Scared About Bite Change?

[rockitorknockit]

A week and a half ago, a permanent crown in tooth 15 just broke in half in my mouth while I was eating a cracker. I went in the next day and had the rest of the old crown removed and a temp placed. Since I had the piece of crown that broke off, they placed it and took a mold of the old crown before removing it.

Yesterday I had the new permanent crown placed. The dentist (whom I generally trust immensely and drive 2 hours to see) looked at the crown and tested my bite ans said it looked "literally perfect". He sent me on my way.

But my mouth feels weird. The crown feels lower than my previous one. He had explained to me that it was barely in occlusion and this was purposeful. I'm thinking maybe the previous crown broke because it was too much in occlusion, in fact. But now my whole mouth feels weird, like my bite has changed. I'm worried about pain, not getting used to it, and damaging other teeth. Currently there are some sore points throughout, primarily on my bottom teeth on both sides of my mouth. Could this be because I was eating weirdly with the temp crown (only on my right side)? Could this be because the permanent new crown has changed my bite? How concerned should I be?

I'm feeling insanely anxious about this because this tooth has been a nightmare for 4 years. I'm worried that my bite being off is going to send me down another long road of pain/jaw issues. Right now it's been less than 24 hours with the permanent crown so I'm trying to just let things settle, but I'm very scared and finding myself obsessively testing my bite and poking at sore areas.

Looking for reassurance, I suppose. Hoping a dentist can confirm this is normal and everything will settle fine in a few days. Worried things will be painful through Thanksgiving while I am out of town as well.

 

[Gordon]

Looking for reassurance, I suppose. Hoping a dentist can confirm this is normal and everything will settle fine in a few days. Worried things will be painful through Thanksgiving while I am out of town as well.

There can be some subtle bite changes when you've had a temp crown for a while and they become noticeable when the permanent crown goes in. They tend to be pretty temporary and sort themselves out in a week or two.
You're not going to have any great pain from this, if it doesn't feel better over the next week then give the dentist a call to check your bite again.

 

[rockitorknockit]

There can be some subtle bite changes when you've had a temp crown for a while and they become noticeable when the permanent crown goes in. They tend to be pretty temporary and sort themselves out in a week or two.
You're not going to have any great pain from this, if it doesn't feel better over the next week then give the dentist a call to check your bite again.

Thanks so much for taking time to respond.

By the time I went to bed last night my jaw was killing me all over. Just fully throbbing everywhere. But I'm struggling with figuring out the real cause. The crown itself feels fine. Chewing when I eat feels slightly strange/new, but isn't actually painful. Everything is just sore. I think my bite has shifted, there is more pressure on new teeth vs the crown I previously had which took a lot of it. It seems possible the psychological impact is causing more tension and pain than anything, as I'm testing my bite a lot but also avoiding putting my teeth together when I'm resting because it feels weird and that's freaking me out.

I appreciate your insight. This makes me feel like I should judt give it some time before I panic. I'll see how things go over this weekend.

 

[Gordon]

Sorry been away on Grandpa duty. How is it now?

 

[rockitorknockit]

Sorry been away on Grandpa duty. How is it now?

Hey there, I hope you have had a good weekend (and Thanksgiving if you're in the US).

Last Monday I went back to my dentist. He made an adjustment to the crown and also gave me some trigger point shots in the painful area of muscles in my jaw.

It's been a week now and whatever he did greatly reduced my jaw pain but everything still feels weird. My teeth feel super uncomfortable, chewing is strange and sometimes painful, and the most troublesome thing has been that now my bottom front teeth are bumping the back of one of my front teeth, especially when I talk/say anything at the front of my mouth. It's making the top front tooth super sore. This has been going on most of the week. I'm freaked out about it, uncomfortable, and going insane. I am going to call the dentist again in the morning but idk.

Could this all be because the crown is too low? Should I be requesting a full re-do? Would minor adjustments really fix all of this? It feels impossible that I'll get back to normal at this point.

 

[rockitorknockit]

Just want to add how incredibly anxious I am to speak to the dentist tomorrow. I'm worried about him repeatedly being annoyed and frustrated with me needing so many adjustments or possibly a re-do. My mouth is driving me insane and I'm scared I'll never get back to comfortable. All because a stupid cracker broke my old crown.

