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Can I Get a Functional and Beautiful Smile?

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I had a full-mouth reconstruction done because of a combination of both tetracycline stains and the fact that I sometimes grind my teeth. While the new teeth look okay, my mouth has been hurting ever since. I can’t tell what the problem is but it hurts the most when I bite down to chew. I’ve been back to the dentist who did the reconstruction and he said everything looks fine to him. I don’t know what to do at this point and I’m barely eating. Is it possible to get a beautiful smile that still functions well and doesn’t hurt?

Lacey

Dear Lacey,

Woman holding her jaw from TMJ pain

I am sorry this is happening to you. I’m curious as to the shape your teeth were in before the full-mouth recontruction. If there was nothing wrong with your teeth with the exception of the tetracycline stains, I am confused as to why he used dental crowns instead of porcelain veneers. If there was minor damage from teeth grinding, then wearing a mouth guard would help with that, even with the porcelain veneers, which are the typical treatment for a smile makeover.

As for the dental crowns, if your mouth hurts when you bite down, then everything is NOT fine. You can get a beautiful and functional smile, however in order to do that you need to see a dentist who has training in both cosmetic work as well as neuromuscular dentistry. This would include training in TMJ Disorder.

I think you will need to get a second opinion on your reconstruction case. It could be as simple as some of the crowns are sitting too high. However, it could be more serious. A full mouth reconstruction is one of the most advanced porcedures a dentist can do. If he or she doesn’t have the right training, then it can completely throw off your bite leading to painful TMJ disorder.

When you get your second opinion, you will be better served if you make sure it is from a dentist who has the right training. I would look for someone who has training from one of the following institutions:

  • The Pankey Institute
  • The Los Vegas Institute of Advanced Dental Studies
  • The Dawson Institue

They can give you the right diagnosis for what is wrong with your reconstruction, as well as make any necessary repairs.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Dry Mouth After Full Mouth Reconstruction

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I had crowns put on all my teeth, top and bottom. Ever since the procedure, I’ve had a hard time keeping my mouth closed all the way and I’ve got horrible dry mouth as a result. My dentist did what he called opening my bite so that you could see more of my smile. I was really looking forward to having a beautiful smile but this is miserable. Should I have him grind them down? I feel all the money I saved up for this has been wasted.

Shannon

Dear Shannon,

woman covering her mouth

Putting crowns on all your teeth is known as a full-mouth reconstruction. This procedure is extremely complicated and is usually reserved for some of the more serious dental cases, such as advanced TMJ Disorder. It’s unusual to use it for cosmetic reasons. The standard procedure for a smile makeover is to use porcelain veneers. Substituting crowns for this tells me he doesn’t have advanced training in cosmetic dentistry so he did crowns, which he felt confident in. The problem is placing one crown is much different from than crowning all the teeth, which would take advanced reconstructive training. It appears your dentist does not have that either.

It appears when he opened your bite, he caused what is known as lip incompetence. This means your mouth does not close while it is in repose. There is good news and bad news here. First, the good news. Your dentist messed up and he messed up badly enough that this case will need to be redone AND it should be redone at his expense. You will get a second chance for that smile you have always wanted.

Now for the bad news. Lip incompetence, which leads to the dry mouth you are experiencing, can destroy the health of your teeth. Because of that, you will need to get this repaired rather quickly. Dry mouth means you are not getting enough saliva in your mouth. Most people don’t realize this, but saliva is one of the main defenses our teeth have in fighting decay. Saliva is loaded with bacteria killing minerals. Without your saliva, your teeth will quickly start decaying.

I want you to get a second opinion from an expert in reconstructive dentistry. Look for someone with qualifications like you can read about in Dr. Marion’s bio. If what I is think is going on, he or she can fix this at your original dentist’s expense.

Unfortunately, because you have dental crowns, you will always need dental crowns.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

I’m Concerned About Her Full-Mouth Reconstruction

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I have been going to the same dentist for six years. In that time, I’ve had four dental crowns placed on front teeth that have the metal foundation. This has caused some ugly gray stains on my gums and the crowns keep chipping. She repairs them but charges me for every repair, which I am a bit sick of. So, I went to see another dentist Dr. P—- (name withheld) to get these done right. He told me I need a full mouth reconstruction because my bite is completely off. The temporary crowns look fine, but they hurt when I try to eat. I hope this changes with the permanent ones. My dentist feels it will. As far as the appearance, the one thing I am concerned about is the eye teeth. I would like them a little longer. Do you think it will be too late to fix that? Am I being too picky? I don’t want to upset my dentist because he is much better than the last dentist I went to see.

Asia

Dear Asia,

Dental Crown Being Placed on a tooth

I am very glad you wrote. Not only are you not being too picky, you are not being picky enough. The first thing I want you to do is call your new dentist and ask for the lab order to be placed on hold until you have temporary crowns that fit properly. Then make sure your dentist knows you will not go forward with this until the temporaries are right. You should have no trouble with eating or anything else. They should feel perfectly natural. Putting the permanent ones in will not change how they feel because they are modeled after the temporaries. If the temps hurt, the permanent ones will too.

