I have a erupted/higher wisdom teeth that resulted from a splint that didn't cover my wisdom teeth...and a open bite as well......
I have read your post awhile back that you had occlusal equilibration done on your teeth and that the results were not done properly....you had to get crowns evenually because so much of your tooth was ground off. You said also that equilibration is only as good as the dentist.....
So, I would like to ask you...why did you need equilibration done? How was the equilibration done? Can you give me any suggestions or advice on how I can protect myself from a equilibration that might be done incorrectly/poorly?
I would like to hear from you....thanks in advance.
I don't know quite what to tell you. I had equilibration from my general dentist of many years. My bite was off. I didn't know why. He didn't either, but ground my teeth down trying to get a better bite. Because he hadn't established the cause, he really messed things up. It cost me a lot of money and a lot of distress.
My question to you is did the dentist who fitted you with a splint know that the wisdom tooth would supra-erupt? Did he want it to happen? If he didn't know it was going to happen and hadn't planned on it, I don't think I would let him do more work on my teeth. I found a new dentist. Before I had equilibration done, I would want to know all the why's and how' s and I would want to know if there were any other alternatives. Then I would have to really have confidence in the dentist. A second opinion might be in order. However, when you get a second opinion, go to someone who has no connection with your present dentist--preferably someone outside of your geographical area.
I can see why things got messed up with your bite after the equilibration....your dentist couldn't figure out the cause of your bite being off. That was the problem.
My old dentist didn't make the splint that has caused my super-eruption....it was the family general dentist who made it....but the old dentist didn't make any attempts to change that splint or make a new one for me, to make it cover all my teeth. He figured it was ok for me to continue wearing it....but he was wrong about that. I now have a problem with that higher tooth, which in turn caused my bite to change to a open bite....it has worsen my tmj condition. I now have a new dentist who first noticed the cause of my situation. He has already figured the why's and the how's of my condition....and I am quite confident of his ability to correct this. He said I had two choices...one is to grind that tooth down later on when the time is right or to have the wisdom teeth remove. We both agree that we will try the grinding. But what I need to know is....can he give me a guarantee that the equilibration will be successful...how am I going to know if he is really good at this or what? I don't want to end up having that tooth grounded too much and find that I need a crown for it.
I believe the dentist and I have already established the cause of my case....it's just that I need more information on this equilibration stuff. I just want to make sure that when the time does come to get it done...that I am making the right decision for me.
So, I guess I will have to ask him a thousand questions about this, before he touches my teeth.
I hope you don't mind me jumping in here. I cringe everytime I hear someone say equilibration.
I've been to 13 dentists, not one who was able to diagnose my TMJD. One of the dentists was a very well respected prosthedontist here. He wanted to grind down my wisdom teeth. When he took impressions and discussed them with me, it wasn't just a simple grinding. It turned out to be a major job, which he never called equilibration, but I realize now that's what he was suggesting. Thankfully, I didn't do it. I hate to think what horrible state I'd be in now. Much worse than I am.
Like GenDen said, it really depends on the dentist, and I don't think there's any real way of knowing who will do an excellent job and who won't. Also, grinding down the tooth may not solve your problems. The last dentist I saw did some changes to one of my wisdoms and a molar or two. It changed my bite, but the new bite still wasn't right. With each change, I could feel my facial muscles moving around or tightening up. But no changes gave me a good bite.
I'll likely get a permanent splint. This will have a good bite built into it. Maybe a few years down the road, I'll opt for restorative work, but I'm so distrustful of dentists and realize how easy it is for something to go wrong, that I don't want them working on my teeth if I can help it.
Anyway, that's just my opinion. I wish you the best of luck with whatever you decide.
Hi Sandra, Arleen and GenDen...
I'm still trying to figure out if I'm at risk for this supra eruption due to the fact that my left wisdom tooth did not make it into my splint mold since my mouth is very crowded back there!
Here's a short definition that explains why supra eruption may occur...
"Supra-eruption occurs when a tooth continues to grow out of the gum if the opposing tooth in the opposite jaw is missing. Treatment involves placing a tooth in the missing space and adjusting the height of the supra-erupted tooth"
What I'm wondering is this... on my right side, I have had the bottom wisdom tooth removed (10 years ago). Why hasn't the top right tooth supra erupted
since it doesn't contact any tooth beneath it??
