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I think my dentist damaged my dental bridge while adjusting my bite, and now the metal underneath is showing.

I’ve had a porcelain-covered metal bridge in my mouth for more than two decades. I grind my teeth a lot and while I know I should wear a mouth guard, I simply can’t afford one right now. Even so, my teeth grinding has never caused any damage to my bridge.

I had to get a couple of new crowns placed by my dentist last week and the fit wasn’t quite right, so my dentist had to make some adjustments to my bite. He said he had to adjust the surface of my porcelain-covered bridge, too. My bite felt better, but I noticed the next day that there’s now a little spot of metal showing through on the biting surface of my bridge where before it was smooth porcelain.

When I went back to my dentist to show him, he blamed the damage on my teeth grinding and covered the spot with some white filling material (which came right off later in the day).

I haven’t had a single issue with this bridge in more than 20 years. I refuse to believe that grinding my teeth caused this damage overnight, but my dentist won’t admit that he had anything to do with it.

What can I do?

Thanks,

— Jenny from Worcester, MA

Hi Jenny,

It sounds like you’re right, Jenny: your teeth grinding did not cause damage to your bridge overnight, and it’s highly likely that your dentist removing some porcelain from your bridge had something to do with this. This is an understandable and fairly common error that many dentists make when they are trying to adjust a bite.

Your dentist wouldn’t have removed the porcelain clear through to the underlying metal, but he thinned it out to the point that when you ground your teeth that night, it finished the job. Your dentist probably doesn’t want to admit that he contributed to this damage because he could become responsible for replacing your bridge.

It can be difficult to repair a bridge with this kind of damage, but it’s not impossible. As you’ve already discovered, a little white filling isn’t going to stay on very well, but there are other techniques a skilled cosmetic dentist can use to try to restore your bridge.

You may have a hard time getting your current dentist to repair or replace the bridge, however, if he’s convinced he didn’t have anything to do with damaging it in the first place.

So what you can do is visit a new dentist for a second opinion. This new dentist can take an objective look at your bridge and tell you whether it shows signs of being ground down too far by a dental drill. If the porcelain on your bridge was not compromised, then there won’t be a mark when the dentist gently draws a metal explorer across it. But if the porcelain was drilled away by a dentist, then the metal explorer will leave a mark on the surface.

When you have your “evidence,” you can go back to your original dentist, explain the findings, and ask him politely to help you repair your bridge. And if you feel that your current dentist is not taking your concerns seriously, then it could be time to search for a new one.

You can also avoid this issue in the future by choosing to restore damaged teeth with metal-free dental crowns and bridges.

This post has been published on behalf of Dr. Heng Lim, an Owasso dentist with extensive experience in creating balanced bites.

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My porcelain veneers keep coming off. Is this normal?

I’ve been seeing the same dentist for the past four years, and she recently started fixing my teeth with dental veneers. The problem is, they keep coming off and causing me a lot of embarrassment and frustration.

My front teeth weren’t too bad to begin with. They were a bit yellow and a little chipped. A couple years ago, my dentist said I needed veneers on my eight upper front teeth to protect them because I grind them at night when I sleep and I’ve got some cracks in them. But the veneers just don’t seem to stay on. I lose one or more at a time and this could happen at any time, usually once a week. The last time, I lost two just while eating a banana!

I can even tell when one of my veneers is getting loose because a bad smell comes from it shortly before it pops off.

My dentist says this keeps happening because I grind my teeth. I do wear a night guard to protect my veneers, though.

My dentist has been good about seeing me right away to replace the veneers that come off, but I don’t know how much longer I can keep doing this. It’s so embarrassing to lose my veneers because I’m left with ugly dark yellow nubs that don’t even look like teeth. I’m so afraid of losing my veneers in front of others that I often turn down social opportunities.

I was told these veneers were supposed to last me for at least 20 years, but I can’t imagine going through this for another 18 years. I hate the way I look when I smile, and I just don’t know what to do next.

I’m too embarrassed to see another dentist and I don’t think I could afford to do that, anyway.

Is it normal for veneers to keep coming off like this?

— Chardae from Oklahoma

Hello Chardae,

It sounds like you’re living a cosmetic dentistry horror story.

