Re: jaw pain

Hold it!!!!!


"Dr. Jochen Kulow" <jochenkulowNOSPAM@xxxxxxxxxx> wrote in message
> Thomascall wrote:
>> My wife had some dental work done last summer where she had ceramic
>> inlays replace almagom. The dental work caused her jaw to be
>> misaligned creating chronic pain. The dentist checked her bite and
>> insisted the "dots lined up". She gave my wife a mouth brace but it
>> caused her mouth sores.
>>
>> Any suggestions where to go from here?




>
> A common misunderstandig is that ceramic has almost no wear/abrasion.
> Since the normal teeth do have abrasion it is common that the ceramic
> restauraion must be adjusted from time to time.

Glazed porcelain is harder than enamel and wears the opposing tooth more
that enamel on the opposing tooth would. However, polished porcelain would
have a surface hardness almost identical the enamel, therefore, no
appreciable wear of the opposing teeth.

> As a fast help a NTI could help. But it neglects the real problem.

If the Pt is a clencher, the NTI prevents the problem. The bad part is that
the patient often has to use it indefinately. However, every Dawsonite
occlusionist who insists on the lateral pyterygoid muscle reacting to a CR
descrepancy will insis the patient wear a full coverage splint for the rest
of their life.

> I would suggest the bite is checked again. Let the spots be removed almost
> fully, as long as it feels comfortable. The patient must decide the
> feeling not the dentist.

You cannot remove all the spots. For crying out loud! You will destroy the
vertical deminsion, and the jaw will just close further to make new dots.
The patient needs to relax the muscles first, then re-evaluate the occlusion
with relaxed musclulature. Either wear a full splint with weeking
adjutments for 4-6 months, or use an NTI for 3-4 days.

> After a long time I would also advise to have a physiotherpist check the
> statics of the body since chronic tension moves downward the back. A
> different length of the legs are a hint. It's called derbolowski sign here
> in Germany.

Danger Will Robinson!

>
~+--~+--~+--~+--~+--
Stephen [What's a Temporary?], D.D.S.
Michigan, USA
.....................................................

This posting is intended for informational or conversational purposes only.
Always seek the opinion of a licensed dental professional before acting on
the advice or opinion expressed here. Only a dentist who has examined you
in person can diagnose your problems and make decisions which will affect
your health.
.......................


.

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