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After getting new crowns on my front teeth, my bite feels awkward.

I chipped my upper front teeth in an accident when I was younger, and I’ve had the same dental bonding on them that the dentist placed almost 30 years ago. The bonding has held up well all these years, but it was starting to look old and discolored. So when my current dentist recommended crowning my six upper front teeth (from canine to canine), I said okay. I got the new crowns about a year ago, and although they look alright, they feel strange. I must have been back and forth to the dentist almost a dozen times to try to have them adjusted, but nothing seems to make them feel better. My dentist says she doesn’t see anything wrong with them and even other dentists I’ve seen say the crowns look great. I’m not sure exactly how to describe it, but it just feels like my crowns don’t close against my lower teeth correctly. My crowned teeth sort of burn as if they feel itchy unless I chew on something or tap my teeth together.

Is there any hope of relief for me? Will another adjustment help or do I just have to live with this irritating sensation?

—Marjorie from Pensacola, FL

A woman and her dentist both look at the camera. If your bite feels off after getting crowns, getting a second opinion from a dentist with special training in occlusion can help your bite feel better..

Hi, Marjorie

Thank you for sharing your experience with us.

Although we can’t give you a diagnosis with the limited information we have, it does sound like your bite is off due to the fit of your crowns. When crowns are done well, they should leave your bite feeling so natural and comfortable that you forget they’re even there. You say that the crowns ‘don’t close against your lower teeth correctly,’ and that strongly suggests that your bite is off.

One thing we’d like to make you aware of is that it’s possible for individual crowns to be nicely placed and yet still cause your bite to feel “off.” This is especially true in complex cases like yours where you have multiple crowns in a row on your upper front teeth. There are a few key principles of occlusion (bite mechanics) that dentists need to follow when restoring front teeth, and it sounds like perhaps the dentist who placed your crowns isn’t experienced in those principles.

Here’s an example of some of the principles, or factors, that affect the fit of crowns on upper front teeth:

Centric occlusion – This is when all of your teeth close comfortably together at the same time when you bite down.

Anterior guidance – This means the front crowns need to be shaped in a way that they help open your upper and lower back teeth when you slide your jaw forward.

Canine protection – This means that your canine teeth need to be shaped in a way that they help separate your teeth when you move your jaw from side-to-side.

Besides these, a dentist also has to consider how a row of crowns will affect the way you speak. So as you can see, there are a lot of factors at play, and if something doesn’t line up just right, it can spell discomfort in the form of TMJ pain and tooth sensitivity.

Another worrying point is the fact that your dentist recommended six crowns in the first place when it sounds like just updating the bonding would have done the job. We don’t fully understand your dentist’s rationale for suggesting the crowns, however.

There is good news. You don’t have to live with the discomfort forever—you just have to find the right dentist who is experienced in things like the principles of occlusion, full-mouth reconstruction, and the correction of uneven bites.

Some dentists have post-graduate training from institutions that give them insights into treating complex occlusion problems. A dentist who has completed training at one of these institutes is likely beyond qualified to adjust your bite and help you get relief:

  • The Pankey Institute
  • The Dawson Academy
  • The Spear Education Center
  • The Las Vegas Institute for Advanced Dental Studies

We suggest you search for a dentist near you with such qualifications and schedule an appointment to get a second opinion.

This post was published on behalf of Owasso TMJ dentist Dr. Heng Lim, graduate of the Las Vegas Institute for Advanced Dental Studies.

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Is it worth it to save my last two upper teeth, or should I replace them?

I have just two teeth left on top, my upper front teeth, and I currently wear an upper partial denture to replace the rest of the teeth whenever I go out or need to chew tougher foods like steak. Otherwise, I can manage most foods just fine with my two upper teeth and remaining lower teeth.

Here’s the issue I’m facing: my last two upper teeth are perfectly healthy, but a couple of dentists I’ve seen have suggested that I get them pulled anyway and replace them with a full upper denture. They say that a denture will probably look and feel better than my current partial, which is rather cheap and bulky.

I’m inclined to go with the dentists’ recommendation to replace my last two upper teeth, but I’m a little hesitant to make the commitment because I know that once those teeth are gone, they’re gone for good and there’s no going back.

What is the best decision in this situation? Should I try to hold on to my natural teeth for as long as possible, or should I just get it over with and replace them with a full denture?

Thanks in advance for any advice you can offer.

— Erin from Iowa

Hi, Erin

First, we’d like to remind you that we cannot give you a definitive treatment recommendation without examining your mouth and seeing X-rays of your teeth. But we can supply you with a list of key principles that we hope will help guide you in making the best decision.

