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Dentistry/full mouth reehab

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Question
HI,
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.
thanx

Answer
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
Jonathan
Patient Point of View  

Dentistry

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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.

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

Education/Credentials
College Graduate with Bachelor of Arts Degree

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