Patient presented with a chief concern of cold and hot sensitivity in her teeth. She had no apparent headaches but was only chewing on her right side.
Clinical evaluation revealed multiple teeth with fractures, old mercury fillings (black), and broken white fillings. Palpation of all the Muscles of Mastication (chewing muscles) revealed more tension and tenderness on the right side. When she opened her mouth, her jaw moved towards the right side where the tension was focused. Ultrasound of the Temporomandibular Joint revealed Crepitus (gravel) noise bilaterally. Review of the function of the teeth revealed significant interference when moving the jaw left, right, and forward contributing to the fracture of the back teeth. Multiple front teeth had mobility.
Treatment involved an Orthotic Appliance to relax the muscle and then an adjustment to the teeth to re-balance the bite. The muscle tension and aberrant jaw movement disappeared and the tooth sensitivity stopped. The restorative care pictured is primarily focused on the back teeth and are all Porcelain-Esthetic Crowns.