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Dentistry/full mouth reehab


i had full mouth rehab with 28 crowns leaving wisdom teeth in order to raise my vertical height of teeth ..   treatment was completed ok.. after sometime i felt some (1 or 2) high points .. bt the dentist did my entire right side upper and lower mostly pre molars not molars ... and sir now i am facing problems below -

1)pressure on lips while sitting idle or speaking ..
2)i feel like getting a high point touch in front of my teeth due to which i feel a gap and its causing stress (feeling restless)
3)muscles that were strong are now loose (well thats what i have noticed)
all i want is that i donot face the above problems..
main question is -
So if i was to change some crowns (premolars maybe?) which ones should i go for lower ones or upper ones ?      does having an option in upper and lower ones effect the face muscles or its same for upper and lower ?

please help me on this one .. ihave felt a lot of effects in upper upper or lower raise of teeth .. so am confused ..
looking forward to ur reply.

Hello Omi,

Before I go spouting off on questions like these, I always like to preface my answer by saying...."I am not a doctor."  But I do feel like I have definite "Patient Point of View" opinions.

I have never heard of anybody capping such a large number of teeth with crowns to adjust a bite.

I am not surprised that after putting caps on your entire upper right side and lower that you are facing problems.  Let's say that even though in theory, you put the caps in all the correct places, I don't think that approach would work.

Ok, now that you have all those caps on, you think, ok, I will move some caps here, replace those there, add some over here, etc., it is a losers battle.  The odds that you will ever be able to get your teeth balanced and get off that merry-go-round of where to put the caps, will go on indefinitely.  Every other week you will be thinking, let me move this cap here, or move that cap there.  You are going to end up being frustrated and tormented.

My best advice, would be for you to visit a dentist who's PRIMARY SPECIALTY is working on patients with TMJ disorders.  It is not enough to just go to any dentist and have them work on you.  

Typically, TMJ dentists will also make a night guard retainer for you.  And you want a dentist who CONSTANTLY is making night guards for patients and who has had a lot of practice fitting them.  A good dentist will also lay out a plan for follow-up visits, to get that night guard, just right.  It could sometimes take as many as 3 or 4 visits and adjustments to get your night guard comfortable for you.

Any dentist can make a night guard and put it in your mouth.  That is no trick, especially since the lab does most of the work.  What you want is a dentist who makes these appliances on a routine basis, and has a lot of experience fitting and getting that balance just right.

The other part of this equation is that when you have added all those caps in your mouth to adjust the bite, it will confuse all your facial muscles. Your face is a complex network of facial muscles all working together in a rhythm. It would be nearly impossible to have all those caps positioned perfectly and then still have all those facial muscles feel like everything is in the right place.

My gut tells me that the whole thing just does not sound right.  Remember.....Most dentists will tell you they can treat TMJ.  But you want the person who does this sort of work on a DAILY basis.  You don't want a dentist who does fillings one day, braces the next, and then maybe takes a TMJ case a couple of times a month.

Good luck and please check back here at Allexperts and let us know how you did.

Best Regards
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Jonathan at PatientBabble


My area of expertise from the patients point of view would be 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 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 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 come from a family of dentists. My first house growing up was one of those residential/dentist combination homes and I was around the dental practice all the time. My teeth had always been perfect, and in many respects they still are. I have never had a cavity and my teeth are straight. About 25 years ago, I had my wisdom teeth out and since then my bite has never felt "normal." I have learned a lot over the years as I tried to figure out my problem from the Dentists, Speech Pathologists and assorted doctors that I have visited. I will try and recall information or experiences that may be helpful to you.


Twenty-Five years ago after my wisdom teeth were removed, my bite did not feel right and then had trouble speaking. 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. The years of searching for proper treatment has underscored the importance of understanding the relationship between dental and speech methodologies.///// To this end, and to further my research, I recently attended the American Speech-Language-Hearing Association Convention (ASHA) in Atlanta. At ASHA I learned about a specialty within Speech Pathology termed “Orofacial Myology”. In laymen's terms Orofacial Myology Disorder (OMD) deals with the establishment of correct functional activities of the tongue, lips and jaw. OMD is a motor speech disorder that impacts the normal flow of speech, chewing or swallowing.///// If you believe that your struggles with your teeth also present speech, chewing or swallowing challenges, you may want to seek out a licensed Speech Language Pathologist.....preferably one that has training with Orofacial Myology Disorder.

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Abridged Version of a Letter I Sent to a Health Care Professional (3/14/13): "..In my early 20's I had my wisdom teeth out. Almost immediately within a few days, something did not feel right in my mouth. I had trouble speaking. When I raised my tongue to try and touch my palate, I felt mostly just teeth. It is very cumbersome to talk and my bite also became a little bit off. If feels almost as if someone put a fork in my mouth and said "now try and speak." Very difficult. My articulation is fine, so to an observer I sound normal. But it takes a monumental effort, so I hate situations like talking on the phone or when somebody asks me to "tell them a story." ..I spent years going to different dentists, who lumped me into their generic version of what they knew about TMJ. They just automatically gravitate to what they have heard about TMJ and assume I am either stressed, or just imagining it. Years later, I look back at all those dentists and doctors and I am amazed at how little they really knew about my condition. I have seen the best dentists, including my dad who is a Orthodontist in New York, to TMJ Dentists in Atlanta and Florida. No one ever suggested that Speech Pathology may be a direction I should explore. ..And I was frustrated by the fact that several MRI's over the years, showed nothing. How could the MRI’s show nothing, and at the same time, I know something does not feel right? I do wear a night guard to sleep in, but it does not fix the trouble that I have when I try to talk. ..I went with a Speech Pathologist friend of mine to the American Speech Language Hearing (ASHA) Convention last October in Atlanta...There was a Speech Pathologist at ASHA who was saying that sometimes when you have your Wisdom Teeth taken out "late" that it could possibly cause damage to the Trigeminal Nerve and surrounding muscles.” POSTSCRIPT: At ASHA, I discovered OROFACIAL MYOLOGY (OMD) which is a specialty in Speech Pathology that addresses Oral Muscular Issues.

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