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Dentistry/tmj, new crown and cheek biting

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Question
I recently had a crown put on tooth #14. this tooth had 2 root canals prior to the crown. The prep was done with very little anesthetic ( no epi), The crown is a Cerec so it was done on site as I waited.
I have had TMJ problems over the past 30+ years and have had no new crowns since becoming asymptomatic for the past 5 years. I had a previous dentist that was able to establish my bite placing composite on my posterior teeth. Not pretty but did the job when no one else could solve my problem
After an hour or so the anesthetic wore off and the crown was placed without any more anesthetic. When the Dr. checked my bite I said that I am biting my cheek way in the back. He adjusted and said it should go away. Now, during the day periodically I bite my cheek and at night when I sleep on my side the cheek tissue falls into that area and is very sore.
I went back to the dentist he did a little adjusting, I said that tissue is still going into my teeth. He said there is nothing he can do about it, said that I bit it  while numb (which did not happen, as the first time he checked my bite I told him that the tissue is falling into that area. He said to stop biting it and be careful, he said it is swollen from biting it over and over and that it is not from the shaping of the crown.I asked how do I stop biting it when it is happening involuntarily in my sleep. I asked will it go away and he said he hopes so.
He says the articulating paper is not showing anything out of the ordinary, however after years of TMJ and knowing that the slightest shift in my bite also throws off my joint which after 9 years of being asymptomatic is now starting to hurt.
I really like my dentist but feel that he was very frustated when I insisted that it has to be the crown,  I have had this cheek biting happen before after dental work and it was corrected after reshaping the crown or filling. He said that the shaping of a crown does not cause cheek biting if the crown is not too high.
how long do I wait for this to clear up, or should I seek another Dentist?

Answer
Hi Dawn,

I feel your frustration.  Over the years I have had similar frustrations in dentists offices happen to me.

First, you have to understand that not even the best dentists can know what your feeling inside your mouth.  So I am definitely behind you, when you say that you think it is your crown or filling.  Don't sway from your convictions about what you are experiencing.  At the same time, I do believe that your dentist was using the right trouble-shooting methodology with the "articulating paper."  That is what is leaving him to believe that it is not your crown.

I am going to give you a quick analogy and a clue as to what might fix your problem.  The analogy is this: Over the years, I have had different things happen to my computer.  Sometimes it was hard to figure out what to do to fix whatever issue the computer was having.  But over and over again, the most common remedy would simply be to shut the computer down and then restart it.  A lot of the computer issues would simply go away, by just restarting the computer again.  Usually we never knew why restarting the computer fixed an issue.  But the important thing was that some how it worked, even if we did not know why.

So what does all this mean?  Perhaps if your dentist would just re-do the work, that may help.  I do like what you have said about him in your question and it does sound like he has experience with bite problems.  And to answer your question.....I would be very proactive about this and not wait.  If you need to go for a second opinion, or find another dentist, then do so.  All I ask is that the dentist you select be someone whose primary everyday work is TMJ and Bite Problems.

Since you have TMJ, am I correct to assume that you wear a night guard when sleeping?  Perhaps that may prevent you from biting on your cheek.  If you do not have a night guard, then seek out a dentist whose primary work is TMJ and Bite Problems.  Any dentist can make a piece of plastic and put it in your mouth.  That's no trick.  What you want is a dentist who has had a lot of practice making night guards.  It is truly an art form.

I hope you find the comfort you are looking for.

Best Regards,
Jonathan
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Jonathan at PatientBabble

Expertise

My area of expertise from the patients point of view would be Dentistry/TMJ plus the speech challenges that these jaw and bite problems sometimes represent. Over the years I have seen a multitude of dentists, orthodontists, oral surgeons, speech therapists, neurologists and other health professionals who all had an opinion about my TMJ/bite problem. I AM NOT A DOCTOR...but would purely be a patients point of view type person. I "get it" when people say they tried to explain to their dentist what their TMJ/bite problem is and that they are misunderstood. I can listen to people's trials and tribulations and there is a good chance I have been down that road before. I can make suggestions as to what people can do at home, or what questions to ask their doctor or dentist when they visit. I will try and recall information or experiences that may be helpful to you.

Experience

About 25 years ago, I had my wisdom teeth out and since then my bite has never felt "normal." For whatever reason, the first sensation I remember was not that my bite was off.....but rather that my normal tongue and speech patterns had been impeded. I spent years going to different dentists, who lumped me into their generic version of what they knew about TMJ. The majority of dentists believe they can treat TMJ, but only those whose primary focus is TMJ treatment, are really any good at it. Any dentist, can take an impression of your teeth, send that impression off to the lab and have them make a night guard. That is the easy part. The tricky part is what the dentist does with the night guard, once receiving it from the lab. The dentist has to do a "fitting" where they tailor the night guard to be evenly balanced and comfortable in your mouth. Sometimes it can take a few visits, because further adjustments need to be made to the night guard appliance, to get it just right. I have found that dentists, who have had the most practice, do a better job at fitting your appliance. It's almost like an art form.

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Jonathan's Blog is: https://patientbabble.squarespace.com/jonathans-blog

Education/Credentials
College Graduate with Bachelor of Arts Degree

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