 

[Gordon]

Getting occlusion right for some patients is a time consuming and somewhat frustrating exercise, but it's just a facet of doing crown and bridge work. You just have to suck it up and get on with it! (The dentist, not you!).
We're pretty lucky in dentistry that most people are able to accommodate small discrepancies or errors in their occlusion. You're clearly not one of them and that's in no way your fault.

 

[rockitorknockit]

Getting occlusion right for some patients is a time consuming and somewhat frustrating exercise, but it's just a facet of doing crown and bridge work. You just have to suck it up and get on with it! (The dentist, not you!).
We're pretty lucky in dentistry that most people are able to accommodate small discrepancies or errors in their occlusion. You're clearly not one of them and that's in no way your fault.

I appreciate you so much. Your words eased my anxiety a bit this morning before I called my dentist. I felt less insane!

Spoke to him and he is having me come in tomorrow morning wearing my night guard so he can remove it and immediately examine my jaw and bite. I asked him if replacing the crown was something we should consider... he said he will if it's necessary but isn't convinced yet.

So, I'm glad at least the next step is in place. Dentist again tomorrow. And honestly he is very nice. He's never acted frustrated with me.

I'm gonna be honest, I think we need to redo the crown still. Today I'm realizing that a ridiculous amount of food is being impacted in the opposing tooth and I think part of why chewing feels so weird is because I keep trying to chew there and feel like I can't. I'm anxious and stressed about needing multiple more visits with the dentist. But hope we can resolve it. I'm so scared about never feeling normal again.

 

[Gordon]

Sounds like he's tackling it the right way (i.e. the way I'd do it )
Let me know how you get on.
It might take multiple visits but it's fairly painstaking stuff, very fiddly and detailed but EXTREMELY unlikely to be actually physically painful for you, if that helps any!

 

[rockitorknockit]

I'm back from the dentist. He used a bunch of fancy tech to analyze my bite. Where we landed: as I suspected, we will start with re-doing the crown to see if making it higher will re-balance my bite.

But he showed me why I'm having so much trouble. I have a very slight overbite and my teeth aren't lining up correctly, so they are sliding and knocking around. This is why I'm so sore. My front teeth knocking when I talk and hurting is what's bothering me most at the moment.

He said if the new crown doesn't resolve things, the next step will be adjusting my other teeth to try and fit my bite, and/or orthodontics. Nightmare for me.

So, pretty much worst fears confirmed. This feels like a huge ordeal. Now I have to wait a week for the new crown and in the mean time I feel like my mouth has forgotten how to chew and talk. I'm saying words weird, chewing slowly, and just always conscious of my mouth. All cause of this one tooth being thrown off. I realize this may seem dramatic to others, but this year has been hard on me. I just had my gallbladder removed 3 months ago, and 3 months before that my cat died. I feel super defeated. I'm sick of being uncomfortable and in pain and waiting for an uncertain resolution that may never come.

 

[Gordon]

There was a poster on here a few years ago with a similar issue, Daphne I think she called herself. It took a wee while but she sent me a PM a few months ago with everything sorted out and she's in a much happier place.
There will be a successful outcome, unfortunately the systems involved in biting are extremely complex and not that well understood so it can take time and patience to sort things. Hang in there.

P.S. I'm really sorry about your cat.

 

[rockitorknockit]

@Gordon Thank you. I'm back with another update, hoping you can ease my anxiety some once again, especially since I cant see my dentist for a bit...

It's been 5 days since I went back. The permanent crown that was too low and weird was removed and a new one has been placed. The dentist was very nice, intentional, methodical, trying to get it right. So, I have a new crown now. It is more in occlusion, we used a techscan to confirm. Immediate sensation was that my bite felt less slippy-slidey. Left cautiously optimistic.

First couple of days after, my jaw was absolutely killing me. It took 2-3 days for the muscle tension and inflammation to calm down, just from being worked on for a while again I guess. I'm still feeling it a little as we speak, sometimes some twinges here and there... not sure if jaw is still recovering or if tooth needs adjustment.

Now I'm a little worried the crown is weird or not quite right still, too.

I'm noticing that on the back side of the crown it feels slightly odd. Like maybe it doesn't fully meet the gumline, or something? For a couple of days after the crown was placed, it felt sore there, as if my gums had a knick in them. I no longer feel that so much, but it's still... like something is different. It's not perfectly smooth to my tongue when I run it over my tooth to my gum. When I press it with my tongue hard, it is slightly sore. But it's literally the back of tooth 15 so I can't see it. Whatever it is must be small because my finger can't feel it.