Principle #1: It’s almost always ideal to save natural teeth whenever possible.

You already said that you know how important natural teeth are and you are correct: it’s best to hold on to healthy teeth and only extract them when absolutely necessary.

But “healthy” is a subjective term, as we’ll clarify in a moment. Just because your individual teeth are in good shape doesn’t guarantee that your bite will remain functional indefinitely.

This brings us to the second principle.

Principle #2: Teeth can only take so much stress.

Your remaining two upper teeth may be healthy at present, but they likely will not stay that way for much longer.

Eventually, they will need to be replaced to avoid painful complications. This is because teeth are meant to share the forces of biting and chewing. If you have just two upper teeth to chew against, then they can quickly wear down or shift out of functional alignment due to the unusual amount of stress.

Additionally, when those two upper teeth are the only ones supplying bite force from the upper part of your mouth, then they will cause the teeth directly below them to wear down much sooner than the other lower teeth which have no opposing neighbors to bite against.

So if you’re presently doing most of your chewing with those two upper teeth, then it’s only a matter of time before they will need to be replaced, anyway.

Principle #3: A well-made upper denture can be a comfortable, functional, and affordable option.

Upper dentures are usually much more stable and comfortable than lower dentures because they stay in place by suctioning to the roof of your mouth. An upper denture would also be much gentler against all of your lower teeth when you chew.

It’s highly likely that a complete upper denture could be worth sacrificing your upper front teeth for.

The dentists you’ve seen have evaluated the health and function of your smile and concluded that the pros of replacing your last two teeth with an upper denture outweigh the cons of extracting healthy teeth. While we cannot confirm this is the best treatment course for you, your dentists’ rationale for suggesting it shows that they carefully weighed the two principles we listed above.

Principle #4: Dental implants are the next best thing after natural teeth.

Lastly, it’s important to know that you have other treatment options besides getting a full upper denture. For example, you could get dental implants to replace some of your missing upper teeth. You could even extract your remaining two teeth and get implants to support a full-arch implant bridge or to retain an implant-supported complete upper denture.

Dental implants are an excellent treatment choice to consider because they are the closest you can come to having your natural teeth back. If implants are out of your budget or if you have a health condition that disqualifies you from getting implants, however, you can still have a beautiful and comfortable smile with a traditional upper denture.

Ultimately, it’s up to you to decide whether it’s worth it to extract your remaining upper teeth and replace them. Ask a trusted dentist who is familiar with your case to help you understand the advantages and disadvantages of all the treatment options available to you before you make a decision.

This post has been published on behalf of Owasso dentist Dr. Heng Lim.

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Persistent bad breath no matter how much I brush.

A woman covers her mouth with her hand in embarrassment due to bad breath. A dentist can help her have fresher breath.

 

 

 

 

 

 

 

I have an embarrassing and frustrating problem. Even though I brush my teeth every day, my breath still smells terrible. I’ve noticed that people will lean away from me and turn their heads to the side when I’m talking to them, so I know my bad breath has reached the point that it’s affecting my social life.

Do you have any suggestions about what I can do?

– Karen from Albany, NY

Dear Karen,

Having persistent bad breath can be quite a distressing problem, as it can take a toll on your relationships and social interactions.

There are two things you can do to try to resolve your issue and improve your quality of life.

Step #1: Improve Your Oral Hygiene

Start by taking a look at your oral hygiene routine. You may be brushing once or even twice a day, but that may not be enough to keep up with the bad breath-causing bacteria.

Mouth odors are often caused by vapors released by the bacteria that make up dental plaque. This soft film of germs can grow on many surfaces of your mouth, including your teeth and tongue. Try flossing your teeth and then cleaning your tongue with a tongue cleaner. Doing so will remove a significant amount of the plaque bacteria that could be releasing foul odors.

You may also find it helpful to incorporate an antimicrobial mouthwash into your daily routine. Used several minutes after brushing, a mouth rinse can reduce the levels of residual bacteria in your mouth and keep your breath fresher between brushings.

Step #2: See a Dentist

If you find that improving your oral hygiene doesn’t freshen your breath, then the second thing you can do is visit a dentist.

A dentist can:

  • Recommend or even prescribe powerful oral hygiene products that can improve your breath
  • Detect and diagnose underlying oral health problems that may be causing bad breath
  • Provide you with treatment for gum disease and other oral and dental infections that often cause bad breath

It may simply be that you are due for a dental checkup, and there’s no one better qualified than a dentist to help you get rid of bad breath!

