occlusion Archives - Ryan Perry, DDS

I recently had a root canal and got a crown on a molar on the bottom and now my bite is off. It doesn’t feel like it used to. My teeth don’t fit together the same when I bite or clench my jaw. I think it needs to be ground down or something, but my dentist thinks I’ll get used to it and I just have to give it time. Will it ruin my crown if the dentist grinds it down? Is that why my dentist doesn’t want to fix it?

Kay, Denver, Colorado

Dear Kay,

That’s too bad that your dentist is asking you to be patient instead of trying to adjust your dental crown. Unfortunately, when dentists do that, it is often a sign that they aren’t comfortable or knowledgeable about the correction.

The way your upper and lower teeth meet when you chew, and how your teeth function together, is called occlusion. When you get a crown, the shape of the crown is similar to, but most likely not exactly like, the contour of the original tooth, and the occlusion may be different. Over time, you may get used to your new bite, but in some instances, when the bite is off, it can cause unusual stress on the teeth. This stress can lead to bone loss or contribute to TMJ disorders.

When a new crown feels off, most dentists will simply fix it so it isn’t so high. There is a special “registration paper” that the dentist would ask you to tap and bite your teeth together on. When there is a part of the tooth that hits before the rest of the tooth, the dentist will grind the tooth in that spot to fix it. It doesn’t hurt the crown to grind down small spots that may be causing discomfort. This is a common practice with crowns.

You have a couple of options. You can wait as suggested and see if your bite adjusts if you have had a good experience otherwise with your dentist. If you do go back and ask again to adjust the crown and he is hesitant, don’t push it. It may end up worse than leaving the crown as it is.

If you don’t have any ties that bind with this dentist, it may not hurt to get a second opinion.

This post is sponsored by Dr. Ryan Perry in Baton Rouge, Louisiana.

I’m 53 years old, and had six crowns placed a few years ago. Two weeks ago, I had a new dentist fit a porcelain and gold crown to my upper rear right adjacent molars. These are the permanent crowns and aren’t temporaries. These new crowns are at least one mm or more away from touching the opposing lower teeth (these are crowned). I discovered that crowns should slightly touch opposing teeth. I need to have another crown placed on the other side of my mouth and need to know if my dentist made a mistake.
– Doug from Louisiana

Doug,

You’re correct that dental crowns should touch their opposing teeth. If they are created properly, there are other important considerations. It’s important where the crowns touch and this is also called “occlusion.”

Proper jaw function depends on how your upper and lower teeth meet. When your jaw is aligned properly, you should be able to clench your jaw together and have your teeth meet at the same time. You should also be able to grind your teeth to the side and have only your canine teeth touch. This is important because these teeth have sturdy, long roots that help with sideway stress.

Another consideration is called “group function.” This is when all the posterior teeth have the same slope and when you grind your teeth to the side, they all touch evenly.

You have probably had the bite strip procedure done at the dentist. This is where the bite is checked with a thin strip of plastic between your teeth. No matter where it’s placed on your back teeth, you should be able to clench your teeth together and keep the strip from being pulled from your teeth.

If you have back teeth that don’t come together all the way, this may cause a problem because over time, they may drift together and then touch. While this may seem to work, there’s a strong chance they won’t touch correctly and will eventually throw your bite out of alignment. When this happens, you may suffer from TMJ disorder and this has to be dealt with right away as it can lead to other serious issues.

This blog sponsored by Baton Rouge Family Dentist, Dr. Ryan P. Perry