Tag Archives: teeth grinding

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.

How Do I Know if I Have TMJ or TMD?

I’m at a loss. I’ve been doing some research and have narrowed it down to two conditions, but I can’t tell the difference between them so don’t know who to see.
Here are my symptoms:

  • Jawpain
  • Headaches
  • Clicking in jaw
  • Teeth have shifted

Do I have TMJ or TMD? Who do I see for it?

Marilyn

Dear Marilyn,

A Chart showing how joints muscles and teeth all work together in TMJ

I understand why you’re confused. These two acronyms are used interchangeably. TMD stands for Temporomandibular Disorder. TMJ stands for Temporomandibular Joint. When the joint is out of alignment, which can happen for several reasons as seen in the chart above, it causes TMD.

Your symptoms are pointing to this disorder, whether you call it TMJ or TMD. You’ll want to see a dentist, but not just any dentist. First, not all dentists treat it because it is so complex. Secondly, some do treat it who shouldn’t. You really want a dentist who’s invested significant training in diagnosing and treating this disorder. As an example, look at Dr. Burba’s TMJ Dentist credentials. This is the type of dentist you want to find in your area.

What to Look for in TMJ Treatment

Because TMJ is so complex, it is imperative your dentist finds the underlying cause of your TMJ in order to begin proper treatment. You also want to start with the least invasive treatment possible. For instance, if it turns out your problem has stemmed from nighttime grinding, the first thing to do is protect your teeth from any further damage.

From there, you can take up repairing the damage. Maybe your teeth are ground down to nubs and you need dental crowns. Or possibly, your teeth have been pushed out of place and you need Invisalign to realign your bite. Maybe you need a combination. The key is a dentist who knows what to look for.

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

Store Bought TMJ Treatment

I’m drowning in medical bills right now and don’t think I can afford a dentist. But, my jaw has locked up. My sister says TMJ does that and that I need an oral device to help. All I know is I can’t even eat. I’ve heard you can use an oral mouthguard to treat TMJ. I saw one at the pharmacy the other day and it was only about $20. I can afford that much. Is there anything I need to know about using it?

Drew A.

Dear Drew,

TMJ Treatment Dentist

Your sister is right on both points. Lock-jaw is often caused by TMJ Disorder. While, the orthotic anterior repositioning splint can be used to treat TMJ, that’s not what you saw at the store. A mouthguard is completely different. They’re used to protect people’s teeth from habitual tooth grinding. If that’s an issue you struggle with, you’ll want a mouthguard after you finish your TMJ treatment. However, the store bought ones aren’t custom fit. They just come in small, medium, or large. You can also find a one size fits all. They’re okay on a temporary basis, but you’ll grind through them rather quickly.

One made by your dentist will be more effective. I know your TMJ is the focus right now, but if you don’t protect your teeth from the grinding there are serious consequences. Not only does the grinding aggravate your TMJ, but it can lead to cracked teeth or even teeth coming loose and needing to be replaced. Best case scenario, they end up ground down to nubs and all need to be crowned. Talk about expensive!

But, back to your current issue. Here’s what I’d like you to do in the immediate so we can try to get the swelling down and get you eating again. I’d like you to take 800 mg. of ibuprofen about three times a day. In addition, you need to alternate heat and ice packs. Wear them for about ten minutes at a time, a few times a day as you’re able.

You will need to see a dentist to get the appropriate treatment. I know you’re buried in medical bills right now. Many dentists are compassionate and would be willing to work with you on payments so you can get the treatment you need right away and pay it out later.

Even if you can’t find one willing to work you, Care Credit is a fantastic option. It’s a medical “credit card”, but they let you choose your terms.

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

Diet or Dentist For TMJ?

I feel a little foolish asking this question but I’m wondering if TMJ can be a diet related problem? I have horrible jaw and head pain, especially in the mornings. My closest friend truly believes that if I switch to a whole foods diet it will be taken care of. Even as I type it, it seems like a stupid idea. However, I’ll have to admit my friend is a lot healthier than I am. So maybe there is something to what she has to say.  Do I need a dentist or a diet change?

Lucia M.

