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Dr. Crapo

What A Headache   

Q: I have excellent health, at least I did until about eighteen months ago. I saw a dentist for some dental work and had two crowns done then another dentist and he did three more crowns. They were to hold together teeth breaking down. I thought after having them done that I could now forget my teeth as everything was fixed. However, I began noticing something that became constant after the crowns had been placed. I began having headaches and jaw ache. That’s the only way I can describe it. I went back to the second dentist and he said it looked like I needed all my crowns on the back teeth redone- they weren’t sitting quite right is what I made of it. I went to the first dentist and he said something similar after I told him what the second dentist said. This was perplexing and frustrating. Finally, I saw a third dentist who took all kinds of records and molds after I told him my plight. He had me come back with my husband and told us that the posterior tooth could be an instigation of my problem- but the muscular pain in my jaw as he put it was because my front teeth did not mesh properly and the back teeth were forced to do that work of the front teeth. I didn’t know anything about that but I’ve got TMJ and I don’t know how to get rid of it. Is it my front or back teeth?

A: It is possible for work done on posterior teeth, whether crowns or fillings to upset the established balance one’s joints and muscles are accustomed to. This may even happen if the bite feels fine when the dentist asks you to bite together to ensure comfort. There are many reasons for this but for simplicity’s sake it seems that our muscles and joints can detect very fine differences when teeth are modified and this can be “the mole hill that becomes a mountain.”
TMJ symptoms fall into two large categories. The first category is the joint itself the second deals with the muscles surrounding the joint. From your description, it sounds like your situation falls into the muscle category. This category is the easiest to treat but tooth relationships make the whole difference.
The front teeth are the steering mechanism of the whole chewing apparatus. When significant dental work is done in adults it is imperative that the front teeth are guiding all the chewing and grinding movements. Front teeth are built to cut, rip and tear, posterior teeth are not. When back teeth are asked, by new dental work, to carry the function of the front teeth the whole chewing mechanism can be thrown off and produce the symptoms you describe. In comprehensive dental restoration/reconstruction everything starts with the front teeth.




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