My dentist placed a crown on an upper left molar three weeks ago. The tooth touches the opposite bottom molar tooth when I chew, but it feels off. I think the crown needs deeper grooves so the other tooth will match it when I chew. If I ask my dentist to drill down some of the crown’s surface, will it damage it? Although I will need laughing gas or another sedation to cope with my anxiety and get through this, I want it resolved. I already told my dentist about the discomfort, and she said that I need time to get used to my bite. How long will that take? Thanks. Randall from Memphis
Your dentist’s request to give your concerns more time means that she does not know what to do. Brooksher would need to examine your tooth and crown to determine what is causing the disharmony when you chew. But the situation could be challenging to correct, or your dentist’s lack of knowledge might be the problem.
Your bite should be perfectly comfortable when you receive a new crown or onlay. But the motions involved in chewing make the occlusion—how the upper and lower teeth fit together—complex. And many dentists lack the training and skill to resolve the issue.
Post-graduate institutes, including the Las Vegas Institute for Advanced Dental Studies, the Texas Center for Occlusal Studies, the Dawson Academy, the Pankey Institute, and others, train dentists in the science of occlusion. Many cosmetic dentists attend the institutes or receive courses from other organizations that teach the same principles. Still, many other dentists feel that basic dental school education is enough, and they do not need occlusion training. Although dentists who bypass additional training might complete single crowns or onlays, they may not be qualified to complete a full-mouth reconstruction with a balanced bite. So, as a patient, a dentist may tell you that it takes time to get used to your bite.
What Is Malocclusion and What Problems Can It Cause?
Malocclusion is the term for disharmony in how your upper and lower teeth line up. The shape, size, or position of your jaw or teeth may cause malocclusion, or misaligned teeth. The shape and size of a dental crown can affect your bite. Although you might adjust to how your bite feels, it does not mean it is aligned correctly. And malocclusion can lead to other issues.
- Unusual stress on teeth – The stress can lead to bone loss around the affected teeth.
- TMJ disorder – You might experience symptoms or signs related to TMJ, including jaw, facial, or neck pain, and headaches or earaches.
Many dentists adjust a new crown or onlay by asking you to bite on bite registration paper. The paper leaves marks where the crown or onlay makes contact prematurely. The dentist will grind down the crown in those places. Your dentist has completed that essential step, and your crown is not high.
The issue with your bite is more subtle. But a dentist—perhaps not your dentist—can adjust the crown to make it comfortable without damaging it. If your dentist does not know how to correct it, you can wait a few months to see if the tooth begins to feel better with your bite. Or you can get a second opinion from an advanced cosmetic dentist. Look on a few dentists’ websites for information about post-graduate training in occlusion from one of the institutes mentioned on this page. You can talk to the dentist about your anxiety and discuss sedation options during your consultation.
Baton Rouge dentist Dr. Steven Brooksher sponsors this post.