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Dentistry/Teeth are ground down.


I am not sure who to ask. When I was a child I had a backbrace I had to wear 24-7 for 10 years. It was metal to my neck. In fact the point of it was to stretch out my neck so my back would grow straight.  Damage was done to my teeth either due to grinding or they simply didn't grow. In any event, I have very little teeth left at 45. Every dentist I go to wants to crown 28 of my teeth. I have a hard time believing them as  

(1) my teeth really don't bother me that much (though on occasion they do) and a dentist told me that there has been minimal damage in the 10 years since seeing him.
(2) it seems a little extreme.

My question(s) is... is this a scam or something I do have to do. Question two, a dentist I saw today was shocked at their condition and doesn't believe I grind them but clearly says there is something going on to wear away the enamel. He didn't know what it was... and I do NOT eat fruit or citrus drinks. Could there be some medical cause? As far as I know I don't have gerd.

As to a specific problem a filing came out and now that tooth is bothering me. I have been to three different dentists and they keep going on about getting a crown. Everytime I ask them why I can't simply get the filling put back, they seem to duck the question and start talking how eventually I will have to get the crown so I should just get that done. But that isn't an answer. One opined... it will just fall out again. But why? It was good for 20+ years.

Dear Sara,

Although it is an expensive option, for some patients with extremely worn teeth doing a full mouth reconstruction ( with multiple crowns) can be their best option, since it will prevent further wear to their teeth. If the teeth continue to wear it can even make it more difficult to fix them with crowns because insufficient tooth structure can remain to hold any restorations. If you are in doubt about your dentists recommendation you would be wise to seek a second and / or a third opinion, since fixing your teeth will involve a significant expenditure of time and money and you should explore all your options.

The answer to your second question is that often when teeth are extremely worn there is not sufficient tooth structure to predictably restore a tooth with just a filling. Just because your last filling worked for twenty years doesn't mean that another is likely to have a similar success, especially since your teeth are so worn.

That being said, if you were my patient I might place a temporary filling or temporary crown  while we decided on an overall treatment plan before I fabricated any permanent crowns.

I hope this discussion is helpful to you.


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Lawrence Spindel DDS,


Cosmetic Dentistry, Endodontics, General Dentistry, Preventive Dentistry, Comprehensive Dental Care


Former Clinical Instructor of Comprehensive Dentistry, and Prosthodontic Department New York University School of Dentistry. Also former instructor of Preventive Dentistry Columbia University School of Dentistry.

Ask Dr Spindel Dental Blog also numerous articles on (over 100 pages of original content)

1980 DDS New York University College of Dentistry 1981 GPR Manhattan VA Hospital

Awards and Honors
OKU 1980 Honor Society 1980 Long Island Academy of Odontology award for highest combined Academic and Clinical Achievement.
In 1997 he was elected to Fellowship into the International Academy for Dental Facial Esthetics

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