This post has been published on behalf of Owasso dentist Dr. Heng Lim.

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My dentist did a terrible job with my dental bonding.

I chipped my two front teeth on a saxophone back when I used to play in my high school band and my family dentist had fixed them with some dental bonding. That was years ago, and the bonding had discolored, so I asked my current dentist to fix it. All I wanted was to get rid of the discoloration, but that’s where the problems started.

My current dentist didn’t get the color right when she rebonded my teeth, but that’s not the only problem. The bonding has a very obvious texture, one of my front teeth looks longer than the other, and they have a noticeable gap between them.

My teeth look so unnatural now, but the worst part is that my dentist sees nothing wrong with them. When I pointed out all the things I disliked, she just told me that this is the tricky nature of dental bonding. My dentist thinks it’s an improvement because the discoloration is gone, and she told me I probably just need a few days to get used to the look. She did offer to redo the bonding for me again if I’m still not happy with it, but I’m nervous to let her try again.

I think she did her best, and she is a nice dentist, but I’m so disappointed with how my teeth turned out.

Should I let my dentist try again to get my bonding right, or should I just ask for a refund and move on?

— Joshua from Oklahoma City, OK

Joshua, we’re sorry to hear that your latest dental bonding experience left you feeling disappointed in your smile.

Dental bonding is a straightforward procedure on the surface, but it requires a great deal of artistic skill for dentists to blend the right shades and materials to create the perfect finish.

From what you’ve told us, it’s highly unlikely that you’ll have better luck after letting your current dentist redo your bonding.

Your dentist may be a fine general dentist and she may have a pleasant chairside demeanor, but like all other dentists, she didn’t receive special training in cosmetic dentistry when she went to dental school. Some dentists have natural artistic ability and can produce stunningly lifelike results when they treat teeth with dental bonding. Your dentist is not one of these, unfortunately.

A chipped upper right front tooth will be prepared with dental bonding by a skilled cosmetic dentist.
Before bonding.

 

 

 

 

The same upper front tooth is shown after receiving dental bonding by a skilled cosmetic dentist. It looks perfectly natural.
After bonding. Dental bonding is supposed to look so natural that no one would ever notice it.

 

 

 

 

 

The mark of a truly excellent cosmetic dentist is that he or she will listen to you and work with you tirelessly until you are happy with the results of your treatment. A dentist with little to no artistic inclination will not make that kind of effort. Given what you’ve shared, it seems like your current dentist only made excuses for why your bonding didn’t turn out well. It also sounds like she wants to avoid redoing it, unless you ask her to try again.

If the appearance of your smile matters to you (as it does to almost everyone), then you should seek treatment with a dentist who has a reputation for providing beautiful smile makeovers with cosmetic treatments such as dental bonding. If you stay with a dentist who is more focused on the mechanical aspect of restorative dentistry, then you probably won’t get the results you’re looking for.

This post was published on behalf of Owasso dentist Dr. Heng Lim.

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Invisalign didn’t work for me. What should I do now?

Invisible clear aligner by Invisalign is shown against a blue background.My front teeth were crowded and my midline was off, so I started Invisalign treatment in January 2019 with a general dentist. I was told my treatment should take about 9 months and my dentist gave me a quote, which I agreed to.

But as it turned out, 9 months wasn’t long enough to correct my midline. My dentist said he would need to order more trays for me to wear for another 9 months.

I’m frustrated about this because it means my treatment took twice as long (and cost me twice as much) as I was originally told, and my midline is still off.

I went to get a second opinion from two orthodontists who place both regular braces and Invisalign, and they both told me that Invisalign wasn’t the right choice for me and that I should have gotten regular braces from the start.

I’d like to get a refund from my original dentist who didn’t seem to know what he was doing, but I’m also not sure whether I can believe what these new dentists are telling me about Invisalign.

Do you have any advice?

— Amanda from Connecticut

Hi Amanda,

If Invisalign treatment fails to straighten your teeth, or worse, if it actually ruins your bite, then it’s natural to be frustrated by the wasted time and expense.

Some orthodontists are biased against Invisalign simply because they prefer to use traditional braces which give them more control over the outcome. But the fact that two orthodontic specialists who also offer Invisalign examined your teeth and recommended regular braces is a good indication that they are right and that you can trust their assessments.

This doesn’t mean that your original dentist was wrong, however. Your case sounds like one that was hard for your dentist to predict. It is notoriously difficult to correct a midline issue with Invisalign alone. So your dentist didn’t necessarily do anything wrong, but you are on the right track by seeking treatment with professionals who can offer you an alternative to Invisalign.

