I used to grind my teeth but didn’t know that until I went to see a new dentist for jaw pain after moving to a new city. He said it has been going on for years and now I need a full-mouth reconstruction. Here’s my problem. He did the lower arch first. I hurt for quite a few days after. Plus, the dental crowns look so dull and lifeless compared to how my natural teeth did. I miss my sparkly smile. I’m no longer having the jaw pain I was having. Is it completely necessary to do the upper half? I don’t want to have a dull smile. I’d rather just get some Zoom Whitening done so the upper teeth aren’t darker than the lowers and be done with it.
Olivia
Dear Olivia,
I am sorry you are going through this, especially when it was so preventable. If your previous dentist would have brought it to your attention and provided you with a nightguard, your teeth would not be worn down and you wouldn’t be spending a fortune repairing the problem. However, that is water under the bridge and you have to move forward from here.
Bear in mind everything I am telling you is based on general principles. I haven’t examined you so won’t be able to address your case specifically. Let’s start with what is bothering you about the first half. When you say you hurt for days afterward, there should be some soreness for a short period of time, but not a lot of pain. If you are sensitive, here are a couple of options that could eliminate that problem with the upper arch.
One option is your dentist could do porcelain onlays, which stop short of the gumline, instead of full crowns. This will prevent any sensitivity at the gumline. Another option would be to do porcelain crowns that stop at the margin instead of going into the sulcus.
The other issue you mentioned was the appearance of your porcelain crowns. This is completely down to the skill of the dentist. If they do not look natural, then it is a reflection of his skill as a cosmetic dentist. This is easily solvable by having a dentist with more cosmetic expertise and artistry take over.
If you decide to go that route, your dentist is ethically obligated to provide all the diagnostics and notes on your case so you won’t have to start over.
Finding an Expert Cosmetic Dentist
Because there isn’t a recognized specialty in cosmetic dentistry, it makes it a bit of a challenge for patients to know who has invested in the post-doctoral training and who hasn’t. The American Academy of Cosmetic Dentistry realized the quandary that puts patients in and started an accreditation program. This gives patients confidence in knowing the dentist they chose has the technical skills along with the artistry to create a beautiful smile for them.
In order to get AACD accredited, a dentist has to pass stringent exams and then present visual evidence on a large number of specific cases they’ve done to an examination board, who will judge the health and artistry of their work. AACD accredited dentists are considered the best cosmetic dentists in the country.
Should You Finish This Reconstruction
One of the things I worry about with you not finishing off the case is your other teeth getting worn down by the dental ceramics on your bottom arch. Some modern ceramics are easier on natural tooth structure, so you may want to talk to your dentist about what he used and how hard it is on teeth.
However, if you are out of pain, which is why you went there in the first place, maybe the bottom arch will be sufficient. If that is the case, then get your Zoom Whitening and be done with it. If, later, you determine you’d like to finish the procedure up you can. Just make sure your dentist is qualified to give you a beautiful smile with correct occlusion.
This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.
