Posts Tagged ‘porcelain crowns’

Bulimia and damage to teeth

Monday, May 16th, 2011

I’ve had bulimia since 1990. I’ve been seeing a therapist for the last five years, and finally feel like I have things under control. I will always have bulimia, but now I am in control of the disease instead of the other way around. I’m finally at a healthy weight, and my skin looks nourished and healthy. The one thing I can’t change with diet, though, is my teeth. They are very badly damaged from more than 20 years of abuse. They are chipped, discolored and really thin, and they don’t fit together like they should. One side sticks out when I open my mouth to bite something, and I’ve been getting headaches.

I think I really need to see a specialist for all this. I need someone to help me with my bite issues, and I really want to improve the appearance of my smile, too. Should I see someone for the bite first, and then address the cosmetics, or vice versa?

Thanks,

Kelly in Sacramento

Dear Kelly,

If you find the right cosmetic dentist, you could address both issues with the same professional, which would really be ideal.

The issues with your bite are likely the cause of your headaches, and it sounds as if it is a temporomandibular joint issue, commonly known as “TMJ”. TMJ treatment will get everything back in alignment and functioning properly, so your nutrition is not compromised and your headaches ease or cease.

Because you have so little tooth structure left, you will probably have to have dental bonding before anything can be done to address the appearance of your teeth. Traditional dental cement is not strong enough to hold dental crowns in place when there is very little tooth structure to work with.

This will not be a quick fix, unfortunately. You are probably looking at porcelain crowns for all of your teeth. The improvement in appearance and function will be dramatic, but the price will be steep.

Best of luck to you as you move into this healthier phase of your life.

York PA cosmetic dentist Dr. Currie’s dental office sponsors this blog.

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My dentist won’t do all-porcelain crowns for my front teeth

Monday, October 18th, 2010

My top two teeth are worn, and just recently what was a small gap has chipped into something a lot more noticeable and a lot less attractive. I’ve been talking to my dentist about getting porcelain crowns for a while now, and now it is time to get serious about it. The problem is, my dentist and I don’t agree about what kind of crowns should be used.

As soon as I knew I was going to go ahead with the procedure, I started researching what kinds of crowns I wanted to get. I decided on an all ceramic set, like Zirconia, but here’s the problem. My dentist won’t agree to do all porcelain or all ceramic crowns!

He says it is because I grind my teeth and will not wear a night guard, but after reading around I wonder if he just is not comfortable placing them. A lot of the sites I’ve looked at say that placing all porcelain crowns is more challenging that placing the porcelain-fused-to-metal ones he wants to use. My dentist doesn’t have any kind of smile gallery on his website, or any before and after pictures of all porcelain crowns. He does have impressive sounding credentials hanging on his wall, but I guess I’d really like to be sure he knows what he is doing.

I’d really appreciate an outside opinion on this.

Rolfe in Ohio

Dear Rolfe,

I would recommend seeking a second opinion from an expert cosmetic dentist. Zirconia crowns are strong enough to be used even with patients who have severe grinding issues. It could be, however, that your dentist is concerned about wearing issues with your lower teeth, if the grinding remains unresolved. If that is a potential issue, there are soft porcelains that can be used on the surface of the Zirconia crowns.

I think you may have hit on the key issue, which is that your dentist is not comfortable placing all porcelain crowns. It is very important that you respect this, and if you are fixed on what you want, you will need to seek the services of another dentist.

The last bit of advice is this: think about giving in on the night guard issue. Grinding can create tremendous damage, and sometimes the situation is worse with crowns. If you don’t address what sounds like the root cause of your current issue, you are only inviting those same issues to continue to create problems. Ongoing grinding can cause your teeth to snap off at the gumline, causing the need for dental implants or a dental bridge.

Good luck.

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My son’s front teeth are a mess!

Wednesday, September 29th, 2010

My 10-year-old son was jumping on the neighbor’s trampoline, and came down on his face on the frame (no safety net). Half of his left front tooth broke off, and there is a horizontal crack in the right one. We took him to the ER to make sure he did not have any other injuries, which thank God he doesn’t. This morning, I took him to our family dentist and couldn’t believe it when he told us we will have to wait nearly three weeks for his schedule to allow him to fix it! Are you kidding me?? When I asked him if he could recommend someone who could fix it right away, he said we need to wait anyway, to let the root desensitize. I’ve never heard of this before.

Is it medically necessary to wait? I want this fixed right away.

Thank you in advance,

Jennifer in Portland, OR

Dear Jennifer,

Medically, there is no reason to wait. I’m not sure why your dentist won’t recommend someone else if he is too busy to take care of this right now. Your letter kind of implies that there is not much a trusting relationship with this dentist, which is a good indicator that you may want to consider finding a new dentist.

You don’t mention whether or not you have the piece that broke off the tooth, and hopefully you do. An experienced and talented cosmetic dentist may be able to reattach the broken piece of tooth. If you do not have the missing piece of tooth, the most likely fix for a child this age is direct dental bonding. When he is older, he will likely need porcelain crowns on one or both front teeth.

Direct dental bonding is a very demanding procedure, both technically and artistically. Keep this in mind when you choose a dentist to do the repair. You should look for an expert cosmetic dentist with demonstrated skills in direct dental bonding, and one who is sensitive to self-esteem issues in kids. If you talk to a dentist and he or she seems to be dismissing the importance of the appearance of those front teeth in a child, seek another opinion.

Best of luck to you.

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