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After getting new crowns on my front teeth, my bite feels awkward.

I chipped my upper front teeth in an accident when I was younger, and I’ve had the same dental bonding on them that the dentist placed almost 30 years ago. The bonding has held up well all these years, but it was starting to look old and discolored. So when my current dentist recommended crowning my six upper front teeth (from canine to canine), I said okay. I got the new crowns about a year ago, and although they look alright, they feel strange. I must have been back and forth to the dentist almost a dozen times to try to have them adjusted, but nothing seems to make them feel better. My dentist says she doesn’t see anything wrong with them and even other dentists I’ve seen say the crowns look great. I’m not sure exactly how to describe it, but it just feels like my crowns don’t close against my lower teeth correctly. My crowned teeth sort of burn as if they feel itchy unless I chew on something or tap my teeth together.

Is there any hope of relief for me? Will another adjustment help or do I just have to live with this irritating sensation?

—Marjorie from Pensacola, FL

A woman and her dentist both look at the camera. If your bite feels off after getting crowns, getting a second opinion from a dentist with special training in occlusion can help your bite feel better..

Hi, Marjorie

Thank you for sharing your experience with us.

Although we can’t give you a diagnosis with the limited information we have, it does sound like your bite is off due to the fit of your crowns. When crowns are done well, they should leave your bite feeling so natural and comfortable that you forget they’re even there. You say that the crowns ‘don’t close against your lower teeth correctly,’ and that strongly suggests that your bite is off.

One thing we’d like to make you aware of is that it’s possible for individual crowns to be nicely placed and yet still cause your bite to feel “off.” This is especially true in complex cases like yours where you have multiple crowns in a row on your upper front teeth. There are a few key principles of occlusion (bite mechanics) that dentists need to follow when restoring front teeth, and it sounds like perhaps the dentist who placed your crowns isn’t experienced in those principles.

Here’s an example of some of the principles, or factors, that affect the fit of crowns on upper front teeth:

Centric occlusion – This is when all of your teeth close comfortably together at the same time when you bite down.

Anterior guidance – This means the front crowns need to be shaped in a way that they help open your upper and lower back teeth when you slide your jaw forward.

Canine protection – This means that your canine teeth need to be shaped in a way that they help separate your teeth when you move your jaw from side-to-side.

Besides these, a dentist also has to consider how a row of crowns will affect the way you speak. So as you can see, there are a lot of factors at play, and if something doesn’t line up just right, it can spell discomfort in the form of TMJ pain and tooth sensitivity.

Another worrying point is the fact that your dentist recommended six crowns in the first place when it sounds like just updating the bonding would have done the job. We don’t fully understand your dentist’s rationale for suggesting the crowns, however.

There is good news. You don’t have to live with the discomfort forever—you just have to find the right dentist who is experienced in things like the principles of occlusion, full-mouth reconstruction, and the correction of uneven bites.

Some dentists have post-graduate training from institutions that give them insights into treating complex occlusion problems. A dentist who has completed training at one of these institutes is likely beyond qualified to adjust your bite and help you get relief:

  • The Pankey Institute
  • The Dawson Academy
  • The Spear Education Center
  • The Las Vegas Institute for Advanced Dental Studies

We suggest you search for a dentist near you with such qualifications and schedule an appointment to get a second opinion.

This post was published on behalf of Owasso TMJ dentist Dr. Heng Lim, graduate of the Las Vegas Institute for Advanced Dental Studies.