Can a Dental Crown Cause TMJ

I’ve had a problem over the last month of my jaw aching, especially in the morning. I’ve been under some stress and have caught myself tensing my jaw some throughout the day. Then, I got a dental crown. It’s made the pain so much worse. I went back to the dentist…several times. He’s adjusted it several times, but the pain never seems to go away now, plus, it’s always hitting my other teeth before the others. Could this be causing TMJ?

Beatrice

Dear Beatrice,

Woman holding her jaw in pain

Yes, a poorly placed crown can certainly cause or exacerbate existing TMJ problems. There is a lot that goes into understanding how the bite should go together. Some dentists invest more time and training in that area than others. You may have a dentist who doesn’t invest much in it.

The fact that your teeth are not meeting uniformly is a cause of concern and he should know that. Some dentists who have trouble getting it right will just adjust and adjust until the patient is too embarrassed to keep complaining and drop it. This needs to be fixed.

The fact that your jaw had already had some minor pain and you’d noticed some clenching during the day worries me too. If you notice clenching during the day, you almost certainly are doing it at night as well. You should be wearing a nightguard. They’re custom fit to your bite and comfortable. Their function is to protect your teeth and jaw from the pressures of clenching and grinding.

Finding a TMJ Dentist

It doesn’t sound like your dentist is going to deal with this properly, so you need to see one who understands TMJ. While there isn’t a recognized TMJ Specialty, there are ways to know if a dentist has a good knowledge of the condition.

You’ll want to especially look at their post-graduate training. Don’t feel weird asking them about it. It’s important knowledge for you in choosing the right dentist. For instance, Dr. Stanley Burba invested significant training on TMJ Disorder. He’s studied at both the Spear Institute and the Dawson Academy.

Some other great centers are the Kois Center and the Las Vegas Institute for Advanced Dental Studies (LVI). If a dentist has trained at any of these institutes, they’re sure to be able to help you.

Additionally, if it turns out that your dental crown isn’t properly placed the new dentist can help you get a refund from your current dentist.

This blog is brought to you by Dr. Randall Burba.

Replacing all Crowns because of One?

I had crowns placed on all my front teeth about 17 years ago. Since then, my dentist passed away. I’ve been happy with his replacement, up until now. One of my porcelain crowns started to feel loose. I looked at it closely and there’s a dark spot on the top edge. I went to see the dentist. He said there’s decay at the edge and the crown needs to be replaced. But, (and here’s the catch) he says I have to replace all of them if I want them to match. That’s a LOT of money. Is that really necessary or can I wait until they need replacing individually?

Mara Lynn

Dear Mara Lynn,

Side by Side images of dental crowns done by two different cosmetic dentists on the same smile. One is ugly. One is beautiful

Believe it or not, the images above are of the same smile. In both pictures the patient had dental crowns placed. The only difference was the quality of the cosmetic dentist she used. I’m guessing your current dentist is more like the one on the left. He’s not a cosmetic-oriented practice, therefore his skill is limited.

It sounds like the margins on your porcelain crown opened, leaving a little ledge ideal for the development of decay. At the very least, the one with the decay needs to be replaced.

When your current dentist says your crowns won’t match if he doesn’t re-do all of them at the same time, he not lying to you. He’s admitting the limitations of his skill. In this case, you have two choices.

Choosing a Cosmetic Dentist to Re-do Your Smile

  • Just replace the crowns as needed to save money.

You’ll definitely need a new cosmetic dentist in order to do it this way. A good cosmetic dentist CAN just match one crown to the rest of your teeth. They won’t need to do the entire arch. The first thing I’d do, though, is check all the crowns for suspicious marks and open margins. You’ll want to replace any of those at this go-round before they turn into decay. After that, it’s fine to just change them as you need to.

  • Replace them all at once to save time

Even though this is what your dentist suggested, he did it for the wrong reasons— to cover his lack of cosmetic skill. Because of that, I’m not sure you’d be happy with his results. I believe you’d be better served with another dentist in this case as well.

The top cosmetic dentists in the country are those who’ve reached the accreditation level of the American Academy of Cosmetic Dentistry (AACD). AACD accredited dentists create beautiful smiles. In fact, most of them even have a beautiful smile guarantee.

On a side note, you’ll be much more comfortable using sedation dentistry to have that much work done in one sitting. You can simply go to sleep (if you want to) and when you wake up all the work is done.

This blog is brought to you by Dr. Randall Burba.