Dear Lucia,

There is one aspect of TMJ which can be diet related, but one only. Chewing. TMJ is a disorder of the temporomandibular joint.  Changing your diet won’t repair the joint. However, if you’re eating things such as raw carrots and apples it could be adding stress to the joint. It might be a good idea to lay off the hard and chewy foods while your dentist gets to the cause of your problem.

Your symptoms sort of sound like the cause could be teeth grinding. You wouldn’t necessarily even know you’re doing it if it’s happening while you’re asleep.

If that’s the cause, a simple mouthguard could be just the solution for you. Your dentist can custom design one to fit comfortably in your mouth while you sleep. If you start to grind your teeth, the mouthguard will absorb the pressure, protecting your teeth and your joint.

This will also protect your teeth from damage. The grinding can cause your teeth to become loose or cracked, causing you to need a dental crown.

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

I’ve had some degree of dental anxiety ever since I was a child, but I did a fair job of keeping up with appointments until I was in my early 20s. At that point, I was having some minor jaw pain and the doctor also found a couple of cavities that needed to be filled. He knew about the jaw pain, but told me there wasn’t any cause for concern over it. He felt it was related to grinding at night. My experience with the fillings, however, was horrific. He must have made me keep my mouth open for about two hours straight. It hurt so bad and I kept telling him I needed a break, but he kept going and telling me it would only be a minute or two more. By the end of it, tears were streaming down my face and he basically told me I was acting like a child. It really hurt! I couldn’t eat normally for weeks after that and I haven’t been back since. Now, I know my teeth have some issues going on, but my jaw pain is really flaring up again too. I think I should see a TMJ dentist for that, but where do I go first? Can he treat me before I get my cavities filled, so I can get through the treatment or do I need to start with my teeth and then address my jaw? I don’t think I can do more fillings before fixing my jaw pain.

Marie E. – Pittsburg

Dear Marie,

See the TMJ dentist first. It sounds like you’re already familiar with how one can help you. A TMJ dentist can address the root cause of your jaw pain and hopefully get it to settle down so you can be comfortable getting your other dental needs seen to.

With that said, something about what you said jumped out. You mentioned that your prior dentist said you grind your teeth at night and that’s what was causing your jaw pain. If this is the case, getting a simple night guard made might be all you need to address the sore jaw. Undoubtedly, the TMJ dentist will discuss this with you if you’re a good candidate for one. However, what’s striking is that your prior doctor didn’t mention this. It was cause for concern and should have been treated back then.

Continuous grinding not only strains your jaw and muscles, but wears down your teeth. If wouldn’t be too surprising to find that you’ve weakened the biting surface of your teeth enough that they’re either sensitive or highly susceptible to decay. In extreme circumstances, you can wear them down enough or crack them so that they’ll require crowns, but most of the time fillings can repair the damage.

Although this doesn’t matter in terms of getting you out of immediate pain, you may want to keep this in mind for when you go in for a full diagnosis. It’s not the end of the world by any means. You’re on the right path and will get your dental concerns addressed, but it could take some time to restore the damage that’s occurred over years of grinding. Best of luck to you.

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

Could a crown make TMJ worse?

I’ve been diagnosed with TMJ. My dentist suggested a night guard, which I’ve resisted, mostly because the TMJ only bothers me for a short time in the morning.  I recently got a dental crown.  It’s hitting the tooth above it way before my other teeth do, which is uncomfortable. I’ve mentioned it to my dentist and he said he could grind it down or try to adjust it. But, I’ve also having a much more difficult time with my TMJ. The pain has gotten worse. Could that also be from this crown? Should I let my dentist ground it?

Sylvia M. – New Jersey

Sylvia,

I’d like you to take a step back from this dentist and get a second opinion on your crown. Understanding how bites come together properly takes a significant amount of study and training.

Without the bite properly aligned, it could significantly increase your TMJ symptoms. Just grinding it down won’t help and could hurt the crown.

I’d like you to get a second dentist to look at this crown before moving forward.

Also, it will be important to get that night guard, if you truly do have TMJ. It will protect your teeth from nighttime grinding, that you may not even realize you’re doing.

