Tooth eruption with open bite - TMJ Disorder -TemporoMandibular Joint Message Board

blahblah · 07-31-2007, 03:57 PM

Has anyone ever heard of this?

I had a tooth root canaled a year and a half ago. Initially the tooth hit the tooth below it - and they thought it was not healing properly due to my bruxing at night. But not soon after my bite shifted and i make NO contact with that tooth - haven't in over a year. It has been established by several endodontists that there is NOTHING wrong with the root canal and all looks VERY normal with the tooth itself. BUT a recent consult with another endo uncovered another possibility. Apparently the side of the tooth that also hurts me has a space along the ligament - he feels this tooth has shifted/rotated and this ligament is being hurt by the movement of the tooth. The tooth is also erupting because it has no tooth above it to prevent it from doing so.

I have an open bite due to TMJD and am under treatment for that - - but the tooth pain is driving me mad. I asked why the other teeth that are not meeting the teeth above are not doing this and he said this often only happens to teeth that have had root canal done because the roots have been disrupted I guess?

I will probably end up having antiinflammatory injected into the ligament after a local anesthetic and then I will bite down on the tooth and see if there is any pain - if not then the tooth eruption is the cause of the pain which I only have on sides of tooth. If there is still pain then it is the original hairline fracture that probably has cracked further down the tooth - so I will have the tooth pulled.

Thelma-Louise · 07-31-2007, 08:23 PM

I'm not sure tooth eruption due to teeth not meeting is limited to rc'd teeth - I had a upper molar w/ no rc that did not meet the lower molar correctly that erupted on one side only - actully looked like a cone shaped spike on the back end of the upper tooth that seemed to be "growing" as one dr put it. But I did have a front tooth that was rc'd that also seemed to "grow" as the same dr put it - he would shave it from time to time per my request b/c it was longer than the other matching front tooth - but it would "grow" again after some time.

However to your other possibility, my tmj started after a crown was replaced on a rc'd canine - immediately after the crown was permanently cemented on I started to get intense pain in the tooth and it felt like it was being pushed or twisted. Evenutally the pain became chronic and I started having problems with closing my mouth on that side and the dentist who did the crown refused to remove it when I said it was causing problems. Long story short it turns out the canine developed a strained and torn ligament and did rotate b/c of the ill fitting crown - it is still a source of my frequent facial spasms and although other temp crowns have been tried I still toy with the idea of just pulling it to see if it would solve some of my tmj and bite problems. I tried the injection directly into the ligament route - it really did not help me - but certainly try it since you never know it could help so its worth a try.

blahblah · 07-31-2007, 09:18 PM

Hi -

A bit more about my experience today:

I met with a new Endodontist today about my ongoing pain in one tooth I had root canaled a year and a half ago due to a fracture. Several Endos have all maintained the tooth does NOT need to be retreated. One Endo insists it is 'referred' pain, my TMJD dentist says NO WAY- that the RC should be redone.

So today i went for a new consult with an Endo who comes highly recommended. He believes my tooth hurts because of my very bad malocclussion/open bite. The tooth does not hit ANY tooth above it and so it is rotating and erupting. He said the ligament on the one side of the tooth is thickening indicative of this movement and THAT will cause intense pain on the sides of the tooth.

He plans to speak to ALL of the doctors who have treated me over the past year and a half. He also said if he had treated me for my root canal there is NO WAY he would have let me feel a thing - the way I did last year. AND to ensure my comfort he would use a cervical collar, a bite guard (very small one) and keep my mouth open at a real minimum - he said he can work that way NO problem, he also said he would give me a muscle relaxant ahead of time. Thought all that was SO understanding - he seemed to know quite a bit about TMJD, one of the girls in his office suffered with it for a long time and he knows two of the BEST docs on the East coast.

Lastly - the way he feels we should approach my tooth once he speaks to everyone will be to try injecting an anti-inflammatory into the area - after he gives me a local. He will ask me to bite down on gauze to see if there is any pain - if there is, it is the fracture that is causing my pain. If there is no pain, it is the tooth eruption causing the pain. He said this is an easy way to diagnose the issue with the tooth. So if I still have pain, I am having it extracted and will go the tooth implant route. At this point i am fine with losing the tooth after dealing with this for so long.

He also said he did NOT think I was necessarily a good candidate for orthodontia - that he would think crowns would be a better option for me. That changing my open bite could be hard to do with orthodontia and could cause a lot of trauma (movement of teeth etc) and potentially make me worse. He said he has two docs, one an orthodontic surgeon and another a regular orthodontist who he would want me to consult with.

As for my splints - he said my upper appliance splint did not appear to be a repositioning splint but rather a simple retainer. The lower one which i can't wear right now because of my sore tooth IS a repositioning splint but could also be moving that tooth - and again that would be a source of great pain.

He concurred that no way do i need a retreatment of the root canal.
And he didn't charge me a penny for his time!

To be continued!

Beth

Thelma-Louise · 08-01-2007, 12:42 PM

Is it me or does it sound like the endo guy knows more about tmj then the dentist that did the splints? Does he know your tmj dr and feel he is competent since he is referring you to other ortho's for consults? I can tell you that as someone with an extensive dental history, crowning can be quite expensive and the prepping of teeth for crowns can damage the nerve thus requiring root canals previously not anticipated on. I believe my tmj problems were caused by ill fitting crowns and bridges. There are other alternatives however like an overlay or inlay where just a cover of porcelain is put over teeth which require less prepping or filing down of a tooth limiting damage done to the tooth structure. Let us know what the ortho's say - I'm kind of wondering why the endo thought you were not a good candidate for braces.

blahblah · 08-01-2007, 01:11 PM

>Is it me or does it sound like the endo guy knows more about tmj then the dentist that did the splints?

Well I think for an Endontist he knows more then average about TMJD, but my TMJD specialist also knows a lot too. He is the
first person to have helped me with my pain in the last year and a half. The endo definitely agrees with my current treatment plan. BUT he
also told me he knows two of the top TMJD specialists on the East Coast. One is Steven Syrop out of Columbia and he is on 5th Avenue in NYC
and the other he thinks is working out of St. Joseph's hospital in Paterson, NJ but he is unsure if he seeing new patients or not. He mentioned it incase I want yet another opinion.

Pretty much EVERYONE I have mentioned this to feels the same and says HANG ON to that Endo, anyone who offers to help you like this not to mention not charge you for literally sitting in their office is a keeper! Clearly very dedicated! I am not saying doctors should not charge fees but like everyone else on here I am TIRED of spending thousands of dollars. However I am happy with my current TMJD specialist and do believe he is trying his best to help me.

>Does he know your tmj dr and feel he is competent since he is referring you to other ortho's for consults?

He does not know him no. He is not sending me to other orthos now. He just said when I am ready - as in when my TMJD doc and I feel my jaw is healed enough - he has two orthos he would want me to see.

> Let us know what the ortho's say - I'm kind of wondering why the endo thought you were not a good candidate for braces.

I will! But I am a long way away from that - have a lot of healing to do first.