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After 28 Dental Crowns, My Bite Is Off, and My Mouth Is Dry

In February 2021, I got crowns on all my upper and lower teeth. I have battled with dry mouth since then. My smile is broader because my dentist opened my bite, so I try to smile with my mouth closed. My dentist said he could lower the crowns, but the thought seems overwhelming—lower the crowns on all my teeth? I am not confident that my dentist’s solution is the correct answer or the only answer. Any suggestions? Thanks. Kendrick from Michigan

 

Kendrick,

Unfortunately, your dentist opened your bite and made your crowns higher than your natural teeth, so you are experiencing lip incompetence and dry mouth.

What Is Lip Incompetence?

Lip incompetence is a condition that occurs when you are unable to close your teeth naturally after getting dental crowns. But the long-term effects are more severe than being uncomfortable or annoying. Persistent dry mouth leads to reduced saliva production and overgrowth of bacteria in your mouth. Bacteria can creep into the crown margin and cause gum disease.

Your dentist should accept responsibility for his mistake of seating 28 crowns too high. He should refund you so you can find a skilled dentist who can address all your concerns.

Most dentists do not have enough training on full-mouth reconstruction. The procedure is complex and requires advanced training and experience in occlusion and bite and cosmetic dentistry.

Opening Your Bite

Temporary crowns or composite can open your bite for you to experience the look and feel and how it affects how your lips close and how you chew. A dentist trained in occlusion and bite opens your bite temporarily to ensure you are comfortable with it. A ceramist can custom make your permanent crowns when the test is complete.

What Can You Do Now?

We recommend finding a skilled dentist with experience and training in cosmetic dentistry, occlusion, and bite. Schedule a second-opinion appointment. If the new dentist feels that your teeth issues result from your current dentist’s work, ask them to help you get a refund from your current dentist.

If your dentist is unwilling to refund you, other options are to report the issue to the state dental board or seek legal advice.

Dr. Heng Lim, an Owasso, Oklahoma dentist, sponsors this post.

Before-and-after dental crowns
Before and after photos of Dr. Lim’s patient with a beautifully restored smile

 

 

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Will a Mini-Implant Work for a Missing Lateral Incisor?

I was born without my upper right lateral incisor. I wore braces as a teen, and our family dentist had a dental flipper made to replace the incisor. Now I want something more permanent. I have seen the cost of dental implants and am wondering if a mini-implant will work since incisors are smaller than other teeth. If not, what other options might I have? – Thanks. Sydnee from Portland

 

Sydnee,

Thank you for your inquiry.

Dental implants are ideal for replacing missing teeth. After orthodontic treatment and creating space for tooth replacement, an implant is the only way to prevent bone shrinkage in the area. Also, an implant will last longer than other types of tooth replacement.

Will a Mini-Implant Work for a Lateral Incisor?

A mini-implant can work for a lateral incisor. Mini-implants are one-third the diameter of standard implants. But they are not as strong as standard implants.

Mini-implants have these uses:

  • Replace small teeth
  • Fit spaces too small for a standard implant
  • Stabilize dentures

Mini-implant for an incisor

Standard dental implant and mini implant
Standard (left) and mini-implant (right)

Although Dr. Lim would need to perform an exam and take impressions and a CT scan of your mouth, many dentists replace lateral incisors with mini-implants. It might work for your case, too. After an exam, a skilled implant dentist will explain which implant size will work best for your case.

Dental Bridge – An Alternative to Replace a Missing Tooth

A dental bridge can replace a missing tooth. It contains at least three adjoined crowns:

  • Crowns on the end of the bridge are anchors
  • Center crown replaces missing tooth

Your dentist must grind down the tooth on either side of the missing one so the end crowns will fit over your natural teeth. But if your teeth are healthy, why grind them down? Dental implants do not require work on other teeth.

Schedule consultations with at least two dentists with advanced implant training to discuss your options for replacing your missing lateral incisor.

 

Dr. Heng Lim, an Owasso, Oklahoma cosmetic dentist, sponsors this post.

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My New Veneers Affect My Speech

Close-up of a woman's mouth portraying porcelain veneers that affect speechAfter getting ten upper porcelain veneers, I complained to my dentist that the veneers affected my speech and bite. My dentist removed the front four veneers to replace them. He broke off the tooth while taking off the veneer for the left central incisor. I needed an extraction and dental implant. Now I am wearing a temporary crown while the implant heals. My dentist estimates that it will be three to four months before getting the final crown.

I asked my dentist to compare my temporary veneers, which fit well, with the permanent ones to see what went wrong. My dentist claims that the lab made my right and left first molar veneers too short because they used my original bite. I am now wearing nine temporary veneers and a temporary implant crown. Two of the veneers are too long and touch my lip. I know that I must keep calm. I think I should switch dentists in the middle of treatment. Could I make things worse if I switch? Thank you. Brooklyn

 

Brooklyn,

Thank you for your question.

Although Dr. Lim would need to examine your teeth, veneers, and bite to identify the problem, something is going wrong.

Porcelain Veneer Molars Too Short

If porcelain veneers for molar teeth are too short, they will affect your speech. But it is not the lab’s fault. Before a lab makes your veneers, your dentist gives them instructions. The issue is the vertical dimension and collapsed bite, which can cause long-term problems. Although you already have speech problems, the case can progress to TMJ disorder with jaw and neck pain and headaches.

What Is Vertical Dimension?

Vertical dimension is your lower jaw’s (mandible) vertical position in relation to your upper jaw (maxilla) when your mouth is closed and your upper and lower teeth touch. Taking a physical measurement is not enough. It is essential to assess how vertical dimension affects your facial appearance and speech.

It takes a highly trained dentist to correct vertical dimension—beyond what dental schools teach. A skilled dentist may recommend orthodontics before completing dental restorations.

Many dentists use this method:

  • Replicate your bite on an articulator—a machine that allows the dentist to analyze all your bite movements
  • Use temporary restorations to test in your mouth and establish a vertical dimension
  • Send your case on the articulator with detailed instructions for a lab to reconstruct your mouth

Breaking Your Tooth When Removing Porcelain Veneers

After a dentist bonds porcelain veneers to your teeth, they become a second enamel. A dentist must gently grind them off—not try to pop or pry them off. Your dentist’s method of removing your porcelain veneers broke your tooth and created the need for a dental implant. That is inexcusable. And we encourage you to hold your dentist responsible for compensating you.

What’s Next?

Although Dr. Lim would need to examine and x-ray your teeth, what you describe sounds like a dentist must completely redo your dental work. Your dentist seems to be incapable of restoring your teeth correctly.

  • You can explain to your dentist that you know that he has violated the standard of care.
  • You will find a new, expert cosmetic dentist to correct your bite and replace your dental restorations.
  • Insist that your dentist pays for the work and forwards your dental records to the dentist of your choice.
  • If your dentist is uncooperative, promptly report the issue to your dental insurance company if they provide benefits for any of your treatments. And report the problem to the state dental board.
  • Without exception, transfer to a dentist with advanced cosmetic dentistry and experience with proven skill in occlusion and bite.

We sincerely wish you success and a healthy, beautiful smile.

Dr. Heng Lim, an Owasso, Oklahoma cosmetic dentist, sponsors this post.

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