Is TMJ/TMD Post 18 Dental Veneers Curable with a Bite Guard and Adjustment?

I had 18 teeth restored with veneers. In the front, he placed 360 degree veneers, top & bottom, all lasting 6 hours for the prep visit and 5.5 hours, two weeks later, for the installation. I needed 18 lidocaine injections. It has been 5-6 weeks since installation still with constant jaw, sinus, temple, headache pain (Tylenol/Aleve 24/7). My bottom front teeth "hit" the back of my top front teeth and my rt. molars hit precluding a full bite. Is this TMD? TMJ? Curable? Bite guard? Please help!

Doctor Answers 9

Is TMJ/TMD Post 18 Dental Veneers Curable with a Bite Guard and Adjustment?

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TMJ problems that occur following  dental procedures are almost always correctable. There are many types of TMJ problems and can be related to internal derangements in the joint, capsulitis or most commonly muscle pain.

It is extremely import and to correct the occlusal issues as most TMJ disorders are a type of repetitive strain injury.  Once a healthy closing pattern for your jaw is established your body will begin healing.

The good thing about most TMJ/TMD problems is they are relatively easy to diagnose and treat.

Dr Ira L Shapira

TMD/TMJ issues after 18 veneers placed

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I am sorry to hear about what yor are going through. It sounds you had a lor of work done and things can feel like is too much to deal with. By what you are explaning, it sounds like you can definetely have TMD/TMJ issues and it will get worse with time. First, go to your dentist and have them check your bite , its probably high and the interference are causing pain and discomfort. Once your bite is stable and you feel comfortable, all symptoms are gone you will benefit from a Hard/SOFT night guard, that will protect your new porcelain restorations and will give some freedom to the joints and muscles. Keep in mind in symptoms do not improve you should consider going to a consultation with a TMD specialist , Neuromuscular trained dentists are very good at this.

Pamela Marzban, DDS
Fairfax Dentist

Veneers Bite Adjustment and Theraputic Use of Botox for Pain

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Sounds to me like you have had a tremendous amount of dental work done in a very short period of time! Two things are likely the cause of your problem and, it does sound like you have TMJ. You need to see your dentist and have him check your bite and correct it. This will help the overworked muscles in your face. This make take sometime and a bite guard at night, would help if your clench or grind your teeth when sleeping. This will also protect your veneers at night, in case you are bruxing and clenching. You should have by now, six weeks later, recovered from the amount of time you had your mouth open while the veneers were placed.  Dealing with the pain,now, is your main problem.   Theraputic botox injections placed in your masseter and your temporalis muscle, which open and close the jaw, could help with the pain. They relaxe the muscle and allow your jaw to recover. It is by far a better solution then to continue with meds over a long period of time. My advise to you is go back to your dentist and make sure he does the right thing and corrects your bite and seek advice from a neuromuscular dentist who is a specialist in this area. Also check out sites and dentists who use theraputic botox to help people deal with the pain from TMJ everyday!  Good luck and I am assured once the bite is corrected and your muscle spasms cease, you will love your new smile!

Robert Fields, DDS
Van Nuys Dentist

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TMJ/TMD following complex dental treatment

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With that amount of dental work, it is common to have a few adjustments to the way your teeth fit together, however if the front teeth hit when you close that needs to be corrected either by adjusting the restorations or remaking them to a comfortable bite.  A bite guard will not really help.  You should be able to close your teeth together comfortably without any specific teeth hitting first.

Carlo Biasucci, DDS
Ontario Dentist

Pain after placing multiple veneers

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When you undergo a dramatic dental treatment such as what you have, going back to the dentist for multiple bite adjustments in order to remove the bite interference  is very normal.

if you were already a clincher and/or a grinder the discomfort and the adjustments will take longer to be dealt with.

Hopefully you have chosen a dentist who knows about occlusion principles( changing /altering bite) .Good Luck.

Soheyla Marzvaan, DDS
Orange County Dentist

Pain after 18 veneers placed

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18 units of veneers or crowns is a big work, requiring compliance from the patient, and usually leaving quite a discomfort for the patient. It practically is changing all the bite and occlusion. Most likely from your description it sounds like you need a follow-up visit to your dentist for occlusal adjustments, to correct the interferences between the top and bottom teeth. The pain usually goes away pretty quickly once the bite is balanced. Also the nightguard for you is a must. When so many teeth is covered with porcelain- they need to be protected. 

Curing TMD/TMJ related pain following placement of Porcelain Veneers

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TMD/TMJ (joint) related pain following the placement of Porcelain Veneers is generally the result of occlusal (bite related) interferences which is precipitating neuromuscular spasm and pain. This needs to quickly be eliminated such as anterior interferences (such as hitting the inside of your purer anterior (front) teeth and uneven posterior (back) occlusion such as hitting one side vbefore the other. A "balanced occlusion" is essential for proper jaw function. With that said, the amount of dentistry you have had (18 teeth) and the time you were under treatment with your mouth open can also precipitate TMD/TMJ pain especially if you had any underlying predisposition or para functional habit such as clenching or bruxism (grinding). A night guard or clenching suppression device can help symptomatically however it is essential to treat the cause which is most probably occlusal in origin by a dentist who is knowledgeable in occlusal function.

As far as the pain, you should be aware that this may take some time to simmer down as neuromuscular spasm and pain can be very persistent and adjunctive therapy such as physical therapy, diet modification, and certain muscle relaxant medications can be helpful as well.



TMJ/TMD Post 18 Dental Veneers

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It is very normal to have to go back to dentist a number of times after having multiple restorations. The occlusion (bite) MUST be dealt with correctly. A bite guard alone is NOT the answer. First, the correct occlusion MUST be established. Once it it established, then a nite-guard can be fabricated. Once the occlusion is correct, the TMD symptoms should go away.

Jay Neuhaus, DDS
New York Dentist

Dental Veneers Pain Curable with a Bite Guard and Adjustment?

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When you have extensive teeth changes made (for example a smile makeover or many porcelain veneers done to change the shape and color of your smile), it sometimes is very uncomfortable for a few days.


However, things ought to be working well at five to six weeks after the fitting. When you have a major change in your bite, it can produce TMJ and other jaw and facial pains.


Make sure your dentist knows how much trouble you are having. It can take a few adjustments to get it to resolve.A guard can sometimes give some relief, but the main issue sounds like getting your bite to align better.


If your dentist is not making progress for you then you may want to consult with a great cosmetic dentist or a dentist that has a lot of experience with bite alignment and bite function (sometimes a prosthodontist).

It's highly likely that it can be improved.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.