Full Mouth Reconstruction Disaster
Question submitted by Sandy
Can you help me? I originally went to my dentist because I wanted my top and bottom front teeth repaired. My teeth are all ground down pretty far. My dentist said it wouldn’t be possible to do what I wanted without opening up my bite and doing my whole mouth. I went forward with his recommendation. The bottom teeth were done with little problems. However, since having the top arch done, I’ve had lots of pain. They look beautiful, but my teeth aren’t matching up correctly and I feel that is the source of the agony I’m feeling. The left side touches top and bottom, but are a little off-kilter, if that makes any sense. The right side doesn’t touch at all. When, I’m chewing, I’m coming down on half my bite first and it is giving quite the zing of pain. Plus, my jaw hurts almost constantly. He’s already cemented it all in and says I’m just not used to them. Can the ones that are hitting too quickly be filed down without damaging the crowns? I really don’t know what to do and can’t take this pain much longer.
Sandy
Dear Sandy,
I do not think this is going to be the best dentist to help you with this. When all your teeth are crowned, this is known as a full-mouth reconstruction. It is an extraordinarily advanced procedure that requires much more than dental school training in order to know how to do it well.
There are complexities to this and it has to be done very carefully in stages. Your dentist should have built up the bite with temporary crowns first. You’ll need to have perfect vertical dimension. That means your teeth are coming together precisely. Even after the permanent crowns are done, they should be seated with a temporary paste so that the bite can be adjusted. The crowns should not be permanently bonded on until everything is completely comfortable. Your case is far from tolerable, let alone comfortable. The complications you are dealing with could even lead to TMJ Disorder.
As your dentist does not seem to care about the pain you are in or the quality of his work, my recommendation is that you get a second opinion from someone with more training in this area. Look for someone with prosthodontic and maxillofacial prosthetics training. If things are as bad as I suspect, they may be able to talk to your dentist on your behalf and hopefully help you to get at least a partial refund. It sounds to me like you are going to need to have these crowns redone.
This blog is brought to you by Tucson Prosthodontist Dr. Howard Steinberg.