Overall I also just have a sensation that I can just feel the crown. It doesn't feel as seamless like a normal tooth. There is a sort of hard to pinpoint very very faint tenderness, and also sometimes I get this sort of wave of very strange pain that sort of just washes over that area of my mouth/jaw. It's hard to describe.

Does this sound like something that just needs time? Do I need to have him check that back of the crown? Does it just need an adjustment?

My car is now out of commission and I'm trying to buy a new one. So I won't be able to see him til that happens. I'm scared it's wrong. I'm scared my tooth underneath is gonna be damaged badly. I'm scared of never being able to stop focusing on my damn teeth again. Thanks for your help, as always.

 

[rockitorknockit]

Gonna go ahead and show a photo here too. This is not the side of the crown that feels strange to my tongue, but I'm worried it looks strange. None of the previous crowns made my gum look like this. Is this normal or concerning? It's not a great photo but I'm talking about the way there is sort of a line in the gum above the crown.

 

[rockitorknockit]

Having some of the pain I described above and just wanted to try and articulate it better. It sort of feels like a dull nerve pain. I'm not noticing any particular sensitivity to heat or cold, but it's a similar sort of pain that sort of faintly throbs from that area, it seems. Idk if that even makes sense, just trying to describe things. Now I can't stop thinking about it so it feels like it's always there this afternoon.

 

[Gordon]

Your jaw joint and muscles of mastication will take some time to readjust, so I would expect a bit of tenderness and stiffness for a wee while yet. Ice packs or heat packs may help.
Similarly the periodontal ligament that holds the tooth in place may need a bit of time to recover as well.
There may well still need to be some adjustments made to the crown once things have settled down a bit more, your bite may well still be changing slightly. It's not a "do it once and forget it" process I'm afraid.

 

[rockitorknockit]

Your jaw joint and muscles of mastication will take some time to readjust, so I would expect a bit of tenderness and stiffness for a wee while yet. Ice packs or heat packs may help.
Similarly the periodontal ligament that holds the tooth in place may need a bit of time to recover as well.
There may well still need to be some adjustments made to the crown once things have settled down a bit more, your bite may well still be changing slightly. It's not a "do it once and forget it" process I'm afraid.

Thanks for this. I am trying so hard not to obsess but when I can feel that tooth constantly it's really hard to let it go. I guess I am struggling with knowing if I just need more time or if I need to get things adjusted. I am worried about how much work has been done on that tooth recently and if I am somehow damaging it. I guess I am worried waiting to fix things will really just be me damaging things more. And since it looks a little different than the other crowns I had in terms of how it is seated, that is freaking me out too. I definitely was feeling it last night, and this morning it's there too. It's sort of this low grade ache that almost feels nerve-y but I know there aren't any in that root canaled tooth. I had a similar experience before I had this same tooth retreated (The Tooth From Hell), where I had nerve pain shooting up the side of my mouth that confused everyone but retreatment resolved it. I have a call into my dentist but he's in surgery this morning.

 

[rockitorknockit]

Finally spoke to my dentist on the phone. He wants me to wait and give it more time before further adjustments or treatments are tried. Said we should touch base after the new year unless something else comes up. I'm very anxious about this because he hasn't laid eyes on it and I'm worried I didn't articulate what I'm experiencing very well, but... idk what else I can do but wait now and hope I get used to things as he suggests. I thought I would be reassured by him not wanting to see me but now I wish he would. I'm scared and obsessed and feel CRRAAAZZZYYYY!!!!!

My dentist is SO patient and nice. He said he actually felt optimistic we were on the right track. He said it seemed unlikely something was wrong with the tooth underneath, which is what I'm most concerned about. And of course I'm all freaked out about the appearance and just wish he would look at it, but I didn't articulate that on the call. My wife wants me to chill out and just give myself time to keep getting used to things. I would love to do that. It's just SO HARD for me. I hate it. All I can think about is this tooth, it makes me tense and then I talk weird and bite my cheek and then I am convinced I can feel it all the time and then I literally can't tell if it hurts or I'm making it up!

Thanks for giving me space to vent.

 

[Gordon]

Your wife is quite right (my wife told me to say that!) it would be better to try to let it settle a bit more before making any adjustments, the problem is if you do it too soon, things are still readjusting and you might inadvertently make it worse rather than better.

