it seems like my teeth don’t line up. What I mean by this is that the top and bottom teeth are off when my mouth is closed. Do you know if this is typical?

– Ruth from New Hampshire

Ruth,

From what you described, something is not right. Your teeth should be aligned correctly and naturally. When your mouth is closed, they should come together. If this isn’t taken care of so your bite does close properly, you may end up with TMJ disorder.

Dental implants require a lot of additional training beyond dental school, but implant dentistry is not a recognized specialty within the profession. Unfortunately, this means that any dentist can claim to be an implant dentist.

At this point, you may want to consider a second opinion. When you are researching a dentist’s credentials, there are a few organizations that will help to qualify them; the International Congress of Oral Implantologists, and the American Academy of Implant Dentistry. Their involvement or any special designation, like fellowship or diplomate status is especially impressive within these prestigious organizations.

As far as what happened in your case, it is difficult to make any observation without actually seeing you in person. But it may be that they were placed incorrectly during the surgical phase. Maybe the surgery was done by one dentist, while another did the restoration? Communication can become a stumbling block when multiple dentists are involved.

Best of luck to you.

This post is sponsored by Newton MA dentist Ultimate Aesthetics.

Related link: Dental implant versus dental bridge

My jaw keeps cracking

Since I was little my jaw has always popped and cracked. Now that I’m an adult, it is doing it constantly. Sometimes it feels like my jaw is locking up. It has been recommended that i have my jaw broken to fix it, but that seems a little extreme. Do you have any other suggestion or is that the only course of action?

Caroline from Texas

Caroline,

No, I tend to agree with you and think that is a little too aggressive of a treatment. You have some classic symptoms of TMJ. ┬áThere is a small disc between your lower jawbone and the socket where it fits that slides along with the joint. If it gets out of place, or gets damaged, it can click or pop and sometimes it can interfere with you closing your jaw.I’d recommend that you go see a TMJ dentist. They’ll be able to prescribe a course of action that can repair this problem without breaking your jaw.

This blog is brought to you by Newton, MA TMJ Dentist Dr. Steve Bader.