Q: Dr. Crapo: I’m from Poland. Two years ago, I moved to Canada. Last week I went to the dentist because a filling fell out. I also have other problems with some broken pieces, I don’t know if tooth or filling. He looked at my mouth then told me about other problems I wasn’t aware of. He told me I had a very strong bite. He said my bite was too strong for the fillings. He said my teeth would keep breaking. He told me my wisdom teeth were bad to keep. He said they make my bite even harder for my fillings. He told me one of my root canals was not working and I might need surgery on it. He told me my front teeth were dissolving and wearing very fast for my age. I am thirty-five. I don’t know why my teeth are dissolving and breaking. He said I would need crowns on my teeth. It sounds expensive and confuses me. This is the first time I have heard of these problems. I don’t know if it’s right all of these things. Can you tell me if this can be right? What do I do if it costs too much money?
A: Though the experience you’ve had may seem overwhelming – and it is, a careful and thorough approach is best. From what you’ve related, three forces are operating aggressively that must be checked. Mechanical forces are causing breakdown of your white fillings. Chemical forces are causing the erosion (dissolving) to your teeth and bacterial forces are causing your root canal to fail.
Mechanical forces (your bite forces) need to be managed with protective care. This will prevent destructive wear. Also, your dentist may well be right about your wisdom teeth. Many times their removal decreases the mechanical forces in your mouth.
Chemical forces may be diet related or part of your makeup. It will be very important to keep a written record for at least two weeks (a month is better) of everything you eat. Soda, sports drinks or energy drinks, can produce devastating breakdown in combination with grinding and clenching. It is also important to note the manner in which you drink. Swishing these drinks throughout your mouth is especially harmful. Front teeth are more affected by acidic drinks that are swished. Another source of acid is stomach acid that gets regurgitated up and into the back of the mouth and starts dissolving the inside and top of back teeth.
Finally, the bacterial problems associated with root canal failure may have to be solved surgically. This is done when there is no other route to eliminate the bacteria.
Start carefully, proceed from most urgent to least urgent, one step at a time. A good plan and consistent effort will save your teeth.