I'm getting paranoid about the other side...given the splint I have in is worn 24/7 (now for about 6 weeks). When I do remove it - I am sensing the top right wisdom tooth feels long and hits before the other molars. Not sure if I'm imagining this - or it's just the new bite I'm sensing.
I still need to confer with my tmj dentist about all this, but thought I might try to get an understanding before I do. Wouldn't everyone who has a single wisdom tooth pulled (say due to infection) have this supra eruption as an outcome??
You should make sure that your dentist is trained in
equilibration before you get it done. If he determined your bite is off then he should proceed with reshaping your teeth but he shouldn't take off a lot of the tooth
Equilibration has helped me to achieve a more stable bite
on my back teeth. but I still have an open bite to contend with on my front teeth.
Arleen...you said that grinding down the tooth may not solve my problem. But since my dentist and I both agree what caused my tooth to erupted in the first place....that grinding it should even out the bite and change my open bite to a proper bite? Isn't that the goal for my situation? So, I would think it would work for me.....but I need to be sure first before I do anything to my teeth.
Now, you did say that your dentist made some changes to one of your wisdom teeth and the other molars.....so, what caused your bite to be off in the first place? The changes made on your bite didn't give you a good bite....what do you mean by that? Do you mean that your tmjd condition remained the same as before....did you have some relief from your tmjd symptoms since your bite was changed by your dentist?
Thanks for sharing your information....it's something I can mush on.
I would like to hear from you again regarding my questions....
I agree with you that you better discuss this issue with your dentist regarding your splint....the information you mention here about how super-eruptions do get started is very interesting....tell your dentist about this information you have found here...and see what he says. I don't have any thoughts or input regarding this super-eruption stuff because this is all kind of new to me....except what I know may have happened in my case.....but I want to be very sure that my dentist is 100% positive of what caused my situation and what can be done to correct it. That's my concern wait now....
I know you still have concerns about where you are regarding your splint......so, for your sake, speak up to your dentist and make your concerns known to him.
You have a good day....and wish you the best....
Thank you for that information....
I will discuss with my dentist about who will do the equilibration on my teeth, and how it will be done....
You said that your bite was equilibrated and helped you to stable bite, but that you still have a open bite (front teeth)? It was your dentist's goal to get you a more stable bite and then in turn, that will change your open bite to a normal one? What was the cause of your bad bite in the first place?
I would like to hear from you again....take care.
Thanks to all of you...
[This message has been edited by sandra1 (edited 09-05-2003).]
Equilibration was done on my back teeth,
however, I have an open bite on the front teeth
which couldn't be fixed with equilibration because these teeth do not touch. So I have a splint that snaps on my front teeth which has a plastic "shelf" underneath my
front teeth which helps to stabilize my front teeth so they touch.
My lower jaw moved into an uncomfortable position, pulling my front teeth out, and that is what caused my open bite.
The way my tmj dentist describes it is that when you bite down all of your teeth, both front and back should touch equally all around.
I hope you don't mind me asking, but I want to be clear on your situation. The equilibration that was done on your back teeth....I assume you are talking about your wisdom teeth....were they higher than the other teeth? If they were higher than the others, what caused your wisdoms to get higher?
It's hard to know if grinding your wisdom tooth will help or not. All I can tell you is that it didn't make much difference in my situation. But in my situation, no one should have adjusted my teeth. With TMJD, first thing is to stabilize the jaw and get the muscles relaxed. Once everything's had time to fall into place and heal, then you consider bite changes, if warranted. I don't know if your jaw has been stabilized. If not, grinding teeth may not be the best thing to do.
I hadn't been diagnosed with TMJD when my bite was adjusted (the dentist missed it entirely). Pre-TMJD my bite was perfect and my teeth were midline. They're currently quite a bit off. So the dentist I saw, instead of noticing that and trying to ascertain the cause, tried to file the teeth to correct the problem. She did very small changes over 4 or 5 appts, and with each change, I could feel my facial muscles shift, and my bite change, but none of it was good. My teeth don't fit into each other any better than they did before these adjustments were made. Only thing now, is that once I get an orthotic and everything is stable, I will likely need reconstructive work to correct the damage this dentist did by grinding my teeth. I have had no relief from having this done, with one exception. One of the fillings that started this process always seemed a bit high to me. That was adjusted every so slightly and it reduced the tooth and gum pain I felt in that area. Bite is still a mess.
