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Old 02-13-2013, 01:16 PM   #1
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NikkiSp HB User
Exclamation Bite Adjustment now TMJ that I never had before

Hi, I got a new dentist. Two weeks before I saw her I had some occasional pain in my left bottom first molar that has had a composite filling for the last 7-8 years. With xrays, the tooth does not show any secondary caries. She adjusted the heigth on the tooth, because she felt that it was too high with not enough "groves" in it and the adjustment will relieve the pain. Two weeks later, I still had the pain in that tooth every so often. During those two weeks I had some left jaw pain but not bad. I didn't even associate it with the adjustment. I saw her again after those two weeks and she adjusted the heigth again in that tooth taking it down more, adjusted the 2nd molar next to it that has a composite filling because now it was bearing a lot of the weight, and adjusted the upper left side first bicuspid that is a crown. I then got severe TMJ symptoms. Every symptom you can have with TMJ problems I have. The pain is outstanding! 8 days after, I saw her again. She then did the whole arch dyed paper testing. She says that the pressure points are pretty much even. She said that it looks like the right side second molar is hitting a little more and said she could take that one down, (Which the right side does feel like they are slamming together). I told her no. That is my natural tooth, no fillings, and I don't want to adjust anymore and create more pain. Looking in the mirror with the dye on the teeth, you can see that the right side is more flat and has more surface area that is hitting. The left side only has the "tips" of the teeth hitting. I explained to her that it feels like there is no resting place for my teeth and they feel like they teeter totter. The right side rests together on its own like puzzle blocks. The left side rests together on what feels like stilts. But trying to put my jaw together, it doesn't rest. The dentist explained that it isn't the amount of surface that they look at, but how much pressure is on each side and it is even. She suggested that I get a night guard to help the jaw muscles since I have spasms. I won't be recieving this custom night guard mouth piece for over a month. My issue is this, I understand that whenever you adjust a bite it takes time to get used to. However, it is about 10 days out and I am still in quite a bit of pain. I have never had TMJ issues before. Now I don't feel like I can function as a human. I can only eat soft, liquidy foods. I am taking the maximum amount of painkillers (lots of them). I can't sleep at all. I have tried all kinds of home remedy exercises etc. I can NEVER meet my teeth together...NEVER. This is quite a hard task when you are talking, swallowing etc. I can never yawn now. I am lisping now and it is very difficult to deal with since I am in customer service. I am very leary of a night guard because I am now experiencing a lot of sinus problems and I have to breathe through my mouth at night. I guess my question is to those out there that have experienced this; Can I just have her refill the fillings in the teeth she adjusted to make my bite correct again? It justs seems like a lot of pain and maintanence for the rest of my life because she decided to make adjustments. Help!!!!!!

 
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Old 02-17-2013, 06:43 AM   #2
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Re: Bite Adjustment now TMJ that I never had before

NikkiSP

occlusal adjustment should be the last option for any TMJ treatment, this normally is only done after very careful consideration and if a bite impression is taken to see what the bite table is before adjusting.

What should have happened is the dentist should have checked for any muscular tension and jaw misalignment or find out if there are any other symptoms or problems before jumping in and grinding down teeth. Doing this is considered to be bite correction and is irreversible and permanent.

I would consult a different dentist and see what their opinion is. Dent have any more work done to grind down or build up teeth until a second or third opinion is had.

I would also look at any other head or neck and shoulder tension which could have started some of the milder TMJ issues. Do some of your own assessment to increase self awareness and to help relieve some of the tension that is now increased.

Good luck and hope you find some relief. Keep us posted on the results.

Last edited by Administrator; 03-07-2013 at 01:16 AM.

