After crowns my teeth feel dry.
When I was a child I chipped both my front teeth in an accident – and the dentist corrected it with filling material as well building up the two on either side (the lateral incisors) to correct some gaps. I had them redone once in my 20’s. At age 50 they were looking pretty worn out so I decided to finally bite the bullet and have crowns done.
In order to even everything out I needed 6 new crowns #6-11. I had them done in January 2018. It was a major change because all the spacing changed on my top teeth making them hit my lower teeth in awkward ways. Not only was the bite heavy in some areas, but I also felt the need to tap my teeth together constantly. Since the crowns I have been back maybe ten times for adjustments, but I continue to need to tap them and I think I have developed burning mouth syndrome. Usually when I wake up in the morning everything feels great but by mid-morning the back of my front teeth are burning and I feel the need to tap the teeth together. The ONE thing that relieves them is to chew gum, so I am now chewing a lot of gum! I don’t even really like gum. On one appointment I went back and the dentist husband (they are a husband/wife practice) told me NOTHING was wrong with my teeth and reluctantly referred me to a gum specialist. I instead went to another dentist who was recommended and he checked out my crowns. He did say they were very nice and seemed very well placed. Is there anything I can do to make this uncomfortable feeling stop and do I need to have more adjustments to stop the tapping together? I feel like they may have made my teeth a little bit longer and that is the root of the problem.
– Laura from Maine
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You’re telling me several things about these crowns feeling funny, and I don’t have answers for everything you’re telling me, but I’ll share what I do know.
Let me start with the entire treatment plan, which was replacing some very successful composite bonding with six crowns. That seems to me to be very aggressive over-treatment. I think that an expert, ethical cosmetic dentist would have just replaced the bonding.
So right away I am suspicious of the ethics of your dentist. And from the experiences you had afterward it gives me the impression that she may have gotten in over her head here. Maybe not. I’m just being as honest as I can with my impressions here. So let’s go to your complaints.
You’re saying your teeth feel dry, there is a burning sensation, you want to tap your teeth together, you think your teeth are a little longer. I don’t have answers for all of that. But one comment you made particularly attracts my attention. You made the comment about your bite, apparently in reference to how the bite felt right after you got the new crowns: “making them hit my lower teeth in awkward ways.” That’s a red flag and is what gives me the idea that there is something wrong with the treatment, that your bite wasn’t right. When crowns are done right, the bite will feel completely natural and comfortable. But from the start you are saying that your bite felt awkward and now you are feeling that you want to tap your teeth together all the time.
And then referring you to a gum specialist. Really? What does this have to do with your gums? The bite is off. Another dentist checked the crowns. That’s nice to know that the crowns look fine. But each crown can look like it is perfect, and the bite can still be off. When you do all six front teeth, there are certain occlusal principles that have to be followed. Not only do they have to all meet simultaneously in what we call centric occlusion, but they also need to provide anterior guidance. In addition, the canine teeth are very important and in most cases they provide what is called canine protection–when you slide your jaw side to side they will be the teeth that force all of the teeth apart. And then add to that the effect that the shapes of these teeth have on your speech and you have a very complicated situation. Something in all of that function has not been done right for you, and what you need is a second opinion from a dentist who knows a lot about occlusion. That training is not generally supplied to general dental students in dental school. Post-graduate training for dentists in all these complex occlusion issues is provided at the Pankey Institute, the Dawson Academy, Spear Education Center and the Las Vegas Institute. I would get a second opinion from a dentist who is a graduate of one of these institutions.
About the burning sensation and the dry feeling, yes, that could be burning mouth syndrome, which in my opinion is caused by stress. If you had your bite fixed, maybe that would go away.
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.