Dr. Hall,
I have been suffering from mild dry mouth over the past few years, but it comes and goes. My upper front teeth have 1 crown and 3 veneers for the past 30 years and the gum line is receding on the crown, and now one of my veneers has chipped (possibly from the dry mouth?)
The dentist suggested a full upper and lower set of crowns as my teeth are not very white. I was going to opt just for the 5 front teeth crowned. However in the past few months my dry mouth is so severe it feels like it is burning and now I think getting all those crowns could be detrimental leading to eventual front tooth loss. I am wondering if it is better to get veneers over the teeth and just replace that one crown. Reading other posts I didn’t realize there are tests for these dry mouth issues, and hopefully I can find some resolve as it is severe.
– Jean
(This is a question that Jean posted as a comment on my post from three years ago answering Randy from Pennsylvania who is suffering from dry mouth after a full-mouth reconstruction.)
(See Dr. Hall’s answer below.)
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Jean,
I want to grab you by the shoulders and plead with you to not let this dentist do any work on you. Please!! Am I hearing you right? A full mouth of crowns (called a full mouth reconstruction) because your teeth aren’t white enough? That is extremely aggressive treatment. Now I admit that I don’t know the full story, but if I am sizing this up correctly, this is a screaming red flag about this dentist.
First of all, the treatment for teeth that aren’t white enough is bleaching. But the problem with that treatment in the eyes of a small minority of dentists is that bleaching might bring in a couple hundred dollars, whereas a full set of crowns would bring in thirty to sixty thousand dollars. Please tell me that there is something I don’t know about your case that would justify this radical treatment. Besides this, there is a significant risk of harm with this treatment. There are very few dentists who are competent to do a full mouth reconstruction. This treatment rebuilds your whole mouth. It can change how you bite, how you speak, and how your face looks. Done incorrectly it can lead to a host of problems: TMJ disorder, lip incompetence, and/or misery.
Furthermore, when a dentist wants to replace porcelain veneers with crowns, that tells me that this is a dentist who isn’t comfortable doing porcelain veneers. That dentist to me would be a very poor choice for doing any cosmetic work. Porcelain veneers are the fundamental skill for any cosmetic dentist. And there are many dentists who will do porcelain veneers who do them poorly. But a dentist who starts off being uncomfortable with that procedure—that’s a non-starter to me.
An ethical dentist will want to preserve as much of your natural tooth structure as possible. As I said, if the problem is the tooth color, bleaching is the treatment of choice. If there are particularly stubborn stains, such as tetracycline stains, that could require porcelain veneers. But not grinding the teeth down to stubs and placing crowns.
About your dry mouth. If you have a full-mouth reconstruction that opens your bite too far, you can end up with lip incompetence which will cause dry mouth. However, that doesn’t appear to be your situation, as you only have one crown. So your dry mouth must be from some other cause. It could be from a medical condition or simply from stress. So yes, if you want to make that worse, then go ahead and have this full-mouth reconstruction. That could add lip incompetence to your list of troubles, not to mention the increased stress.
I don’t believe there could be any connection between your dry mouth and your porcelain veneer chipping.
– Dr. Hall
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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.