Q: When I was about eight or nine I had teeth coming in every which way. It seemed like I had a double row of teeth. Some were behind and others way out front. My parents were told I had extra large teeth and I would need a lot of teeth pulled and then braces.
On the bottom, I had three or four pulled and on the top I had four pulled. The braces were put on and I had braces for about three or four years. They got the teeth pretty straight but there were gaps left on top. Food sometimes gets trapped but I’ve learned to jar it loose and it doesn’t bother.
That was many years ago and now there’s been some relapse with crowding. It’s worse on the bottom than the top. On the top I’m noticing discoloration and cavities. The fillings in the back teeth are breaking down or eroding so that food gets stuck when I chew. As the grooves that were once fillings get deeper it feels like everything jams into the tooth.
I was told I was doing a lot of damage on the back teeth and I was grinding them badly but I don’t know when that happens. I had several back teeth (mostly the lower molars) filled a couple of times in the last few years. One broke off and the dentist filled it but left it feeling like a lump.
Anyway, what do I need to do? I’ve got crowding, decay, discoloration and occasional breaking of my teeth. It feels like I’m falling apart and I can’t get one thing fixed before another problem pops up, it’s frustrating! Please advise!
A: Prioritization of your complexities will be important. Whether the wearing or grinding your teeth happens at night or day or when you chew your food it makes no difference. The proper balance of your bite and chewing forces will be necessary. If the crowding of your lower front teeth is not extreme, then tooth alignment will straighten your teeth so they fit precisely against the upper front teeth. This will lead to less wear and breakage will be non-existent. As a bonus your teeth won’t relapse into more crowding.
In this process discoloration, decay, crowding and break down will be resolved but before anything is done in your mouth a careful examination, diagnosis and three-dimensional workup should be done and shown to you so that your questions will be answered.
The solution I suggested will involve crowning your teeth for proper length, angulation and position. They will also mesh and chew in a manner that is harmonious with your masticory muscles and joints.