Been wearing night guard for tmj for 4 mths.bite seems to have changed. crown feels high on 1 side. could this cause more spasm and may not resolve?

Evaluation: Treating patients for tmd\tmj requires ongoing monitoring, unlike getting a sports guard where it's fabricated for you and you're done. Things change over time- habits, stress, occlusion, ng wear, etc. Therefore, you should see the dentist who made your night guard to be re-evaluated with possible adjustments. Finally, different dentists have different levels of knowledge and experience.

Contact your dentist: Contact your dentist to evaluate for night guard and occlusion. It is important that all occlusion is even.

Yes: It is important to know that the lower jaw is a flooding bone and held in place by muscles and ligaments. By wearing a night guard you relaxing your muscles. Therefore your bite will changes. If you feel comfortable with your night guard and resolving your TMJ issues and symptoms, may be wise to move on to the next level and restore your teeth to new diminution. Consult your dentist or a neuromusc.

Sleep Apnea: I would find a dentist in your area that is trained in dna therapy. It's a daytime nighttime appliance that can correct TMJ non-surgically. It is often used to treat sleep apnea in more advanced offices and dental clinics.

Go to dentist: If your bite is off, definitely go see your dentist, you may need equilibration, occlusal/bite adjustments, or adjustments on your bite guard, or all of the above, having an uneven bite, yes, can cause future muscle pain and discomfort and possible tmd/tmj issues.

Stop immediateley: You need to stop immediately from wearing your guard and have it checked with your dentist is it a custom made night gurd or over the counter this can lead to irreversible damage to tmj.

Be cautious: There are many types of mouthguards for grinding and clenching. Over the counter ones actually may be too thick and throw the muscles into more spasms. Dentists can make custom made, well fitting mouthguards, either upper or lower (i like the lower ones.) the guards can be made of soft plastic or hard acrylic...Depends on severity of grinding. For daytime clenching, other types are indicated.

Yes: Night guards have to be adjusted regularly. Your bite may have shifted. Make sure you are being managed by a TMJ expert. Any dentist can be a TMJ expert with the proper training and experience. Most commonly, oral surgeons, prosthodontists, and orofacial pain specialists. Ask your MD, your dentist and your dental society for referrals.