Q: I have had good teeth all throughout my life, but I’ve been hard on them. Over time I needed one or two crowns and one root canal and a number of fillings. Two years after the root canal, it started to hurt. I went back and the dentist said it looked fine so because it was tolerable I just went along. Another year went by, I moved, the tooth wasn’t better so I decided to see a dentist close to me. It turns out one of the two canals in the tooth was missed. It could happen, the dentist explained, because normally that tooth (third from the back upper) has only one canal… just my luck. As he looked around he said “do you know that you clench your teeth?” I said “oh yes, all my life.” He said it would be wise to do an analysis of my teeth because the wear was quite severe.
As a result, an analysis was done and the findings were alarming. I had clenched so hard that the fillings are chewed all the way through. When the fillings wear like that he said, the tooth grows down or up to constantly keep in touch with its chewing mate. My back teeth are now over grown and it’s causing more breaking on my teeth both back and front. Somehow, I suspected I wasn’t getting away with all that clenching but I had no idea how bad it could get.
He said I also had lost some bone in a few places because of the stress on the teeth. He said stress on teeth plus gums that are inflamed can lead to bone loss. He said most of my teeth need work. Is that possible?
A: It is possible and your needs are urgent. Teeth that over erupt or grow up (for the lower teeth)/grown down (for upper teeth) can cause imbalance in your bite that may stimulate more grinding and make your chewing muscles sore. This will also cause stress and stretching of joint ligaments.
That may lead to TMJ or temporomandibular joint disorders. You may also end up having to do root canals on your overerupted molars because the elongated teeth must be reduced in height first to their original level then further reduced to provide room for the crown. In some situations, this reduction gets into the nerve - thus necessitating a root canal.
Front teeth that become shorter due to wear will need to have length, shape and inclination restored because good posterior tooth balance and alignment depend on the front teeth being in their optimum position.
When your dentist said most of your teeth, that sounds like your molars and all your front teeth as that would be necessary to correct the dental challenges you have.