When I lived in Arizona, I was seeing a dentist for some TMJ issues. I received a nightguard which I have faithfully worn each night for the past 5 months. I’m still having some pain and headaches. My new dentist here says that there is a cavity beneath 1 of the 2 porcelain crowns on my lower right back teeth. I received the crowns in the summer of 2017. He says I don’t have a TMJ issue. Is it possible that I have a cavity beneath a crown and pain with no TMJ issues at all? – Doug

Doug – When a crown is placed, the margin—where the crown meets your tooth—must be smooth and free from gaps. If there is a gap or roughness at the margin, the location will attract plaque and be susceptible to decay.

Generally, insurance companies expect dental crowns to last at least five years. If a crown needs to be replaced sooner, you won’t receive any benefits toward it. Unless a patient is prone to cavities, most dentists would expect a crown to last much longer.

You Can Still Have TMJ Issues

If the dentist you saw in Arizona has advanced training in diagnosing and treating TMJ issues, he or she likely had good reason to give you the diagnosis. In addition to pain, there are other signs and symptoms of TMJ disorder. It is possible to have both a cavity beneath a crown, as well as TMJ issues. We recommend that you get a second opinion from a dentist with advanced training in occlusal and bite.

Your crown and tooth will be examined, and the dentist will check for other signs of TMJ and ask about your symptoms.

This post is sponsored by Colorado Springs dentist Dr. Joseph Rota.