Mouth Hurts After Full Mouth Reconstruction
I need some help. I went in for a full mouth reconstruction. The temporaries seemed to fit okay. When the lower permanent crowns and bridges were placed, they didn’t meet up well with the upper teeth. In fact, it was causing me some pain. My dentist said that would fix itself after he placed the upper ones. Unfortunately, that didn’t happen. I mentioned that to him and he did some adjustments, but nothing that helped. He said the teeth are fine but it is possible that I’m just adjusting to having the reconstruction. To “put my mind at ease” he gave me the names of two other dentists he knows that would give me a second opinion. I went to see both of them. They both said that everything looked fine. They didn’t even mention that I have teeth on one side that don’t meet together. I’m starting to wonder if they were more interesting in protecting their colleague’s reputation than they were in giving me a honest diagnosis. My jaw hurts all the time, and now I’m getting headaches. I don’t know what to do.
Mario
Dear Mario,
Bear in mind that I haven’t examined you, but I can give you some general advice. If your teeth are not meeting together that is a problem that needs to be fixed. The fact that he gave you two names for second opinions before you even asked about a second opinion is a bit sketchy to me. Whenever I advise people who write us about a dental issue and I think they need a second opinion, I advise them to get a blind second opinion. That means they go to a dentist who is an expert on the procedure, but do not tell them what your prognosis was or the dentist that did the work. The dental world is a small world and you don’t want a dentist torn between their diagnosis and loyalty to a friend.
In your case, you want to see someone who is an expert in TMJ disorder. They will have the training to know how teeth should occlude, which is the term for how they come together to meet when you bite down. They will have the expertise to give you the evaluation you need. I would look for someone who received post-doctoral training from the Spear Institute, the Pankey Institute, or the Dawson Academy. There are others, but any of these should be fine.
This blog is brought to you by a friendly dentist in Moline Dr. Thomas Goebel.
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Are Dentures Causing TMJ?
I’ve been in dentures for about 15 years and it feels like every year my jaw pain feels worse. I went to see a dentist about it and he said that I have TMJ disorder. He thinks it is because of my dentures and recommended that I switch to dental implants. Those are pretty pricey. Is this a legitimate thing or is he just trying to get some money out of a patient with no teeth?
Andrew
Dear Andrew,
I want to preface this by saying that I have not examined you, so the information I provide is more general in nature than specific to your case. It is true that you can develop facial collapse from dentures for a couple of reasons. One would be that your dentist made the dentures in such a way that it threw off the proper alignment of your bite. The would become noticeable fairly quickly. Based on what you described yours came on gradually, so I don’t think that is the case for you.
A second way this can occur is from the onset of facial collapse. When you removed your teeth, your body recognized that. Our bodies are extremely efficient. Realizing that you no longer have any teeth to support in your jaw, it will redistribute the minerals in your jawbone to use elsewhere. This has the unfortunate side effect of shrinking your jawbone. In fact, after ten or more years you will no longer have enough jawbone left to keep your dentures in at all. This is known as facial collapse.
As your jaw shrinks, it will affect the temporomandibular joint. This is what helps your jaw move. When your bite changes, the way this joint functions changes too. This can lead to TMJ problems. You’ve been in dentures for 15 years. My guess is, in addition to the jaw pain that you feel, you are starting to have trouble with the dentures themselves. Maybe they’re sliding more than they used to. Or maybe you can’t even keep them in.
Dental implants can fix that. You will need a bone grafting procedure first in order to build back up the lost structure. After that, you can either get removable dentures again, which will restart the whole cycle of facial collapse, or you can get implant supported dentures.
The implants signal to your body that you still have teeth, therefore it needs to leave your jawbone alone. If you go this direction, make sure your implant dentist also has training and experience teaching TMJ. This is so they have the skills to reframe your bite in a way that it has proper occlusion. This should stop your jaw pain.
This blog is brought to you by compassionate dentist in Moline Dr. Thomas Goebel.