I don't know for sure what caused my bite to be off. I had 2 fillings replaced almost 2 years ago. One side I was given a novacaine injection. When the novacaine wore off several hours later, my bite was completely off. None of my teeth fit properly and the front ones slammed into each other. It's hard to explain. Initially, I thought the dentist had done the fillings too low, as my right side upper teeth felt like they had no support from the bottom ones.
One dentist said he thought having my mouth open so long for the fillings may have put my muscles into spasm and they should go back to normal within 6 weeks. I couldn't relax my mouth or my front teeth would push hard against each other, so there was no way my muscles could relax. A recent dentist I saw for a consult said maybe I popped a condyle during that initial appt (I'd never heard this expression before, and who knows?).
One dentists made me an upper nightguard that didn't include my wisdoms. When I saw a prosthedontist a while later, he wanted to grind my wisdoms down, and do adjustments to a number of the other teeth as well. He didn't use the word "erupted" but said my bottom wisdoms are too high because of that nightguard. I almost let him adjust everything, but changed my mind at the last minute. Then I got thinking and went back to the first nightguard (a lower) I'd had made not longer after having the 2 fillings. I discovered my lower wisdoms were high at that point, so obviously the upper nightguard hadn't done anything to them. I examined my mouth, and found that my upper wisdoms are a touch higher than my upper molars. They've probably always been that way. I know each case is different, all I'm saying to you is to be careful. I just don't want anything bad to happen. But you know your history, and the state of your mouth and jaw, and how your TMJD is doing, so I'm sure you'll make an informed decision and do what's right for you.
I don't know if I've explained any of that clearly, but if there's anything else you need to know, ask away.
My jaw has not been stablized since last November. Before that, I was doing fine managing my tmjd, until I had the second splint that caused this setback. My new dentist and I both agree it was the splint that was giving me the problems in my tmjd. So, now I am wearing a new splint that covers all my teeth. So far, I am not having any problems with it...its seems ok. I will be going to my dentist again for adjustment this week, so I will be asking him alot more questions about my situation , regarding the possible grinding of that higher wisdom teeth. He mentioned before, he wants my jaw to settle down first,and then he can do some work on that teeth, if he sees fit. I am ok with that suggestion, except that....I just need to know for sure if grinding that tooth will help my tmjd to calm down( jaw tension), if it will help my situation. I just don't want anybody touching my teeth(grinding) until I know that my jaw is stablized first and know that it's the right thing for me to have done. So far, I have not heard any good reports regarding equilibration....so I am just wondering....is equilibration generally a safe and successful procedure, if it is done properly and done at the right time? And in what situations or cases are they successful?
If you can't answer these questions.....it's ok with me....we are not doctors here.
Thank you so much for taking your time in sharing your story, and your concerns....thank you for listening....
It's good that you're asking a lot of questions. I wish I had all the answers for you.
First you need to get your jaw stabilized. I'm curious why you had a second splint if your jaw was already stabilized. Also, how long had it been stabilized? Was the first splint a stabilizing one, and the second a repositioning one?
If it were me, I'd wait at least 2-3 months, if not longer, to ensure my jaw was stabilized. I'm no expert, and I haven't been through the process yet, but get the sense it takes some people much longer for everything to fall into place. It depends what your TMJD problems are to begin with. You might want to ask him what happens if he grinds it and it throws you bite, or your jaw off again? How will he correct this?
Just out of curiosity, what type of dentist is he? It sounds like he'd do this work after you're out of a splint. If that's correct, ask him how he measures how much should be taken off? Does he do impressions, or other measurements? Will doing this require other teeth to be adjusted?