No, it is not normal for dental veneers to pop off like that. In fact, it sounds like what you have aren’t even veneers at all.

A veneer is a slim shell that covers just the front of a tooth, and it’s a purely cosmetic dental restoration. To prepare a tooth for porcelain veneers, only a slim layer of enamel has to be removed from the front surface and biting edge of the tooth.

But from what you are describing, it seems like your dentist placed dental crowns, not veneers.

A crown is a restoration that covers an entire tooth. The tooth has to be significantly reduced to what you might call a “nub” to make room for the crown.

You can see the difference between a crown preparation and a veneer preparation in the photo below:

Crowns and veneers serve completely different purposes; a crown helps protect and reinforce a weakened tooth, while a veneer, as mentioned earlier, simply enhances the cosmetic appearance of a front tooth.

So the first issue here is that your dentist is doing you a major disservice by telling you that she is placing veneers when in reality, she may be placing porcelain crowns. It seems she isn’t familiar with the technology and techniques for placing actual dental veneers.

Second, placing eight crowns across eight upper front teeth could be overkill if those teeth didn’t need to be drastically shaved down and crowned in the first place.

And finally, even if your dentist felt crowns were right for your teeth in your situation, she is doing you yet another major disservice because she isn’t placing them correctly. You describe a bad smell that comes out of your restoration before it comes off. This is caused by saliva and bacteria leaking inside the loose crown. If your dentist was using the right technique to securely attach the crowns, they wouldn’t be stinking and coming loose like that.

At this point, you should start looking for a new dentist. You might feel nervous about finding a non-judgmental cosmetic dentist. But the reality is that a truly skilled cosmetic dentist will never make you feel responsible for this horrendous ordeal.

Instead, a compassionate and artistically inclined dentist will help you understand your treatment options for making your smile look the way you want it to be. Additionally, your new dentist can help you negotiate compensation for this terrible treatment by your current dentist. She is responsible for paying for any treatment you need to undo the damage she has done.

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

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Dentist damaged my son’s tooth while removing his orthodontic retainer. Is a root canal necessary?

My son wore braces for a year and half and has had a fixed retainer on the inside of his lower front teeth for the past three years. The dentist was trying to remove the retainer recently, and it seems that he damaged one of my son’s lower teeth in the process. The tooth began hurting after the retainer was removed and it has since started to turn gray. My son can’t bite on that tooth and he says that it hurts when he wears his retainer. The tooth is also extremely sensitive, even to just plain water.

We went back to the dentist to get it looked at and he took an X-ray and did a cold test. He said that he suspects that the tooth is dying and may need a root canal. The dentist then referred us to an endodontist for specialist treatment. I’m surprised that the tooth might need root canal treatment.

Is there any chance it’s simply bruised and only needs a little time to heal?

— Sam

Hi Sam,

Unfortunately, when a tooth dies, a root canal is necessary to stop the pain and prevent the infection from spreading. A tooth is filled with living tissue that swells in response to infection and injury, just like tissue anywhere else in the body. The problem with teeth, however, is that there’s no room for the inflamed tissue to swell as it’s confined to the inside of the hard outer layers of the tooth.

If your son’s tooth is truly dead or dying, then a root canal is the best treatment to help him get relief.

A root canal is the only treatment option once the inside of a tooth is compromised by damage or decay.

And based upon the description of your son’s symptoms (namely, sensitivity to biting and cold temperatures) it sounds like your dentist did the right thing by referring your son to an endodontic specialist for a more definitive diagnosis. Those are classic signs of a dying tooth.

It’s worth noting that removing a permanent retainer should be a straightforward procedure with very little risk of damaging the teeth. If your dentist truly caused the injury to your son’s tooth, then he should pay for the root canal to repair the damage.

Additionally, while braces and retainers are only rarely connected with complications like the one your son has experienced, some people find that they get excellent results when they choose an alternative to traditional orthodontic treatment.

If you, your son, or anyone else in your family needs to see an orthodontist in the future, you might want to consider exploring a method such as facial growth guidance.

This post was published on behalf of Dr. Heng Lim, a whole health dentist in Owasso.

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