I need some advice. I had a tooth grinding problem and my teeth were down to nubs. My dentist decided I needed a full-mouth reconstruction. I will say they look better than my natural teeth. The problem I’m facing is the pain I’m in. He told me they’d start with the bottom teeth and open my bite and then go from here. The first stage went fine, but when he added my upper teeth a problem developed. On one side of my mouth, the teeth touch find. The other side, however, had a large space between the upper and lower teeth. I’m in massive pain and it has only been five days. What do I do? My dentist thinks it’s fine and just a matter of my not being used to having “the right-sized” teeth in my mouth. I don’t think it is. I know enough to know teeth should touch.
Maggie
Dear Maggie,
If you’ve been going to this dentist for a long time and he’s just now addressing your tooth grinding, he’s done you a great disservice. Much of this could have been avoided simply by him making you a nightguard. This would have protected your teeth from the grinding while you slept. Unfortunately, that is water under the bridge and you need to deal with his latest error— your full-mouth reconstruction.
You appear to know more than your dentist. It’s absolutely true that your teeth should meet together. The study of this, occlusion, and other important skills for a full-mouth reconstruction, aren’t taught in dental school. It requires an advanced dentist who has invested in this type of training post-doctorally.
Precautions with a Full-Mouth Reconstruction
This type of procedure has to be done carefully. The first step is to open the bite with temporary crowns. The temporary crowns should be adjusted until you are comfortable with the new vertical dimension. Once you and your dentist are satisfied with that, then the permanent crowns are made. However, it doesn’t stop there. The permanent crowns and bridgework should be seated temporarily and adjusted to a comfortable bite BEFORE being cemented permanently.
Your dentist didn’t do that and it is going to cause you massive problems. Not only because you are in pain and will continue to be, but also because it will likely lead to TMJ problems.
Your dentist needs to redo this procedure. You can either give him another chance making sure he follows the procedure outlined above or you can go to a different dentist and have him pay for the repairs.
This blog is brought to you by Des Moines Dentist Dr. Phelan Thomas.