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Dentistry/crown to bite change

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Question
To summarize, I bite so hard that I wear down my teeth. My back teeth have been refilled with fillings more than 4 times each (in the last 8 years), I just keep wasting them away. I have used a bite guard for years and that only seems to slow the process down a little. The more concerning thing is that my front teeth are nearly down to the dentin as well. I want to do something before I need major care.

So my dentist is suggesting that she takes the crowns  (one on each side) that I have and replaces them (just a year or two from needing replacement anyway) and she will raise my bite by replacing them higher than they currently are.

Do you know anything about this idea or have some thoughts about this approach?

Answer
Hi Chris,

One of the most frustrating things about being an AllExperts Volunteer, is writing a long wordy answer, sending it, and then something goes wrong, and it needs to be re-sent.  In your case, it is actually a blessing, because it has given me a chance to re-think your question and reply in a more concise way.

Your letter concerns me.  The rate at which your Bruxism is wearing down your teeth is obviously something that needs to be addressed rather quickly.  And yes, I have heard of the term "raising your bite."

Now comes the more "concise" answer for you......IF IT WERE ME......I would find a Oral and Maxillofacial Dentist or Surgeon who does TMJ cases on a ongoing bases to review my case.  This would be preferable to a general Dentist who cleans teeth one day, fills a cavity the next, and then maybe does a crown or two the day after that.

The reason I want you to see a "TMJ Expert" is that from my experience as a PATIENT, one of the things they need to be really good at is fabricating bite/night guards.  Any Dentist, can take impressions, send it off to the lab, and make you a night guard.  That is easy.  But I have found that fitting a Night Guard for a Patient, is also an art form.  When the lab returns that piece of acrylic to your dentist to do the fitting, I would prefer the person who does this task as part of their primary work.  When the Dentist uses that buzzing tool (not sure of the real name) to shape and fit your new appliance, it is a challenge to get the balance just right.....and sometimes requires follow-up visits for additional adjustments.  And again.....if it were me, I want the person whose primary job is working with TMJ patients.

"Raising your bite" can also have other unexpected consequences.  When you change the symmetry of your bite, it can affect your TMJ Joints, or even cause a shift in the delicate balance of your facial muscles.  I don't know your dentist, and for all I know, she is probably well aware of all of these issues, but these are just some things to think about.  Talk to your Dentist.  She may even know a specialist that you can talk to that can do the actual work.

I wish you well in finding a solution to prevent your Bruxism and preserve the health of your original teeth.

Best Regards,
Jonathan
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Dentistry

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Jonathan at PatientBabble

Expertise

My area of expertise from the patients point of view would be Dentistry/TMJ plus the speech challenges that these jaw and bite problems sometimes represent. Over the years I have seen a multitude of dentists, orthodontists, oral surgeons, speech therapists, neurologists and other health professionals who all had an opinion about my TMJ/bite problem. I AM NOT A DOCTOR...but would purely be a patients point of view type person. I "get it" when people say they tried to explain to their dentist what their TMJ/bite problem is and that they are misunderstood. I can listen to people's trials and tribulations and there is a good chance I have been down that road before. I can make suggestions as to what people can do at home, or what questions to ask their doctor or dentist when they visit. I will try and recall information or experiences that may be helpful to you.

Experience

About 25 years ago, I had my wisdom teeth out and since then my bite has never felt "normal." For whatever reason, the first sensation I remember was not that my bite was off.....but rather that my normal tongue and speech patterns had been impeded. I spent years going to different dentists, who lumped me into their generic version of what they knew about TMJ. The majority of dentists believe they can treat TMJ, but only those whose primary focus is TMJ treatment, are really any good at it. Any dentist, can take an impression of your teeth, send that impression off to the lab and have them make a night guard. That is the easy part. The tricky part is what the dentist does with the night guard, once receiving it from the lab. The dentist has to do a "fitting" where they tailor the night guard to be evenly balanced and comfortable in your mouth. Sometimes it can take a few visits, because further adjustments need to be made to the night guard appliance, to get it just right. I have found that dentists, who have had the most practice, do a better job at fitting your appliance. It's almost like an art form.

Organizations
Jonathan's Blog is: https://patientbabble.squarespace.com/jonathans-blog

Education/Credentials
College Graduate with Bachelor of Arts Degree

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