Can a changed bite cause a toothache?

I the past several months two people came in with a similar complaint. After some recent dental work involving a new crown they had some pain that wouldn't go away. In both cases, initially their tooth was fine, but after several days it started to hurt. I checked the bite and in a habitual closing position it was fine, but in lateral excursions it was hitting. In both cases I adjusted their bite in excursions and asked them to call me back in a day or two.

Both patients reported back that their tooth had stopped hurting. Although a simple bite adjustment doesn't always do the trick, it can't hurt and if it works it saves the patient a possible unnecessary root canal. I should add that only a small minority ( in my experience probably less than 10%)  recently crowned teeth actually end up needing root canal. This happens  if the patient has pain that won't eventually go away or develops radiographic evidence of an endodontic abscess .  When this happens a root canal usually solves the problem.

 Many dentists will adjust a bite on a recently crowned tooth that is hurting before recommending a root canal and only then if the bite adjustment doesn't work will they recommend a root canal as a solution. It only makes sense that if a tooth is in a hyper occlusion in centric (habitual bite) or one of its excursions that it can be the cause of tooth pain so why not make a small bite adjustment first before pulling the root canal trigger.








from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2018/03/can-changed-bite-cause-toothache.html - http://lspindelnycdds.blogspot.com/

Comments

Post a Comment

Popular posts from this blog

Help! My Child is Terrified of the Dentist

Image
If you’re the parent of a young child, you know their brains are similar to sponges that soak up everything around them—especially in their first five years, which neuroscientists say is when they’ll do the most learning and developing in their entire life. At this formative time, your child may amaze you with what they notice: your facial expressions, the different tones of your voice, and your habits. If your habits include regular dental visits and an excellent oral hygiene routine, they’ll notice and want to emulate you. If you happen to feel anxious about your dental visits, or you groan when you’ve got to floss and brush, they may synchronize and feel your dread. This could lead to dental fears that stick with them for years—potentially a lifetime! Kids Can Be Courageous If you’re feeling guilty right now, go ahead and put that away as it won’t serve you or your little one. Everyone has some room for improvement, and Coastal Pediatric Dentistry® is here to help show you an
Read more

Going for the Gold?

Image
On the left is the older allow, on the right the new one that my lab has chosen to use The cost of a penny weight of pure gold is currently $79.53. The cost of a penny weight of pure palladium is $130.6. It used to be that palladium was added instead of gold to the precious metals often used for pfms, but now laboratories are finding that palladium is no longer affordable. The lab that I am using has just changed the formulation of the metal it's using to one that has more gold than palladium. I really do not mind, but metals with more gold are softer and often easier for a dentist to accidentally polish off delicate margins. It is important when polishing "higher gold" formulations to exert less hand pressure when performing the final polishing of the crown's margins. Other wise there should be no problem with this change. Traditionally labs have chosen alloys with higher gold percentages for optimal esthetics, since alloys with higher concentrations of
Read more

Tongue Ties: What Parents Need to Know

Image
For a long time, people just didn’t seem to know much about tongue ties. In the early years of my practice, few of my patients had ever heard of a tongue tie. When I pointed out that they or their children might be tongue tied, I was often the very first practitioner who’d mentioned it to them. When I told them that a tongue tie might actually be the root cause of their oral myofunctional issues, or even their sleep apnea , I’m sure that some of them thought I was crazy. But in the last few years, things have changed so much! Initially, there was a small increase in the number of patients who were contacting me specifically about tongue ties. Dentists and orthodontists also began reaching out more frequently to discuss the application of myofunctional therapy exercises to tongue tie treatment. But in the last year or so, that little bit of interest has become a surge of awareness. Tongue ties and their effects on health and craniofacial development are finally becoming mainstream.
Read more