It still isn’t fair to pay twice for the same Invisalign treatment that didn’t work, so if you would like to request a refund for the portion of your treatment that didn’t go according to plan, you will have to work that out tactfully with your original treating dentist.

Some dentists may not see this as a failed treatment as long as the treatment was rendered correctly, but your dentist may be willing to accommodate you if you ask politely. If you encounter resistance, ask your new orthodontist to help you negotiate your refund as they can provide documented clinical evidence to support your case.

We’d also like to let you know that some patients who have been disappointed by Invisalign later discover that facial orthopedic treatment helps them correct their bites, so that is another option you may want to consider before getting braces.

This post has been published on behalf of dentofacial orthopedic Owasso dentist Dr. Heng Lim.

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This is why you shouldn’t let your family dentist place your porcelain veneers

A woman in a pink dress sits in the dental chair while her family dentist checks her teeth to fit them for porcelain veneers.
You trust your family dentist. But can you trust them to do great cosmetic dental work?

I had some dental bonding on an upper front tooth for a few years, but it came off recently. I went to see my family dentist for help, and she recommended crowning the tooth. She said that since I was missing about ⅕ of my tooth, it couldn’t be bonded again.

I thought a crown might be too invasive, however, so I asked about getting my tooth covered with a veneer instead. My dentist said okay, and she placed the porcelain veneer last week.

My dentist let me look in a mirror to see how I liked my veneer before she cemented it in place, and it looked good, so I signed the consent to go ahead with treatment.

But I didn’t get to see how the veneer looked after my dentist glued it on. The dentist and assistant just told me it looked great, and it wasn’t until I got to my car in the parking lot that I was able to see for myself what it looked like in a mirror.

There aren’t words to express how disappointed I am with my veneer! It looks at least a whole millimeter longer than the natural tooth next to it, plus it feels bulky and protruding, as if there’s too much cement under it. My veneer both looks and feels wrong.

When I called my dentist yesterday to ask about fixing it, I only got to speak with the dental assistant who told me that there’s nothing that can be done to fix it. My only option is to redo the veneer entirely, but I’m scared and embarrassed to see the dentist again.

What should I do?

—Larissa from Minnesota

Hello Larissa,

The sad fact is that your situation is not an unusual one. While we don’t know all the specifics of your situation, we can say that it is common for people to have a disappointing outcome when they let their family dentist do their cosmetic dental work.

The reason for this is that most general dentists take a function-over-fashion approach to their work. They take pride in placing restorations that function well, but they don’t give as much importance to smile esthetics. Cosmetic procedures like dental bonding and porcelain veneers require an artistic hand and careful attention to detail.

There are two reasons we suspect your dentist may not be cosmetically gifted in terms of her dental work:

1. She initially recommended placing a crown on your tooth, insisting that your tooth could not be bonded.

Of course, there’s a chance that your dentist has other reasons for not recommending dental bonding. But if your tooth has been successfully bonded before and has not suffered other damage, then there’s probably no reason that it can’t be bonded again. This sounds like something a dentist who dreads cosmetic treatments would say.

2. It sounds like she struggled to place your veneer correctly and was embarrassed to admit that it did not turn out well.

It’s not unusual for even a skilled cosmetic dentist to occasionally position a veneer incorrectly when bonding it in place. But the fact that your dentist tried to downplay the results by not showing you the completed veneer, and then to send the assistant to tell you it can’t be fixed suggests that she really has limited experience with placing veneers.

So what’s the next step for you?

If your dental veneer came out a little too long and that was the only issue, then yes, it could be fixed by carefully trimming it. But given that it was positioned incorrectly and has been bonded in place, your veneer will need to be redone, which (costs aside) isn’t the end of the world.

The real issue here is the way your dentist has responded to your esthetic concerns throughout your treatment journey. When all you wanted was a little conservative bonding (which requires artistry), she insisted on a whole crown (a functional restoration she is comfortable placing). When you agreed on a dental veneer and had that placed, she didn’t have the confidence to tell you how it turned out and how she could fix it.

At this point, your best bet is to go find a skilled cosmetic dentist near you who can help you create a look you’ll love.

In regards to the costs, you should try to negotiate a refund from your current dentist. She should be willing to accommodate your request, but if you have any issues, you can enlist the help of your new cosmetic dentist. Make sure that your new dentist carefully documents with photographs the position and appearance of your current veneer. This will serve as evidence in your favor should you have any issues with getting compensated for this sub-standard dental work.

This post has been published on behalf of Owasso cosmetic dentist Dr. Heng Lim.

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