Mouth Hurts After Full Mouth Reconstruction
I need some help. I went in for a full mouth reconstruction. The temporaries seemed to fit okay. When the lower permanent crowns and bridges were placed, they didn’t meet up well with the upper teeth. In fact, it was causing me some pain. My dentist said that would fix itself after he placed the upper ones. Unfortunately, that didn’t happen. I mentioned that to him and he did some adjustments, but nothing that helped. He said the teeth are fine but it is possible that I’m just adjusting to having the reconstruction. To “put my mind at ease” he gave me the names of two other dentists he knows that would give me a second opinion. I went to see both of them. They both said that everything looked fine. They didn’t even mention that I have teeth on one side that don’t meet together. I’m starting to wonder if they were more interesting in protecting their colleague’s reputation than they were in giving me a honest diagnosis. My jaw hurts all the time, and now I’m getting headaches. I don’t know what to do.
Mario
Dear Mario,
Bear in mind that I haven’t examined you, but I can give you some general advice. If your teeth are not meeting together that is a problem that needs to be fixed. The fact that he gave you two names for second opinions before you even asked about a second opinion is a bit sketchy to me. Whenever I advise people who write us about a dental issue and I think they need a second opinion, I advise them to get a blind second opinion. That means they go to a dentist who is an expert on the procedure, but do not tell them what your prognosis was or the dentist that did the work. The dental world is a small world and you don’t want a dentist torn between their diagnosis and loyalty to a friend.
In your case, you want to see someone who is an expert in TMJ disorder. They will have the training to know how teeth should occlude, which is the term for how they come together to meet when you bite down. They will have the expertise to give you the evaluation you need. I would look for someone who received post-doctoral training from the Spear Institute, the Pankey Institute, or the Dawson Academy. There are others, but any of these should be fine.
This blog is brought to you by a friendly dentist in Moline Dr. Thomas Goebel.
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Do I REALLY Need to Replace This Dental Bridge?
I have a dental bridge on my lower right to replace a lost tooth. I initially thought about getting a dental implant but my dentist suggested the bridge would be less expensive. Now he is saying the one of the teeth holding the bridge is broken and I need to replace the entire unit. If I have no pain and no symptoms, do I really need to replace this? Is there another option?
Jeremy
Dear Jeremy,
You’ve brought up one of the many benefits of dental implants over a dental bridge. If an adjacent tooth to the replacement is damaged it has no impact on the dental implant. With a bridge, that is not the case. The only reason I can think of that he steered you toward a bridge instead is that he doesn’t have dental implant training and did not want you going somewhere else.
That being said, I am a bit sceptical of your dentist’s diagnosis here. You have no pain. If a tooth was broken, you would be very likely to have some pain, especially when you bite down. Generally, the solution to a broken or fractured tooth that can be saved is a dental crown, so why is this one suddenly damaged when it already has that protection. Plus, replacing the bridge would only be necessary if the tooth had to be extracted, which means you would now need a longer bridge. That is another crown on a healthy tooth, with even more strain on it.
I would not consider this a dental emergency especially since you do not have any symptoms. My recommendation is for you to get a second opinion before following through with this. Don’t tell Dentist B who Dentist A is or what he said. They may know each other and you don’t want Dentist B feeling pressured to not contradict his pal. Instead, just go and say, I am seeking a second opinion on the lower right side of my mouth. If he asks you what the previous diagnosis was or who the dentist was, just explain you don’t want to prejudice his diagnosis in any way and just want a blind second opinion. He or she should not have a problem with that.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.