“I Saw It But I Didn’t Think Much Of It”

Q: Yesterday I saw my dentist for a regular check-up. The hygienist saw me first and said everything looked good. I was happy because I hate bad news. The dentist came in and after a few moments and asked me if I was experiencing any sensitivity anywhere in my mouth. I thought about it then said “no”. He replied “good”. He went on and said that my lower back molars were showing a lot of wear. When he pointed this out to his hygienist, she said she had seen the filling wearing away but hadn’t thought about it much. He gave me a mirror and showed how those fillings were almost gone. He said I’d need to replace the fillings because of the wear, he also said there was a bit of decay at the edges of the fillings. Both of these things he said would be fixed when he did the new fillings. I made an appointment to get those two teeth fixed but now I have questions. How long will the new fillings last? What if I just leave the situation as it is – I don’t have any pain? I think I remember having silver fillings in those teeth and I had my dentist take them out and put in white fillings – should I have done that? I’d like to get them fixed once and for all.

A: This is a problem in people who clench their teeth. Healthy non-clenchers have little or no wear. Changing silver fillings in non-clenchers for white fillings (as needed of course) works well, but the latest research shows that white fillings in clenchers and grinders will not give long term service. In 1986 I did my first white filling. I did it for a woman who did not show a grinding or clenching problem. Twenty-five years later the filling looks like it was placed yesterday. Twenty-five years ago, I did a crown for a severe clencher that resisted breakdown until today. The individual wore a hole through the crown. The leakage this hole created and the patients clenching caused the crown to de-bond. Though the crown wore, there was no damage to the tooth. Very strong and unbreakable material in the crown kept the tooth healthy despite her habit. Your tooth may have small cracks in it. A filling will not prevent propagation of these cracks and severe damage may result when the filling wears again. Using the strongest materials and techniques will prevent future damage to your teeth. The most important part of the task is to realize that “one size does not fit all”. Treating your teeth to match the strength of your bite will give you peace of mind.

If we can help, we’d like to. Call 778-410-2080 for a consultation or visit us today.

Based on actual patient cases

© Calvin Ross Crapo

Victoria Implant Centre 778-410-2080

www.VictoriaImplantCentre.com

I Didn’t Know Veneers Broke!

Q: Dr.Crapo:  About ten years ago, I learned about veneers. I liked the looks of them very much and as I had a lot of old white fillings in my upper front teeth, I decided to have veneers to make my teeth look more uniform in colour and shape. When they were done I was extremely pleased. After five years my dentist said that because I was hard on my teeth throughout my mouth, I needed some crowns. I knew for a fact that I was a clencher, so I went ahead. My dentist told me that the new bonding materials would give me the whiteness I wanted without any metal, so I said let’s go for it. It’s been three years and one of the bonded crowns has come off. There are breaks in my veneers and both my dentist and I are frustrated that things haven’t held up. I’m now forced with redoing a lot of my dental work. Is that what my future is going to look like? I’m so frustrated that my veneers are going to be made into crowns. Is this what others experience? How can I get longevity and cosmetics this time around?

A:  I sympathize with your dilemma. When expensive dental work doesn’t hold up it is indeed frustrating. That said, you obviously fall into a small segment of the population who are extremely hard on their teeth. If this is known before any extensive work is done, different choices about how to make things strong as well as beautiful can be accomplished.

In most people veneers may last in excess of 20 to 25 years, but in folks with extreme clenching and grinding, they may have a few months to a few years of service. It is likely that crowns will have to replace your veneers. At present the strongest crowns have a precious metal support system. These can be made very aesthetically and give you years of service if your dentist balances your bite properly and you use bite management techniques that prevent night and stressful-times-of-the-day grinding and clenching.

Six years ago I saw a gentleman in your predicament. He was breaking up his dentistry similarly to what you’re describing. We worked diligently to repair his broken veneers. Despite our efforts, he continued to break pieces of porcelain off his veneers. We fixed his bite. We used crowns that won’t break down as his veneers did and we managed his unintentional forces so that he wasn’t stressing his new dentistry. Time had also allowed him to see what he was doing to his own mouth. Our working together gave him a great and lasting result.

If we can help, we’d like to. Call 778-410-2080 for a consultation or visit us today.

Based on actual patient cases

© Calvin Ross Crapo

Victoria Implant Centre 778-410-2080

www.VictoriaImplantCentre.com