 
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Old 02-18-2013, 11:04 AM   #3
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Unhappy Re: Bite Adjustment now TMJ that I never had before

I think the dentist was trying to relieve pain in the molar by taking down the fillings since she didn't see any cavities by making more room to impact the bite blow. I didn't have any TMJ at the time, so honestly I don't think she thought about it -Only to hurry up, relieve my pain and get me out of there. It is obvious that my TMJ problems are due to the filling adjustment. The left side of my mouth now sits lower than the right, causing a teeter totter affect. With all this pain and her stating that, "She didn't even do much" I thought about it. There are 4 verticle quadrants on each side of your mouth that bites. The upper and lower 2 molars and upper and lower 2 bicuspids. Since she adjusted 3 teeth in 3 quadrants, this is not a little thing. It is a BIG thing to adjust 3 out of 4 quadrants. To be honest I think that the molar that started all of this has a loose filling. It feels the same as the metal filling did. You can tell if a metal filling is loose or "leaking" because it gives a gray ring affect around the filling. When it is a composite filling, you don't get that type of affect so you have no clue if it is leaking or not unless you feel it. I want to get the fillings redone to not only help the possible leaking in the one molar but to bring it back up to where it was before. Asthetically, she didn't like the look of the filling because it didn't have any groves and looked liked it was filled flat to the top of the tooth. Thus, her thinking that the pain and sensitivity was due to this. I kind of have the theory that if it isn't broke, don't fix it. I only wanted her to maybe go over reasons why that tooth was hurting since there was no cavities. It wasn't until research online that I came to figure out that it was possibly a leaking filling. Why didn't she think of that or discuss any other options with me? That's what is fustrating!

Here is my dilemma. I go in tomorrow to replace my crown. I can't wait any longer because my old one has fissure lines on both sides of the top of the crown where it is attached. It could snap off at any moment (Thus, her taking down the crown to protect it). Since it has only been 7 years since the crown (bad job from previous dentist) my insurance requires dentists to send xrays for proof of a replacement and have prior authorization. If I don't go in, then the prior authorization with another dentist can take up to another month. It probably won't last that long. So...I am going in to get my temporary done. Here is my other dilemma. She is the one who knew where the heigth of the fillings were before. If I go to see another dentist, then they will have no clue how much to put back in. Unfortunately, I will have to go to another dentist for another opinion if she says no she can't fill them again. I have done A LOT of research and have come to the conclusion that Prosthodontists are the ones to go to to make any adjustments. Any dentists can say they are "TMJ dental specialists" since the dental boards do not have certifications for this specialty. If you end up going to a "TMJ dental specialist" usually they are the ones that are very liberal to make all kinds of occlusional adjustments. I want whomever I see to be more conservative and not want to start sanding down all my good healthy teeth.

Has anyone seen a Prosthodontist for this type of thing? I am trying to avoid any more sanding and permanent problems. Fillings can be adjusted but healthy teeth can't. Wish me luck. I will keep you posted. Oh and by the way...anyone out there that is thinking about adjustments or just don't know about this practice (I didn't- only after my fillings were just filled, not years later) please don't make the decision lightly to have it done. I didn't even question her when she did it (she didn't give me options and just did it) but I thought she knew what she was doing and I thought they are just the filled teeth, its no big deal. Believe me...it is a BIG deal!

 
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Old 02-21-2013, 09:36 AM   #4
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Re: Bite Adjustment now TMJ that I never had before

I think your guys' advice is probably the best advice at this point. To go get another opinion. I have never heard of taking a cast before the occlusion adjustment and testing the articulation on it beforehand like someone else has suggested. Is it too late to have this done now do you think? I know that there is a Tscan that is computer generated but the only dentist in the state that has one, doesn't accept any insurances. We bill the insurances ourselves. I just want to try and do the right path now before I go down an irreversable route. I sit many times of the day thinking...'"Is it just me and am I just crazy?"

Last edited by NikkiSp; 03-07-2013 at 04:40 PM.

 
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Old 02-24-2013, 06:37 AM   #5
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Re: Bite Adjustment now TMJ that I never had before

Hi there! I've been reading all of the posts, and one piece of advice that I have is that you see a prosthodontist, who specialize in crowns and making sure the occlusion is appropriate for the TMJ. Also, if your TMJ is hurting very badly, I would suggest a consult with an oral surgeon and get a CT or MRI scan done of the joint. If there's no damage there, then you can focus on the muscles. That would lead you to a rheumatologist or pain management specialist - I get cortisone injections into the masseter muscles to knock back the pain around the joints.

