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Can a Long Dental Appointment Give You TMJ Disorder?

I had a rather long dental appointment. Four of my upper teeth were prepared for dental crowns and the rest were prepared for porcelain veneers. I’ve got my temporaries now. While I like the way they look, my jaw really hurts. The appointment was three days ago and I’m still needing to take pain relievers twice a day. My dentist is on vacation. I don’t know if I should just wait this out or if this is a sign that I’ve developed TMJ Disorder and need to find a dentist who is available. Any advice?

Molly

Dear Molly,

TMJ Disorder can be aggravated by a long dental procedure, but won’t develop because of one unless there was some trauma to your jaw. You did not mention anything unusual about the appointment. Four crowns along with porcelain veneer prep is a lot of work to have done at once. I’m not surprised that your jaw is hurting.

My suggestion is for you to take the following steps, some of which you are already doing.

Continue taking your anti-inflammatories.
Throughout your day, take notice as to whether or not you are clenching your jaw. Most people do not notice when they are doing it and clenching will not only prolong but even increase your jaw pain.
A cold compress will help reduce swelling, if there is any; a warm compress will relax strained muscles and increase blood flow. You can switch between them as needed.

If, after a week, you are still struggling that would be the time to call your dentist to determine if further evaluation is necessary. In all likelihood, you’ll feel better in a day or two. It’s never fun to hurt so I understand the desire for it to just go away.

This blog is brought to you by Agua Prieta Dentist Dr. Tostado.

This Full-Mouth Reconstruction is Going Badly

I have been going to my dentist to fix my teeth. He’s doing crowns on every single tooth. I wasn’t convinced this was necessary because this whole thing stemmed from me mentioning my morning headaches. He said its probably from TMJ, then before I knew what was happening this was scheduled. I feel like everything is spiraling out of control. What has me worried at this point is the temporary teeth. My jaw hurts so much. On one side of my mouth the teeth don’t touch at all. The other side feels swollen, like the teeth are touching too soon. I pointed this out to my dentist and he said this first fitting is just to make sure the crowns fit in my mouth. The touching comes with the permanent ones. I know I am not a dentist, but this just doesn’t seem right to me. Do I go through with this? Though, now that I ask the question I’m wondering if I even have a choice. The real teeth are already ground down.

Casey

Dear Casey,

Please do not let this dentist bond the permanent crowns on you until the temporary crowns fit you perfectly. The permanent crowns are modeled after the temporaries, so nothing will be different. If he does not agree to that, tell him you are going to finish this procedure out with another dentist. When crowns are done properly, you won’t notice them at all. How your teeth meet together is called occlusion. Both sides should meet together at the same time. I’m worried your dentist is in over his head.

When it comes to TMJ treatment, generally a full-mouth reconstruction is a last resort sort of treatment when all other less invasive treatments have been unsuccessful. Based on what you wrote above, it doesn’t sound like he even tried other solutions.

I’d like you to look for someone with extensive post-doctoral training in reconstructive procedures such as dental implants, crowns, and TMJ. This is one of the most advanced procedures a dentist can do and I’m not convinced yours can.

If you do decide you need to go to a different dentist, you do not have to start from scratch. Your dentist is ethically obligated to provide all the diagnostics and notes on your treatment with whomever you choose to continue the care.

This blog is brought to you by Douglas, AZ Dentist Dr. Tostado.