Bite Problems After Cosmetic Crowns

Ultimate success in cosmetic dentistry always requires talent, skill and artistry in creating the beautiful aesthetic results and infinite precision in matching the bite and creating natural function.

Usually cosmetic dentists get to be nationally-known because they can consistently create successful results.

In your situation, you need to spell out exactly what is not working well and make sure someone is listening well. Go back and ask them for as many and as specific options as they can create for you. If you are having this much pain, something else HAS to be done/ Chronic pain is erosive to your work and relationships.

You remind me of a patient I am seeing right now with a similar story-she has seen some excellent dentists, but somehow she had extensive pain and was not getting better. After much conversation and deliberation, we started some reversible therapy, and fortunately she is getting better, so have hope.

At this point, I would wait to have any more new crowns until you make progress on the pain.

It appears that you have undergone extensive dental reconstruction. Before you proceed any further, the bite issues should be addressed. There are diagnostic tools that a highly trained dentist in occlusal (bite) disorders can use. The appliance does not change anything in your mouth, but allows your jaw to reposition where the muscles are in harmony and comfort. Once you are out of pain, then you can discuss with the dentist what needs to be done. At this point, nothing irreversible has been done to your teeth. This is important because now you can see and feel for yourself that the treatment will work without spending any more time or money on promises.

I am surprised that your highly qualified cosmetic dentists could not adjust your bite after the placement of your crowns.  If you seek out a third dentist, I would refer you to a neuromuscular dental expert who has advanced training in treating neruromuscular problems such as TMJ.  Do you remember if your bite was good and you were pain free before the crowns were placed?  If it was and now with crowns it is not, you know the bite is causing the pain you are feeling.  Please seek out a dental expert trained in this field.  He will be able to determine the problem and correct your bite and you will be pain free. 

Smile makeover/full mouth reconstruction is a treatment that involves identification of occlusal problems and solving them as well. And usually in hands of an experienced prosthodontist the case should be functional first and esthetic second. When the patient presents for smile makeover with existing occlusal problems it is critical to find the problem- TMJ, muscles or teeth. After that patient is either wearing the occlusal guard or is placed in provisional crowns/bridge to decrease clinical symptoms such as pain in muscles or TMJ, tenderness or clicks. And only after this step is complete the patient can get final restorations. If the symptoms have appeared after the final restorations have been placed the treatment plan should be carefully revised and all crowns/bridges should be re-evaluated and corrected if possible. In some cases, they can be redone. In such situation second opinion of a prosthodontist can be helpful. Usually a prosthodontist is a specialist who can identify if you have a true TMJ problem and need to see a specialist to treat TMJ dysfunction or you can get your bite corrected without that.

A top, nationally recognized cosmetic dentist should also be highly trained in treating the occlusion (bite) and temporomandibular joint. I must wonder if you have some non-dental condition causing the pain you are experiencing. If you are seeking the help of a third dentist, you want someone with advanced training in treating problems of the occlusion and differential diagnosis of pain.