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Dentistry/TMJ/Teeth-Shift

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Question
HI Dr Elsafi,
Thanks for taking my question.

I am in my early thirties. In my twenties, I had healthy,naturally straight teeth and a wide smile with no jaw/joint/clicking or popping issues. A dentist advised me to extract my fully-erupted wisdom teeth-three in total. Around the same time, the same dentist performed a root canal and placed a crown in my upper-left last molar. That was in 2005. Since then, I have noticed that my jaw is increasingly stiff,painful and grinds with little movement, my teeth are shifting and forming gaps and that my smile is narrow with shadows. I also have difficulty finding a comfortable "space" to "rest" my teeth. I suspect this filling/crown could be the issue?Would you classify this as TMJ? Would you recommend seeing a general dentist or a Prosthodontist for the prognosis? would an adjustment of the crown somewhat alleviate this symptoms? and lastly, can the removal of wisdom teeth cause TMJ or even worse, collapse of the dental arch?

Thank-you for your time.

Answer
I think that the crown could be the issue. Not that the dentist did anything wrong, but it is documented that some people who get a crown made, specially if it is the last crown on that side, start to develop TMJ problems. The reason being is the condyle on that side seat more in the TMJ once that tooth is shaved down.

I would definitely recommend seeing a prosthodontist who should be able to confirm what I mentioned above. Based on the findings, adjustment, sometimes, could alleviate the symptoms.

Removal of wisdom teeth could cause teeth drifting in people who have periodontal (gum) disease, but that usually takes years to happen. There are other causes, for example, clenching and/or grinding your teeth at night could cause drifting too. Again when you see a prosthodontist he/she should be able to confirm that.

Hope this helps.

Good luck,
Dr. Elsafi

Dentistry

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Mohamed Elsafi, DDS, MS, FACP

Expertise

I am a board-certified Maxillofacial Prosthodontist. I do head and neck prosthetic reconstruction for patients with congenital and acquired defects. This also includes trauma and cancer patients. I can answer questions about prosthetic rehabilitation of the head and neck area. I am also a board-certified prosthodontist and can answer questions about dental reconstruction including crowns, bridges, veneers, partial and complete dentures and implant restorations. I can also answer questions about TMJ problems. I can not answer about surgical reconstruction.

Experience

I am a board-certified prosthodontist and maxillofacial prosthodontist and have been practicing denitstry for over 15 years.

Organizations
American Academy of Maxillofacial Prosthetics. American College of Prosthodontists.

Education/Credentials
I received my dental degree from University of Southern California. I did my prosthodontics residency at University of Florida and my maxillofacial prosthetics fellowship at MD Anderson Cancer Center in Houston.

Awards and Honors
Chief Fellow at MD Anderson Cancer Center.

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