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Old 10-19-2006, 09:39 AM   #1
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iluvmydog66 HB User
Poorly fitting crown

Can an improperly fitted crown cause pain in the masseter muscle and TMJ? Can it cause spasms or cramping? Thoughts?
I had tooth pain last January - determined I had a hairline fracture on the biting surface that did NOT go below the gumline. Tooth was bonded - did not help. Around same time I began to have discomfort in the TMJ. Tooth was root canaled - caused a lot of pain in the TMJ area. But pain in tooth subsided. Temporary crown fitted - tooth felt better. Can't recall how my jaw felt - this was back in March!

Discomfort in tooth (sensitiviy on sides) has continued and muscle spasms in masseter are almost daily. I have had root canal re-evaulated by 2 Endos - both feel it is a perfect RC and there is NO infection. The crack might have extended but NO evidence of that - and they have looked at tooth under microscope. Been to oral surgeon who says my jaw and the joints are healthy - no arthritis, MRI is normal. I have a nightguard I wear at night to protect my teeth.

Sensitivity in tooth continues and masseter discomfort continues. The crown has never been put in permanently - it is a permanent crown glued with temp cement, it fell of on Tuesday and was off all day long - jaw was not too bad that day. Dentist adjusted the tooth and the crown, said it was sitting high. (This has been done previously a # of times.) She pushed on the tooth and picked at it and I had no pain. When she put it back in I feel pressure. Felt okay that night but then I was miserable yesterday. Pressure on sides of tooth. I continue to struggle with muscular spasms in my TMJ. Esssentially all opinions are that my jaw is healthy and functioning properly - as in range of motion, no locking or cracking. But the spasms need to be addressed.

I also continue to have pain in the tooth. I have had the crown drilled and adjusted about 8 times. The 2nd Endo I saw last week for another opinion said the work on the tooth looks EXCELLENT. She did say that she thinks the crown might be too high and fitted too close to the gum. So when I returned to my regular dentist she knew this cuz they had spoken. She brought the tooth down further and adjusted the crown again BUT did not do anything to the sides near gum. The Endo last week suggested I have a temporary put on to see if maybe it is the fitting of the actual crown. I had this done on Tues night - because the crown had come off earlier that day. The tooth feels great when the crown is off - they are able to push on the tooth and it will not react. But once the crown is put back on I feel initial pressure and then within a few hours the tooth begins to hurt again. The Endo on Monday night said the crown looked high but she was not convinced that it was fitted poorly at the gumline. She thinks it is all due to my clenching.

I saw the chiro last night - who is a miracle worker. She massages and maniplates the massiter muscle - and really makes it feel better. She thinks that the muscle spasms are one thing but might even be spasming due to the pain in my tooth - and she thinks it is the crown that is fitted improperly. She said all my teeth would be bothering me - if the spasm was triggering a nerve or ligament problem (which is my dentist's theory) - and it should not just be in ONE tooth. She said have a new crown made.

Also - all the doctors think I should see a Neurologist but I am hesitant to do so - because I do not think this is a nerve disease! AND I don't know if i want trigger point injections - tho if an injection would stop the spasm I would do it! Neuros (as you know) are costly - I could see one in my plan, but I am still unsure if it is necessary.

I am wearing the hard upper splint at night - and it does help. I wake up feeling okay usually - but then within a few hours the spasms begin and the tooth pain resumes.


I must repeat it is not believed that the root canal failed - just about all the dentists maintain this. And that if I had an infection it would have become far worse and I would not be able to sustain the come and go pain this long.

 
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