occlusion Archives - Marie Moeckel, DDS

I needed two different crowns placed. One was on a front tooth. The other is a back tooth. The one in the back hurts whenever I bite down. It’s almost as if it doesn’t match up with the tooth across from it. I think it needs to be hollowed out a little or something. My dentist insists this is normal and I will get used to it. The other thing which bothers me is the front tooth. It doesn’t match the other front tooth. It’s sort of close but not close enough. I’m uncomfortable smiling. Again, though, my dentist thinks it’s fine. What do I do?

Claire

Dear Clarie,

Allow me to translate something for you. When a dentist says, “You’ll get used to it,” they generally mean “I have no idea how to fix this.” Generally, they’re hoping you’ll just stop complaining. While is it possible you will get used to it and adjust, it’s likely you will develop some form of TMJ Disorder in the process. It sounds to me as if your dentist has not studied occlusion. This is the science of how your teeth need to come together properly. It usually requires a dentist to take courses in a good post-doctoral center that teaches those topics.

Some good great institutions which teach this are:

The Texas Center for Occlusal Studies
The Pankey Institute
The Las Vegas Institute for Advanced Dental Studies
The Dawson Academy

You will need to see a dentist who has this type of training to make sure your crown occludes correctly. The front tooth is a totally separate issue.

Matching a Crown to a Front Tooth

It takes an exceptionally gifted cosmetic dentist to match a porcelain crown to a front tooth. Most average cosmetic dentists will suggest you crown both teeth or just try to get a single crown close to the other tooth. This seems to be what has happened to you. The top cosmetic dentists are accredited by the American Academy of Cosmetic Dentistry.

I’m going to recommend you see an AACD accredited dentist. One of the benefits they have, in addition to matching your crown and creating gorgeous smile makeovers with porcelain veneers is that they have usually invested time in studying other aspects of their field as well. You will likely be able to find one who’s studied occlusion and they could help with both of your crown issues at the same time.

This blog is brought to you by La Jolla Dentist Dr. Stephen Doan.

I’m having a problem with my full-mouth reconstruction. The temporaries seemed to fit fine, but when the permanent restorations were bonded on things started going south. I noticed not all my teeth were connecting properly. Some teeth hit the opposing teeth sooner and some never hit at all. It was like my bite had become treacherous, rocky terrain. My dentist tried grinding down some of those which seemed to be too “tall”, but that only made things worse. I finally gave up and went to get a second opinion to see if I should just get a full refund and go elsewhere. Yet, when I met with the second dentist, all he kept saying is “Dr —–” is a good dentist. He’ll take care of you properly. It seems like they know each other and he’s more interested in having his friend’s back than he is in my getting my teeth properly cared for. Is there anything I can do?

Marilyn

Dear Marilyn,

We’ll start with your second opinion because I am going to recommend you get another one and I don’t want the same thing happening to you. Dentists are peers. They often are friends as well. When you get a second opinion, you absolutely can NOT tell them who it was that did the original work. If they ask, simply say you want their untarnished opinion on the work without regard to who did it. This is the best way to get a true opinion.

What you are describing to me is serious. Occlusion, the way the teeth come together, is both complicated and important. Without it fitting properly you will have lifelong problems including TMJ Disorder. When you get your second (third) opinion I want you to see a dentist who has had significant TMJ training.

Getting training for this in dental school isn’t enough. It requires a significant amount of post-doctoral training. Three schools, in particular, are known for the training in occlusion and TMJ Disorder.

Dawson Academy
Pankey Institute
Las Vegas Academy of Advanced Dental Studies

They should be able to help you get the care you need. I know this is a difficult experience for you.
This blog is brought to you by La Jolla Dentist Dr. Stephen Doan.

My New Crowns are uncomfortable and Ugly

Matching a Crown to a Front Tooth

Full-Mouth Reconstruction Gone Bad

Introducing Dr. Marie Moeckel