Press-on Veneers versus Cosmetic Dentist

I don’t have a very good cosmetic dentist. He’s great for a lot of general dental work, but even he admits his cosmetic work needs work of a different kind. I appreciate his honesty but it leaves me in kind of a bind. I want to get porcelain veneers. He said he’s fine with me going to another, more experienced cosmetic dentist for that particular procedure. He even recommended someone he said was AACD accredited. He said that’s a huge deal. Not sure why. Anyway, I went to the AACD guy and had a free consultation. He was nice and I could tell by his picture gallery of patients that he does great work, but his prices were through the roof. Today I saw this website for press-on porcelain veneers. The pictures looked pretty to me and they were A LOT less expensive than the guy my dentist recommended. Do you know about these press ons? Are they really as good as the ones by a cosmetic dentist?

Veronica M.

Dear Veronica,

A single porcelain veneer being held up by a dental instrument

First, I really appreciate the honesty of your dentist. Some, less caring practitioners might be tempted to just do their “best” porcelain veneers knowing they’d be subpar but wanting the practice or the money. Instead, he was forthright and even suggested another, more qualified, dentist.

Not just that, he was careful to recommend an accredited dentist with the American Academy of Cosmetic Dentistry (AACD). These are the top 1% of cosmetic dentists in the world. Yes, their prices are sometimes a bit higher (though not always). That’s usually because they’re so skilled and artistic that they’re in high demand with patients wanting cosmetic procedures, such as porcelain veneers. In fact, there are people who travel across the country or even from other countries to have their work done by them.

If you went to one of them you would definitely get a stunning smile. Probably every one of them has some form of a beautiful smile guarantee.

Porcelain Veneers versus Press-on Veneers

The press-on veneers you saw on that website are completely different from the veneers you’d get from a skilled, artistic cosmetic dentist. They’re more similar to what you’d get with a snap-on smile. They’re made from a composite resin and just press over your teeth temporarily. While they may look great for a photo shoot, they do not look nearly as stunning or natural in person.

Because the press-ons fit over your teeth, instead of being custom made and bonded to your teeth, they tend to come off a bit bulky and a little long. It can make it difficult for patients to speak when they’re in.

There are some procedures you can shop around and cut corners on. Teeth whitening is one example. It doesn’t really matter which dentist does that procedure. It’s fairly straightforward. Going for the cheapest dentist, in that case, will do no harm. Veneers are different. They require expertise in both technique and artistry.

If you want a true smile makeover, it’s an investment that will last a lifetime, giving you stronger confidence than you’d imagine.

This blog is brought to you by Dr. Randall Burba.

Will I Have to Have Surgery for Dentures?

I’m trying to figure out whether or not to get dentures or dental implants. I hate the idea of surgery so was leaning toward dentures. But, wonder if they require surgery too.

Jack B.

Dear Jack,

An illustration of both a denture and a dental implant

I think when it comes to deciding between two procedures, I’d first look at the long-term effects. Once you know how they’ll affect your quality of life, then you can weigh that against placement procedures.

Dentures Versus Dental Implants

Dentures are a removable tooth replacement option. The top arch stays in by suction. The bottom arch sits on the ridge of your jawbone. They have several “downsides” but I’ll just give the biggest. Once your teeth are removed, your body will reabsorb the minerals once used by your jawbone to help you keep the roots of your teeth in place. Without those minerals, your jawbone will begin to shrink. After a while, you’ll lose so much bone that you won’t have enough to keep in your dentures. This is known as facial collapse because of the way it makes your face look shrunken and prune-like.

Dental Implants are permanent. Prosthetic root forms, either titanium or zirconia, will be surgically implanted into your jawbone. After a period of healing you’ll have dental crowns placed on top. Aside from the obvious benefits of being just like having your natural, healthy teeth back, implants preserve your jawbone. No matter how many years you have them, they’ll protect you from facial collapse.

Surgery for Dentures

While dentures don’t require the same surgery as dental implants, you are talking about a major extraction. You have to extract all your teeth. This, like dental implants, also requires a healing period of 8 weeks or so.

There are two types of dentures you can get that affect the surgery.

Immediate dentures These are placed right after the teeth are extracted, having two benefits. First, you can walk out the office with your new smile intact. Second, it helps reduce the swelling and bleeding that occurs after having a major teeth extraction. The downside is they’re usually more expensive than conventional dentures because they take more time to make. You’re also required to have more follow-up visits, which are necessary to make adjustments.

Conventional Dentures These require you wait for about eight weeks after the extraction procedure for placement. However, they do tend to fit better than immediate dentures. During the healing process, your tissue will shrink and the immediate dentures will become loose. To aid with that, a soft temporary reline material is placed on the denture for refitting. It takes about six months for your month to completely heal after the extractions and at this time a more permanent reline or new denture is needed.

As you can see, either procedure requires extensive work. So, as I mentioned earlier, ask yourself which one has the best quality of life experience after they’re placed. The answer to that is definitely dental implants.

This blog is brought to you by Dr. Randall Burba.