The prosthedontist I saw made it sound like nothing at my first appointment - just a little off the back. Then he did impressions and when I went for my second appt - WOW. My impressions had red marks all over them. We'll probably be taking a bunch off the wisdoms. This "may" make them sensitive. If they become sensitive, you'll likely need caps on them. I concerns me to think of having perfectly healthy teeth grinded AND capped! I don't mean to scare you. I just want you to be as thorough as possible in asking questions, just based on my experience. In my case, what was presented as a little bit off turned out to me a whole mouth adjustment.
When I go through the splint process, I'll probably opt for a permanent splint. It should give me a good bite without damaging my teeth.
Good luck, Sandi. It's a lot to think about.
I had the tmjd for 10 years which I believe was caused by a whiplash injury 10 years previous. I had the first splint which was a stabilizing type...worn that for 10 years. My jaw settled down about 2 or 3 years after starting this treatment. So, I don't really know what the definition of "stablized" means when it comes to tmjd...because everybody responds differently according to their type of tmjd. My just settle down in the "jaw tension" area or spasms. It was managed ok at about a 3 or 4 out of 10 pain level...a more comfortable level that I could live with. I think it was the best I could hope for in my situation because of the nature of the injury (whiplash). Then my old tmjd dentist took over my first tmjd dentist's practice ( he had to moved to the states). He told me I needed a new splint because my first one was getting abit tired. He also recommended braces for me at that time. My jaw was still managed ok then. It was after wearing a new second splint(stablizling) that didn't cover my wisdoms that my jaw acted up again....jaw tension, inflammation, etc.
My new dentist I have now is one of the top orthodontists in the area. He treats tmjd patients ( about 30 % is tmjd related) but not as much as my old tmjd dentist. But I feel my orthodontist knows more about the tmjd stuff than the old one.
I don't think the orthodontist will be doing the actual dental work on that higher tooth...I think his associate, a prosthodontist will be doing the work. I will ask both dentist those questions you have suggested to me, the measurements, the impressions, etc. I will keep those in mind. Thanks so much. The more questions the better, to be safe.
Funny thing about dentists not agreeing on some things...my old dentist strongly recommended braces for my tmjd, but my new dentist is strongly against it for me.....confusing.....but I have a long way to go to feel better before I make any decision regarding my higher tooth and my main tmjd problem.....
The permanent splint that you are talking about....can you give me more details about that?
Thanks for all your help.....
Have a good sleep tonight....
[This message has been edited by sandra1 (edited 09-08-2003).]
[This message has been edited by sandra1 (edited 09-08-2003).]
I will likely be seeing a neuromuscular dentist to treat my TMJ problems, so I'll be answering your question about permanent splints from that perspective. A permanent splint is a splint that's made to stabilize or reposition your jaw. Let's say I've been wearing a repositioning splint for a while and my jaw in now in the correct position. What happens is that my teeth may not longer fit properly once the jaw's in place. Usually at this stage, neuro dentists give you several options: orthodontics (to put the teeth in a better position), reconstruction (these are adjustments to the teeth, usually in the forms of caps, onlays, etc) or a permanent splint. The splint fits over some (maybe all?) of your teeth and gives you the bite you should have to keep your muscles relaxed and jaw in place. With this option, you're not having work done to your teeth. I'm not sure I've explained that well. I think I'm having a bad case of TMJD brain tonight.
Maybe someone who's been through it can explain it better?
I just came back from my dentist today to have the adjustments made on my splint....he wants me to wear it for six weeks and then have another adjustment made again. He also said I should start feeling some improvements in 2 or 3 weeks, since that old second splint I had before only made my tmjd feel worse. I hope he is right....if it will take longer for me to feel better, that's ok. What matters to me is that I do get better, no matter how long it will take. I did ask him some questions regarding how the grinding of the tooth will be done.....he explained a few things....but I will need to ask alot more on my next appointment to understand everything. Anyways, the visit was pretty good for me...I am not feeling too bad today (tmjd), so I did a little shopping on my way home....I think I overdid it with the shopping though.....oh, well...next time I will control my self when it comes to rewarding myself when I am having a good tmjd day.
Thanks for telling me about the permanent splints.....it will be interesting to hear from you later on about this when you do see your specialist.
I hope you are sleeping well lately....have a good night... talk to you later....and take care of yourself.