 

[rockitorknockit]

Here is what I am currently experiencing:

- The crowned tooth feels like it is very slightly too big on the outer side. This is causing it to rub against my cheek more and sort of bite it more (not painfully, but my cheek gets caught). This is driving me insane because it means I am currently hyper aware of it all the time as a foreign thing, and I am speaking a little uncomfortably without intending to because my mouth seems to be trying to avoid accidentally biting my cheek. When I examine the crown against my cheek when I bite down, I can see where this is happening, but I cannot tell if this is something that will be adjustable with crowns being the way they are. Will I get used to this and stop speaking weird?

- The crown is tender. This is a root canaled tooth. When I bite down, it feels a little bruised. I've felt worse, but it definitely doesn't feel normal. We have retreated this root canal once before. He thinks it is unlikely something is going on with the tooth underneath, more that it just really needs some more recovery/rest time.

- This is a big one because this is where the pain is. Something else is going on in the area. I don't know how to describe it other than to say it feels similar to glossopharyngeal neuralgia, which I occasionally experience in other parts of my mouth/throat (usually involving my tongue). I am familiar with face/head nerve pains because I have had shingles in my face and mouth (actually on this same side as my crowned tooth), and both pharyngeal and occipital neuralgia before. So right now, there is a nerve-y type pain that is sort of washing over that back 'corner' of my mouth and spreading into my jaw a little bit. I can't tell if it is really coming from the crown, but it's more of just that whole area and out. It is not constant, but it seems to be triggered/flare up at random points in the day. When it is actively happening, it feels as if even just breathing in makes it worse. This is what I've been struggling to articulate to him. I am not sure I've made him understand this because I only this morning realized how similar it feels to the other neuralgias I have experienced. But those usually resolve in a day or two after some sleep. I am not sure this is something a dentist would know a lot about? But I am wondering if this is happening because of inflammation around the crown or jaw that is compressing nerves. And if that's the case, what do I do? Does it mean the crown is wrong? It definitely has to be happening because of the dental work. I'm just scared and not sure where things are going to go from here.

- I think my bite otherwise feels better compared to how it was, but it's really hard to get comfortable when the above is happening or know if it is actually right. Everything is linked and making everything else weird.

Lastly, I did speak to the dentist one more time yesterday. Still don't think I articulated the nerve pain but talked to him a little further still. He wants me to avoid eating on that crowned tooth for a few days, and then try soft foods. Wants to see if that settles any lingering inflammation/soreness in the crowned tooth. I guess then I am letting him know if it's not better next week. He had wanted me to wait until the new year to see him again to give my jaw a chance to settle down. I don't see how my jaw is going to relax when I have to eat on one side and I'm talking a little strangely and feeling so uncomfortable with the nervey pain, so I feel like I am working against myself right now.

@Gordon, you have been vital to my sanity here (and your wife! haha). Do you have any thoughts on the above, or advice? Thank you so much.

 

[Gordon]

The crowned tooth feels like it is very slightly too big on the outer side. This is causing it to rub against my cheek more and sort of bite it more (not painfully, but my cheek gets caught). This is driving me insane because it means I am currently hyper aware of it all the time as a foreign thing, and I am speaking a little uncomfortably without intending to because my mouth seems to be trying to avoid accidentally biting my cheek. When I examine the crown against my cheek when I bite down, I can see where this is happening, but I cannot tell if this is something that will be adjustable with crowns being the way they are. Will I get used to this and stop speaking weird?

Possibly or else the crown can be shaved down a bit, hard to say without physically looking at it. It should be an easy fix though.

The crown is tender. This is a root canaled tooth. When I bite down, it feels a little bruised. I've felt worse, but it definitely doesn't feel normal. We have retreated this root canal once before. He thinks it is unlikely something is going on with the tooth underneath, more that it just really needs some more recovery/rest time.

Periodontal ligament is most likely playing up due to occlusal trauma. Hopefully this is sorted and it's just a matter of time till it settles down.

The neuralgia type pain could be from your TMJ, the nerves in this area of the face are a bit of a nightmare, all mixed up with each other and doing similar jobs.

I think the dentist is hopeful that the TMJ will settle down with some time and the occlusion being sorted out, which will narrow any symptoms down a bit. (Or more hopefully clear altogether).