Under-Treatment, Over-Treatment – How Do I Tell?

Question:

Dear Dr. Crapo: Ten years ago I had my four front teeth filled – again. A few years before that I’d had these teeth filled, only to have them break again. Finally I was fed up. I did some research that said porcelain veneers were strong and would solve my problems, so I asked my dentist to do them. That was eight years ago. Five years ago a corner of one of the veneers broke off. Then three years ago another piece broke off. My dentist said I must be grinding my teeth because the porcelain should be strong enough. I decided to go for another opinion and that dentist said something similar. He also said I might need crowns – they would be stronger. I left not knowing what to do. Finally I saw someone else that took molds before giving me an opinion. I went back for a consultation and he showed me how I was biting, how I was grinding and how the forces can be strong enough to break fillings and porcelain crowns if the bite isn’t right and then after that, managed with a bite guard that works in harmony with my joints, muscles and teeth. “It has to protect all three,” he said. He showed me how this could be done by making a simulation of the new bite and showed me what had to be done to my teeth to make it work. He said that my situation wasn’t an easy one and under-treatment could lead to unsatisfactory results. I’d never heard of anything like that and neither had my family and friends. If I do this it will cost a lot of money. He also said that if I didn’t do it, I should have my bite managed – which he explained was wearing a bite-guard selectively through the day and certainly at night. I like what he’s said but I wonder if it’s the right thing.

Answer:

You’ve described a very well thought out and considered opinion. When a bite is not aligned properly and the dentistry performed doesn’t account for these discrepancies, unfortunate events (breakage) can arise. The other half of the equation is the person and how they’re handling the stresses in their life. More people than you’d imagine, take their stresses out on their teeth – unknowingly most of the time. The other side of the coin is that there are just as many with bite problems that never grind or clench at all. That said a thorough evaluation considers all discrepancies, informs you and proposes rectifying treatment.

Those who do not have your problems don’t relate to your needs. Excellent care will yield excellent results. It sounds like you are in good hands.

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

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