Hi Dr. Hall,
I found you by searching on crowns and dry mouth.
A couple of months ago my dentist removed my 18-year-old veneers and restoration of my upper teeth 7 veneers and bridge was to begin. I complained every day about my temporaries and requested that he take them down on 2 separate occasions. My bridge fell out 3 times before permanents arrived. A little over 3 weeks ago he delivered them. The appointment was over in 40 minutes.
I’m suffering with my lip sticking, air stuck in my front teeth blowing bubbles, and my mouth is so dry that I’m eating popsicles all day and night for relief from dryness and the sucking I’m doing of my tongue and lip. I suck on my tongue and back of teeth so hard it burns! I can’t seem to stop sucking. What is wrong with me?!?! The porcelain is tough and rigid. He said he had to open my bite so I can show my teeth but I’m not showing teeth at all actually, it’s really really odd and the dentist claims I’m going to have to adapt because his “checkpoints” are perfect and textbook case. All I wanted was B1 shade and the hand press style porcelain that I’ve known my adult life! Please help me if you can.
I’m 42 and my second time in veneers and I’m miserable. I gained 3 extra crowns and a substantial gap in my bridge. With almost a month in, this can’t be healing tissue, is it?
Sofie from New Mexico
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No, this isn’t a healing issue. This is a “dentist screwed up issue.” You need to get this fixed and I’ll be blunt as is my style—you need this new work taken out and started over again. And I wouldn’t have this guy doing it.
Opening the bite requires crown work on at least every tooth in one arch—most typically it is done with a full-mouth reconstruction meaning every tooth is restored. And it needs to be done with great care. It needs to be done with temporaries first. At least it looks like your dentist did that, but it sounds like he didn’t respond to your discomfort. You wear the temporaries at the proposed new opening to make sure you are comfortable with it and function properly. You’re telling me that you “complained every day” about your temporaries, but it looks like your dentist plunged ahead anyway.
Your body has a certain amount of jaw opening that it is comfortable with. This amount of opening is tied to the muscle tension in your jaw muscles, as well as reflexes that are part of speaking. Opening the bite is indicated when there is bite collapse—you have worn down your teeth to where your mouth is over-closed. In that case, we open the bite to restore your normal vertical dimension.
A big part of the problem in your case is that your dentist opened your bite when I’m guessing that you already had a comfortable bite. He was doing it to get more of the upper teeth to show. That puts him into risky territory from the start. If this is correct, that your bite was already comfortable, opening would put you beyond your normal opening, and that’s when you get into these issues that you are having: lip incompetence (the lips when relaxed don’t close all the way) leading to dry mouth, speaking problems, and other issues. He claims that your “’checkpoints’ are perfect and textbook case.” No, I’m sorry, that’s not the case. The main checkpoint is does your mouth when relaxed close naturally, and it doesn’t.
A side note and warning for you. DO NOT EAT POPSICLES to keep your mouth wet. That is one of the worst things you can do, unless the popsicles are sugar-free. Your dry mouth doesn’t have the proper amount of saliva, and it’s your saliva that has your defenses against decay. You are risking rampant tooth decay getting in under your crowns and ruining your teeth. Get something sugar-free to suck on.
What to Do Now
I’m sorry to have to break this to you, but you need your whole case re-done. And I would not have this guy do it. I’m sorry again, but I wouldn’t trust him. What has happened in your case causes me to question his ethics. This is a serious breach of professional care and admittedly I don’t know all the facts in your case, but from what I know he is liable for malpractice. Maybe he is a really good guy and was just trying to do the right thing. But the stakes are high here and there is a small minority of dentists who know how to do this right.
I’ll tell you what I’ll do. I’ll email you privately with a recommendation for a very good dentist with strong ethics and well trained in cases like yours. I don’t want to give a name like this publicly lest the dentists I don’t recommend get offended. And then I would ask this new dentist to contact your current dentist and ask him nicely to refund your money to keep you from complaining to the dental board, putting his license in jeopardy; or from going to a lawyer.
– Dr. Hall
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