Q: Over the years I’ve had alot of dental work – crowns, five or six implants, all in response to breakdown of large fillings, or loss of teeth. Recently I needed more work. I thought implants, but because I need extra bone a bridge was planned from the tooth behind my eyetooth to my very back tooth. The teeth were prepared and I left with a temporary bridge in place. To my surprise, it came unglued a few days later.
When I went back a few adjustments were made and it was put back in. That happened three times and finally stronger glue was used to hold it in. The dentist seemed frustrated by these events but I’m in the dark as far as the bridge coming out. I should say that over the years I’ve had porcelain break off my crownsso I had them replaced with gold crowns. The dentists I’ve used over the years have commented on my strong bite.
When I ask how they know I have a strong bite, they say because I break alot of teeth. I’m not trying to break my teeth and I don’t see how I am, but now I’ve got a vision of this new bridge being made of gold and me looking like a gypsy every time I smile. Should I try for implants even though the bone seems inadequate? Can it be built up and would that be stronger? I feel stalemated.
A: Your history hints of two classic conditions. First, central nervous system (CNS) grinding which occurs in one’s sleep. We are not sure why people do it, there are many theories but tremendous pressure is exerted during these moments of grinding – far more than can be generated during wakefulness. The power of CNS grinding sends teeth crashing into one another. In a person like this, it is necessary to ensure the bite is ideal and the forces are managed properly.
Second, is an unguided bite. This means the front teeth which are responsible for creating the right amount of space between our back teeth while we are chewing or grinding are not doing their job. It was never intended that backteeth would grind themselves down. When they do, the condition you’ve described occurs.
Think of it this way, when back teeth are able to grind themselves it is like a car that is high centered. Given enough traction, the whole undercarriage, muffler and all is ripped away as the car frees itself. Teeth split, crack and break under similar stress. Unless the front teeth do their work, more force related problems will occur. This demands a thorough exam and accounting for all destructive forces in your mouth.