I had all 28 of my teeth crowned. I was told it was necessary to do because I was breaking my teeth off and it was blamed on my bite. Now that my bite has been “fixed,” I currently have five broken new crowns in my mouth and now I’m being told that I need to wear a mouthguard at night and one during the day to break a habit my dentist claims I have. The fact of the matter is, I have been breaking my teeth when I eat, not when I sleep. My dentist won’t listen to me and blames it on my habit that I don’t believe I even have. He also has no proof of this supposed habit. What are your thoughts? I have $50,000 into my mouth now and I don’t know where to go from here. (He initially blamed my problems with breaking teeth on my bite, which he supposedly corrected when he replaced all my teeth. Now the problem is being blamed on my “habit,” which I mentioned above.) Help!
– Cory in Minnesota
I’d be inclined to look for a second opinion from a dentist who is more expert in occlusion matters. What you’ve had is called a full-mouth reconstruction, and this is a very complex area of dentistry that requires considerable advanced training. Two common sources for this advanced training are the Las Vegas Institute, and the L.D. Pankey Institute. Look for a dentist who has spent considerable time at either or both of these institutes.
Having said that, I would absolutely wear the nightguard. It may not make sense to you because, as you say, you’re breaking your teeth off when you eat. But you’re weakening them while you sleep. I had several patients like you who would break off teeth like that, and when they wore their nightguards they never broke off any more. Just do it. You’ve spent too much money to let it all go to waste. And be careful not to assume that you know what you do with your jaw when you’re sound asleep.
It may or may not be a “habit” that you have to break. So your dentist blaming it on a “habit,” apparently without a thorough occlusal examination, makes me think that his knowledge of occlusion isn’t deep enough. But he has heard that wearing a nightguard helps in that situation, so that much is good. But I worry that he thinks that you just need to re-train your habits and then you’ll be fine. It’s possible that you may need to wear this nightguard every night indefinitely to keep your teeth from breaking. And my guess is that you don’t need the one during the day. But these are just guesses.
It may just be that you have extra powerful jaw muscles. That was the case in most of the patients I saw who broke off teeth like this. It’s a situation some dentists call a “gorilla bite” – a patient with a jaw structure that causes extra intense biting pressures. I’m doing a little guesswork here, because I don’t have all the facts. Get the second opinion and then weigh that and hopefully you’ll get pointed in the right direction.
– Dr. Hall
Additional information: Read about TMJ disorder, bruxism, and TMJ symptoms.
You may also want to read more about dental crowns.
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.
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