Hope this helps!

Pam

 
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Old 02-24-2013, 08:04 AM   #6
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Re: Bite Adjustment now TMJ that I never had before

Nikki,
What you're experiencing is not really that uncommon. Your "bite", or the way your teeth come together, is a very important part of your dental health and is referred to as "occlusion". Unfortunately, most dental schools spend a very very limited time on the subject! My suggestion is to see a Neuromuscular Dentist. You could probably find one in your area simply by googleing the term.

 
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Old 02-25-2013, 09:07 AM   #7
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Re: Bite Adjustment now TMJ that I never had before

So today I am making a few consult appointments. I am making one with a Periodontist FACP Board Certified Surgical dentist, A dentist who is a member of the AACP and studied at the reknowned Las Vegas Institute for Advanced Dental Studies which studies maxiofacial pain (neuromuscular), and lastly a dentist that has over 30 years of experience and is a member of the AACP. Unfortunately, no one I can find has a mixture of all. If I find out that it is a simple fillings that needs to be replaced after seeing the Periodontist, I may have to see a regular dentist to have it done. Pamo810- I already have a CT scan that I paid $200 for, just BEFORE the nightmare causing my TMJ problems. I don't know if I can afford another one, my insurance won't pay for one. Maybe by looking at my CT scan the prosthodontist dentist can determine that my jaw placement was ok before I had the fillings adjusted. I also hope that it will help with determining the pain in my tooth. The dentist that caused the TMJ did not even take a glance at the CT scan that I had done :/ Crossing my fingers that I will find a solution!
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Last edited by NikkiSp; 03-07-2013 at 04:43 PM.

 
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Old 03-04-2013, 05:23 PM   #8
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Question Re: Bite Adjustment now TMJ that I never had before

UPDATE: I am 4 weeks out from my last adjustment. I only have now some clicking in the jaw on various mornings (probably from sleeping on it funky) some cheek muscle dull fatigue pain on my left, some dull temple pain on my right, and the feeling of clogged ears. I saw the Prosthodontist today. I will make a long consult short. He didn't look at my teeth (apparently that is a $117 fee). He listened to my issues and this is what I gathered from it. One tooth adjustment right after a filling usually doesn't bother people, so a dentist can just do a simple one and everything is good. Doing an adjustment years after the filling and on more than one tooth is not what you do- especially the way she did it. The teeth and jaw can do funky things to try and adjust to uneven teeth- even the teeth can do its own growth (super-exposure). At this point, I have to get a scan of the jaw, get a splint and then do a cast to see what my options are to even the teeth out. Apparently the splint will redo the jaw's memory of where my normal resting point is. He says that the splint is like physical therapy and sometimes things will get worse before they get better. So you guys that have said that pain results from the splints and sometimes make the TMJ worse- I am sure he is referring to this. (Yes, I have also read and learned about this before from you guys on here ) K to do all of this without insurance will be $1600. I don't know what my insurance will pay if any. Then once we get an idea of what we can do, the best case scenario would be to just refill the teeth and do a new crown. Most likely scenario, I have to do an inlay on the two molars and get a new crown. A possible scenario would be to adjust the adjacent teeth. Worst case scenario, I will have to have 3 crowns. All I have to say is STICKER SHOCK! This doesn't include any price on the inlays or fillings and the cost of the crown. This consult has brought me to a dillemma once again. Is it worth the price? Well yes and no. What if the splint doesn't really work for me? Then no it isn't worth the price. It is worth it if I can get the crown done right and fix the fillings once we get an idea of where my teeth placement should be. Is this just a bells and whistles that I don't need and since the symptoms are improving, could I just get my fillings redone with a regular dentist and have the crown done? This prosthodontist sees patients that have missing teeth and major dental issues. (Not that I don't feel like this TMJ isn't a big issue) I worry that in order to make his time worth the hassle that we are going through all this that may not be necessary. So my question for you guys is, have any of you guys gone through these steps and is it worth it? Did it resolve anything in the end?
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