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

If you grind your teeth, your mouth is NOT fine

I had a check up. I told my dentist that I’ve been having some pain in my teeth/gums. It’s kind of a low-value pain (say on a scale from 1-10 being about a 4 0r 5), but it feels like someone is grabbing my tooth and then letting go. He checked me over and even did some x-rays. He said it looks like I grind my teeth, but I have no cavities or anything and my mouth looks fine. What could be the cause of the pain?

Jen H. – Milwaukee

Jen,

Regardless of what your dentist says, if you grind your teeth everything is absolutely not fine. In fact, the grinding issue needs to be addressed. It’s obvious your dentist is just a cavity / filling type of dentist. However, there are some other dental issues that need to be addressed in your case, such as the strong possibility you have gum disease, TMJ, and possibly occlusion issues.  Some of these can be quite serious. Do not allow your dentist to brush this off.

You’ll have to bear in mind that I haven’t actually examined you and can only just make educated guesses from your descriptions. The pain could be from progressive gum disease or from your grinding. If either are left untreated you will lose your teeth. If it’s gum disease, your teeth will come loose and fall out. If it’s from the grinding, you will literally grind your teeth down to nubs. Additionally, this can lead to some serious TMJ issues.

If you treat this conditions early, it will be a lot simpler and a lot less expensive.  For gum disease, your dentist will have you come in for some extra cleanings. He’ll probably prescribe some fluoride to you as well.  He may suggest some other things as well, depending on the severity of your case.

Even if gum disease is what is causing your pain, you need to address the grinding. The simplest solution is to wear a night guard. If there are some other occlusal issues, some additional treatment might be necessary.

I don’t think your dentist is qualified to address your grinding/tmj issues. I strongly recommend you find a dentist with specific TMJ training. Look for someone who was trained with either the LVI, Dawson Academy, or Spear.

This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.

Medications causing teeth grinding

I was just told by someone that my parkinsons medication could be causing me to grind my teeth. Is this true? If so, how would I know if I’m doing it?

Brandon L.- Lubbock, TX

Brandon,

Yes, some Parkinson’s medications can lead to teeth grinding.  Are you taking Sinement CR Oral, Atapryl, Carbex, or Selegiline? These are some of the culprits. There are also some anti-depression and dementia medications that can cause the same problem. However, by far, the largest contributor to teeth grinding are stress, anxiety, or anger.

Symptoms of Teeth Grinding:

  • Aches in your jaw
  • Breaking or Cracking Teeth
  • Teeth Wear
  • A clicking sound in your jaw
  • Gum Recession
  • Headaches/migraines
  • Ear Aches
  • Teeth that are worn down

If you have any of these symptoms, I would look for a dentist who has experience treating TMJ disorder. He can design a custom fitting night guard for you that will protect you from the effects of grinding your teeth.

This blog is brought to you by Boston Cosmetic Dentist Dr. Randall Burba.

My teeth are nubs

I have severe bruxism and maloclussion. As a result my teeth have been ground practically down to nubs, though otherwise healthy. My dentist hasn’t done much to help me with this, except give me a mouthguard. However, the condition of my mouth really bothers me. Is it best for me just to pull them all and get dentures? I want a normal looking smile, where it is easy for me to eat. It’s a shame I’m dealing with this at 40 years old.

Steve G. from Minnesotta

Steve,

Bear in mind everything I am saying is without having examined you myself.

This would have been easier to treat in the beginning. If you’ve known about the TMJ issues, have you been to a TMJ dentist? I’d be  hardpressed to call them a competent one if all they did was give you a mouthguard.

I don’t think dentures at 40 is a good idea. In 10 to 20 years you’ll be dealing with facial collapse and won’t even be able to wear your dentures anymore. Even without that serious issue, rarely do denture patients feel like they have an “easy” way to eat.

It is always ideal to save your own teeth when possible. As you’ve said yours are otherwise healthy, though worn down, you might consider getting a full set of porcelain crowns. However, you must go to an experienced, well trained TMJ dentist. There are so many factors to consider when doing a case of your magnitude.

If you ever do get to the point when you do have to remove your teeth, than I recommend you get dental implants instead of dentures. That will protect your from getting facial collapse, and you’ll be able to eat normally.

This blog is brought to you by Boston Cosmetic Dentist Dr. Randall Burba.