A feeling that your bite is “off” or that a new dental crown sits too high is a common experience after a restorative procedure. This sensation, known as malocclusion, occurs when the new restoration interferes with the natural way your upper and lower teeth meet. It is a frequent occurrence in dentistry and is easily corrected by your dental professional. Addressing this issue promptly is important for your comfort and the longevity of the dental work.
Understanding Why Your Bite Feels Uneven
The heightened feeling of a new crown is often due to extremely minor height discrepancies that your mouth is acutely sensitive to. The sensory nerves surrounding a tooth, called proprioceptors, can detect differences in thickness as small as 8 to 12 microns, which is less than the width of a human hair. Any minute addition to the tooth surface registers as a significant obstruction.
Immediately after the procedure, temporary swelling in the gum tissues around the treated tooth can also contribute to the perception of a high spot. The final crown is secured with permanent cement, which may cause it to seat slightly differently than it did during a temporary try-in. Excess cement or a slight shift in the final seating position can disrupt the balance of your bite.
Immediate Patient Steps
If your bite feels uneven once the local anesthetic wears off, contact your dental office immediately. While this is not an emergency, it requires prompt attention to prevent complications. Try to avoid putting pressure on the side of the mouth where the high crown is located when speaking or chewing.
Never attempt to adjust the bite yourself by repeatedly tapping your teeth together or chewing aggressively on hard foods, as this can damage the tooth or the crown. Until your adjustment appointment, stick to a soft diet to minimize the force placed on the new restoration.
The Professional Adjustment Process
Correcting a high crown is a routine clinical procedure called occlusal adjustment or equilibration. This non-invasive refinement focuses on achieving harmonious contact (occlusion) between your upper and lower teeth. The procedure begins with the dentist using articulating paper, a thin, colored film, to map your bite.
You will bite down gently on this paper, which leaves precise color markings on the crown’s surface where contact is occurring. Darker marks indicate points of excessive pressure, known as interferences. The dentist then uses a fine-grit diamond bur to selectively remove microscopic layers of the crown material from these marked high spots.
This selective grinding is done in a controlled, iterative manner, alternating between marking and making small adjustments. The goal is to distribute the biting forces evenly across the chewing surface of the crown and surrounding teeth. Once a balanced bite is achieved, the adjusted area is polished to ensure a smooth, durable surface.
Consequences of Ignoring a Misaligned Bite
Delaying the adjustment of a crown that feels too high can lead to painful and damaging long-term issues. The constant, uneven force creates excessive pressure on the tooth and surrounding structures. This sustained trauma can inflame the ligament surrounding the tooth root, leading to persistent discomfort, pain, and sensitivity in the crowned tooth.
An uncorrected high crown can also cause significant damage to the opposing tooth, leading to abnormal wear patterns, chipping, or fracture of the natural enamel. A misaligned bite can strain the muscles of mastication and the temporomandibular joint (TMJ), potentially resulting in chronic headaches or jaw joint pain. Furthermore, the uneven forces can weaken the crown’s cement bond, increasing the risk of the restoration fracturing or becoming loose and needing replacement.