I have had a problem with breaking off teeth, and last year I finally agreed to let my dentist do crowns on all my teeth. He was telling me that my bite was off, and this is why I was breaking teeth. By doing all these crowns he could make my bite straight and that would solve this.
So I had 28 crowns done. Well, in January I broke off one of the crowned teeth. Then in February I broke off two more, and one more since then.
My dentist now is saying I have a nighttime grinding habit, and that is why I’m now breaking off teeth, after he supposedly fixed me. So he wants me to wear a nightguard to help me break this habit. But they don’t break off at night – it’s while I’m eating. And I’ve lost any confidence I had in this dentist, so I’m thinking he doesn’t know what he’s doing anyway.
What’s the deal? And what do I do now?
- Earl from Oklahoma
There do seem to be problems with your dentist’s understanding of your bite problems. Occlusion (the study of how the teeth come together and work against each other) is a complex area of dentistry. And a full mouth reconstruction, which is what it is called when all your teeth are crowned, should only be attempted when the dentist has extensive post-graduate instruction in TMJ disorders and treatment.
I am suspecting that you are a patient with what some dentists call a “gorilla bite.” You can recognize patients like this because in a profile view, the bottom edge of their lower jaw is practically parallel to the upper. In most patients, the jaw in profile is slanted forward, but when they’re parallel, the muscles on the sides of the jaw, the masseters, have much stronger mechanical advantage and can generate much stronger biting forces. These people will also have a squarish face and you can see the large masseter muscles that make up their cheeks. Patients like this have a strong tendency to break off teeth, and great care needs to be exercised when restorations are created for them.
If this is the case with you, it’s quite possible that your dentist missed this.
What to do at this point? I do agree with your dentist on this, and that is that you need to wear this nightguard. Yes, you do break off the teeth during the day, but if you are one of these “gorilla bite” patients, you will be weakening your teeth with your nighttime grinding, then you finish them off when you add the sideways stresses that occur during chewing. We have had several patients like this, and when they wear their nightguards, they don’t break off any teeth any more.
This blog sponsored by Phoenix TMJ dentist Dr. Arthur Chal