Coping with a Misaligned Jaw Pain Everyday Health MenuNewslettersSearch Dental Health Coping with a Misaligned Jaw Pain By Dr. James E JacobsReviewed: September 8, 2009Fact-CheckedQ. 1 My jaw is out of alignment and my teeth do not mesh; in fact, they're maybe 2 inches apart. I have a massive overbite. I went to my dentist and he said I need a jaw realignment. Are there any alternatives? He also said my jaw has collapsed. What does that mean? He said my insurance won't pay for the kind of surgery I need to have. How can I go about relieving the chronic pain? I've had it for quite a long time now. — Stephanie, Missouri Dentists refer to a patient's bite using the term "occlusion." Occlusion means how the teeth meet during the opening and closing of the jaw. There are a number of factors that relate to occlusion, which include:Your temporomandibular (TM) joint and whether it is healthyThe health of the musculature around your jaw that works to open and close the lower jaw. Also important to consider is whether the muscles are in spasm or not.The binding surfaces of your teeth and how well they're able to simultaneously meet when you bite downWhether there is wear or flattening of the cusps of your teethWhether there is pain when you bite downWhether the teeth are loose These are many of the factors your dentist will consider, but I am sure there are more that relate to your occlusion. It is critical that you see a dentist who is very knowledgeable about occlusion and one who can take proper X-rays of your teeth and possibly your TM joint so you get a solid, definitive diagnosis before you begin treatment. If your teeth are not meshing and they are 2 inches apart, then you do have a serious problem that must be addressed by a dentist, whether that means seeing someone in private practice or at a dental school or hospital, which may be more affordable. Your overbite is a sign that things are not right, and of course having your teeth 2 inches apart is a big factor. There are many treatments available to you once you receive a proper diagnosis and get a full evaluation with X-rays. Some possible treatment options include:Orthodontic therapy to realign your teeth with braces. This can help bring your teeth back into the proper positions in the arches of the upper and lower jaws.Wearing occlusal or bite appliances to try to relax the muscles and joint so you can reestablish your bite at the right levelsSpecial surgery to cut the jaws and realign them back into placeBite adjustments that help your teeth to simultaneously meet at as many contact points as possibleBehavioral therapy and relaxation therapy to try to relax the muscles around your joints A misaligned jaw is something that should not be postponed as far as treatment is concerned. You must see a very competent dentist or dental specialist who understands occlusion and oral joint issues. You should be sure to get a full diagnosis with proper examination and X-rays, asking questions of the dentist if he or she is unclear. If this is not the type of care you've received so far, please seek out someone in your area at either a dental school or hospital who understands and treats patients like yourself. And although your dentist said this treatment would not be covered by insurance, you should also check directly with your insurance provider to make sure you understand the terms of your dental insurance policy. Q. 2 When I lie down on my side, I often feel immense jaw pain and pressure on my teeth, especially on the upper left first molar. What could be the problem? — Nikki, Texas The easiest way to find out what’s causing the jaw pain and pressure is to see your dentist and get a full set of X-rays, an examination, and a diagnosis. A very large cavity could be pressing on the nerve in your first molar, or that molar might need root canal therapy because the nerve has died. These problems would be most obvious on an X-ray. The problem could also be caused by grinding and clenching if you have a crown or filling on that tooth and the bite is not quite right. Grinding and clenching on a high spot could cause pain in the tooth. A sinus infection can also cause pain in a tooth because the sinuses are very close to the top of the roots of the upper molars. There may be neuralgia, or nerve pain similar to that of muscle spasms, in the area as well. Because there are so many possibilities, it is hard to know, without seeing you in person, exactly what's causing your jaw pain. A competent dentist can determine whether the jaw pain has a dental origin or not. If not, then you must consult a physician to see what other kinds of problems might be causing the pain. Q. 3 My daughter just got braces. Last night her jaw started hurting and felt "weird." She had me take a look, and it seemed as if the jawbone was sticking out of her mouth. The orthodontist says she had a muscle spasm. Could that be right? — Melissa, Kansas Obviously, it's hard to say exactly what is going on without seeing your daughter. An important factor to consider is how recently the braces were placed in her mouth (and/or how recently they may have been tightened). It's very common to experience pain for at least one to three days after having new braces inserted or after having braces tightened. A muscle spasm is definitely a possibility because pain can bring on many reactions. If it was indeed a muscle spasm, it would have had to occur in the muscles surrounding the upper and lower jaw and neck, and could have resulted from the pain of the tightening of the wires or from clenching or grinding as the teeth shift. Once teeth are moved in the mouth as the braces do their work, the bite is thrown off and the tops of the teeth do not interdigitate with each other. A muscle spasm is clearly a possible result of this, but I would certainly check with the orthodontist involved and have him or her examine your daughter. Q. 4 What are some ways to reduce or prevent jaw clenching? Jaw clenching often occurs because of the following:AnxietyStress responseAngerWeightliftingGum chewing Some people are aware that they are clenching their teeth, while others realize only later that their teeth ache or that the muscles around their upper and lower jaws are tight. One can reduce jaw clenching by seeing a dentist to determine the underlying cause and develop the right treatment plan. This treatment can include:Psychological counselingNight or day appliances to relax muscles or keep teeth apartAnti-anxiety medicationsMeditation or yogaEvaluation of the occlusion (bite) As I always advise, it is important to seek out a dentist who is knowledgeable in the area of the bite, or occlusion. You may need to see an orthodontist in conjunction with your regular dentist, or even a therapist. Q. 5 I had a lower jaw tooth pulled several weeks ago and I have been in constant pain ever since. My dentist says I have a dry socket, which he packed with some type of medicine. That helped for a while, but now the pain is almost unbearable again. What can I do to speed up the healing? How long do I have to suffer with this pain? – Daisy, California On average, caps (dentists call them crowns) last about ten years. Many last a lot longer but 25 years would be considered excellent longevity. If crowns do last this long, it is a tribute to a top-rate dentist. Today, new caps or crowns are made with thinner, stronger, and more cosmetic porcelain material. Some crowns are still appropriately made with a metal/gold foundation. Your dentist's recommendation to replace crowns is a judgment call based on decay, fracture of the old crown, poor cosmetic look, or loose teeth that need splinting or joining together. In your case, there may be other reasons to replace them of which I'm not aware. If you don't trust your dentist, then go for a second opinion from a highly regarded dentist. Let the new dentist give you a fresh opinion without bias from the previous dental plan. Removing crowns is routine work for dentists. Your dentist will drill them off and make temporary crowns immediately while giving you a local anesthesia for your comfort. Impressions are taken and a color shade is picked to match your other teeth; the impression is then sent to a dental lab, where the crowns are made to order. In a short period of time, your dentist will see you for a follow up visit to permanently cement them in place. Learn more in the Everyday Health Dental Health Center. NEWSLETTERS Sign up for our Healthy Living Newsletter SubscribeBy subscribing you agree to the Terms of Use and Privacy Policy. The Latest in Dental Health Byte Invisible Braces Review 2022 Byte clear aligners are a more affordable option for correcting mild to moderate dental issues at home than Invisalign or metal braces. Treatment with...By Will CarterSeptember 8, 2022 Are You Grinding Your Teeth Here s How to Know and How to Stop This Harmful HabitExtreme tooth grinding may shatter teeth, destroy dental work, trigger jaw pain and morning headaches, and provoke nagging from sleep partners addled ...By Susan K. TreimanAugust 18, 2022 SmileDirectClub 2022 Review Can This Clear Aligner Brand Improve Your Smile for Less Are you considering at-home clear aligner kits? 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