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Dentistry/Jaw pain and emotional trauma after dental work


I had a crown (no rood-canal) on a second-to-back molar put in one side of my mouth and a filling on a second-to-back molar on the other side of my mouth a year ago.  I almost immediately noticed that my bite was off, and my dentist did several adjustments on my teeth since then.  Nothing has made my bite feel better.  My back teeth on both sides feel like they don't touch down correctly.  My bite has moved from sitting comfortably in the back of my mouth to where the front teeth are the ones that touch.  My jaw is sore every day now and I have never had jaw pain before.  I massage it daily, but it doesn't really help.  My dentist sees no problem with my bite and suggests it is an orthodontic problem now.  
I don't know what to do about this pain.  I also feel like I need to do something to help my bite feel more comfortable, but the dental advice now is that I need to get braces to get my bite to fit again.  
I use a night guard now, but when I wake up in the morning, it makes my bite feel really off all day.  
I didn't need braces or have jaw pain before this procedure.  I would love any advice on what is wrong with my mouth and how to get the help I need.  
I never had dental anxiety before, but now I need to take anxiety medication because I am so stressed out about my mouth and my jaw.


Hi Veronica and thanks for your question.

Let me firstly express my sadness about what you have been going through and for your dilemma. I am sure you can appreciate the danger and difficulty of me giving you a definitive diagnosis without having the privilege of examining you together with the appropriate diagnostic tools needed, but I can offer this advice...

Every good clinician should have the best interests of every one of their patients at heart and clinical reputation counts for a great deal towards their success and overall enjoyment of their profession.  Therefore, a good place for you to start, is with the dentist who did the original work. If I was you, I would approach this dentist in person and discuss your dilemma in detail, explaining all your issues and requesting a suitable resolution of the matter. Don't make demands and do this with a subtle approach, but be direct and explain your emotional affliction as a result of this matter. A good suggestion would be to remove this crown and fit a temporary crown for a period of time in order to evaluate the change in symptoms. Temporary crown material is not as hard as the porcelain of a permanent crown and allow for greater adjustment to bite. If, or when, the symptoms have resolved, a new crown can be made, making any necessary adjustments to the final crown as needed. The filling on the other side should also be evaluated in the same fashion as well, after the crown issue has been resolved or if the problem still persists, because it is very difficult to ascertain which side is causative in this problem and each should be evaluated independently. The costs involved should also be discussed in depth.

Should this problem persist or should you get no satisfactory outcome with your dentist, then go for a second opinion of the matter elsewhere, preferably to a prosthodontist or oral maxillo-facial surgeon. This is important, because there is a possibility that the jaw pain could be unrelated to the work recently completed and could be co-incidental. A diagnosis must therefore be made for what you are experiencing in order to develop a suitable treatment plan and treat the cause effectively. The specialist will be able to advise you further on the matter and should it be due to the work of your dentist, they will issue you with a report to present to them in order to rectify the problem the best possible way.

If you still have no success in resolving this matter, then contact your local dental council and ask them for appropriate clinical and legal advice on the matter. But this can almost always be avoided by effective, honest and direct communication with your dentist.

Finally, please do not let this issue overtake your life anymore, I know it's with you every hour of every day but have faith that it will be sorted out in time - don't make this problem the focus of your life or affect your good attitude in any way. The solution might not come immediately but it could be a process of eliminating possible causes until you get the peace of mind you deserve over this and relief of your facial pain. For me, it is ludicrous to assume that you may need ortho work at this stage, until a diagnosis has been made of the exact problem and an ortho consult has been requested. This may happen down the line if needed, but as far as I'm concerned, that is not where I would start your effective management of this problem. It's a matter of cause-and-effect and this should be evaluated in greater detail.

I hope this helps and wish you all the very best in resolving this problem and getting the relief of your pain and the peace of mind that you definately deserve. Take care.

Kind regards
Dr Craig Peck


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Dr Craig W Peck ( B.Med.Sc., B.Ch.D., Clin. Botox, Cosmet. Derm.)


I am a General Dental Practitioner, with special interests in Cosmetic Dentistry & facial aesthetics and Periodontology, placing a strong emphasis on the establishment and maintenance of a healthy periodontium (the support structure of the tooth) before cosmetic options are considered. I uphold all principles of prevention above interventional treatment and try as far as possible, to remain conservative in my approach. I believe in detailed, open and honest patient discussion, establishing what the patients expectations are and what the reality is of achieving this and involving the patient at every level of the treatment. I have strong principles on ethical treatment and appropriate patient management. I have chosen to treat and rehabilitate many nervous and phobic patients, who, for whatever reason, find it impossible to take part in the very important task of even a routine check-up. I will accept questions relating to general and cosmetic dentistry (in conjunction with the use of facial cosmetic procedures) and dental fears/phobias. I will be more than willing to answer any academic questions in dentistry, biology, physiology, psychology and health sciences in general. As most dentists will tell you, there is often not only one way of dealing with a dental issue - so very often, there is no precise right and wrong way of approaching the problem. All clinicians vary when it comes to treatments and what works best in their hands is often the treatment that is advised. Be understanding of this and bear in mind that nothing lasts forever! Patients are happy to accept only a one-years warrantee when buying a new car, but seem to expect that dental work is going to last them their lifetime.


I have worked for many years in the UK and RSA as a general dental practitioner - within the NHS, private practice and the government dental health services. I am certificated for the administration of Botox and Dermal Fillers for facial lines and wrinkles as I have attended further courses in minimally invasive facial cosmetic procedures. I started seeing an increasing number of patients who presented with severe to moderate dental fears, even with full-blown phobias, so I started with the slow and patient task of tackling this problem and have successfully rehabilitated many patients. The key is good, effective, concise and understandable communication, shifting control from the dentist to the patient in order to slowly, but confidently, regain their trust back in dentistry, thereby giving them the feeling of achievement and this self-empowerment which drives them to the next level of treatment.

Academy of General Dentistry. American Dental Education Association. IAPAM (International Association for Physicians in Aesthetic Medicine). Professional Speakers, Writers and Managements Consultants in Dentistry. The British Dental Association. UK Aesthetics Group. ARC - Aesthetic Professionals. Botox. Aesthetics & Beauty. American Association for Dental Research. FDI - World Dental Federation. SOURCE1uk. World Dental Hygiene Forum. ProDentalCPD. Public Health Dentistry. Dentist Network. LinkedIn. Who's Who of South Africa.

B.Med.Sc. Degree (Medical Physiology and Medical Virology; Physiology Cum Laude; Stell 1994). B.Ch.D. Degree (Bachelor of Dental Surgery; Clinical Dentistry Cum Laude; Stell 1997). CPR and CPR-Advanced Courses (2000/2001; UK). Clinical Botox (UK, 2001). Cosmetic Dermatology (Botox and Dermal Fillers; RSA 2011).

Awards and Honors
Placed on the Dean's List at University for academic achievement (1994). Highest achievement in the subject Dental Materials. Medal from 3M and the Radiology Association of South Africa for highest achievement in the subject Dental Radiology and Imaging. Medal from The Periodontal Association of South Africa for highest achievement in the subject Periodontology. Highest achievement for Oral Medicine. Highest achievement in Oral Pathology. Received the DASA (Dental Ass. of South Africa) Gold Medal for highest achieving dental student across the 5 1/2 years of the Degree. Passed the subject, Clinical Dentistry with distinction in final year.

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