Another concern I have is the dentist you are using. When I looked him up, there is no advanced training listed that qualifies him for this procedure. Doing a full-mouth reconstruction is one of the most advanced procedures around. I am honestly not certain he is qualified to do this. In fact, I am going to recommend you get a second opinion by someone who does have the advanced training necessary.

I can’t stress enough how important this is. If this isn’t done correctly, he can completely mess up your bite, leaving you with a lifetime of pain and TMJ Disorder. When you are looking for that second opinion dentist, look for someone who has training at either the Pankey Institute in Florida or the Las Vegas Institute for Advanced Dental Studies.

I am going to suggest you get the second opinion before letting your dentist do anything else.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

A Full Mouth Reconstruction for Teeth Whitening??

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I have an old dental crown that really needs to be replaced. They’re quite old. I have several porcelain veneers about the same age. These were all done by a dentist from another city where I used to live. My new dentist wants to replace all my teeth with dental crowns. This suggestion is because my teeth are not very white and he thinks this is the best way to make sure everything matches. This seems rather drastic to me. Can’t I replace them all with porcelain veneers instead of dental crowns? That way I don’t have to grind down my teeth that are healthy. Isn’t that a better solution?

Kathleen

Dear Kathleen,

woman covering her mouth

Yes, that would be a better solution. However, I have an even better one that will save you a significant amount of money. Unless you have a reason for wanting veneers on the teeth that don’t currently have them, such as wanting a complete smile makeover, then the simplest solution to your teeth not being white enough is to do teeth whitening. I’m absolutely appalled he is suggesting crowning all your teeth instead of whitening them.

Such a procedure is known as a full-mouth reconstruction. It is one of the most difficult and advanced procedures there is. In order to do it properly takes extensive post-doctoral training. Not only that, but if your dentist doesn’t do it correctly, it can completely throw off your bite leaving you with painful TMJ Disorder.

Here is my suggestion. If you just want to replace the old dental work. First, get your teeth whitening. Then, get the dental work replaced. You will only need one crown. Replace the porcelain veneers with more veneers. However, I am going to suggest you find a different dentist to do this. I don’t trust this one. You will want one who does beautiful cosmetic work. Check out their smile galleries to see what type of results they get.

If you want a full smile makeover, you would do the same as above, but you could add more porcelain veneers to the procedure, rather than just the ones you need to replace. Again, you will need a dentist better than the one you have.

I hope this helps.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Tanda Pearl Teeth Whitening System

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I have TMJ disorder and have noticed that my jaw hurts more when I am whitening my teeth. I recently read about the Tanda Pearl Ionic Teeth Whitening System. It touts to work in 5 minutes a day. I think that would really help my jaw pain. Have you seen this system? Is it legitimate?

Mary Grace

Dear Mary Grace,

teeth bleaching trays

Teeth Bleaching Trays

I am sorry you have been having jaw pain. One thing I am wondering is whether you are doing your teeth whitening through your dentist? If so, did he make a custom-fitted bleaching tray for your procedure? If not, that is the very first thing I would talk to him or her about.

As for the Tanda Pearl System, I looked into this. Its main ingredient is a peroxide gel. That is a viable teeth whitening solution and the same basic ingredient you would get with any other whitening system. There are some differences to consider before making your decision.

The “Ionic” Technology

Something that niggles at me about this is that they provide zero information about their special technology. There does not seem to be anything special about it. If it did work, they’d make more money marketing it to dental offices, but they don’t do that. This makes me wonder if they don’t want it looked at too closely because it is only there for psychological reasons. I don’t like it when companies or even medical practitioners manipulate patients. They could leave that light out altogether and save their customers money.

The Whitening Period

They say it will whiten your teeth in five minutes use each day. Sure, that could happen. It could happen equally with another system as well. Essentially, the longer you wear the whitening gel, the faster your teeth will whiten. There is nothing magical about the amount of time. If your jaw aches, I would wear your current trays for less time until you have a chance to visit your dentist about your bleaching trays.

The Tanda Tray

I placed a picture above of the type of bleaching trays your dentist should have provided for you. Notice there is a separate tray for each arch of your teeth. The Tanda system is different. It uses a single tray for both arches of your teeth. You have to bite down on it in order to keep it in place. In my opinion, that will increase the pain you are experiencing in your jaw, not help it.

Another thing to consider is you bite down to “create” your trays with Tanda Pearl. This will not be a tight fit. That means that whitening gel will leak out, which weakens its effectiveness. Saliva will also leak in, which (again) weakens the gel.

Your safest option is to talk to your dentist about the pain you are feeling and see if you can get to the bottom of it.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Full-Mouth Reconstruction Horror Story

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I had every tooth crowned because I am a tooth grinder. The results were terribly unattractive but I know I needed teeth and not nubs. I’m not sure they were placed properly because my jaw ended up slanted a bit and I’ve had jaw clicking ever since. Somehow I managed to grind those down too. My pain worsened so I went to someone who said he was a neuromuscular specialist. He had me in an orthotic for a few years and that ended up opening my bite too much. Now I am worse off than ever. I feel like after all of this “treatment” I have gone backward. Is there any way to actually fix this? If I get another treatment, is there a way to get a functional AND attractive smile, or does it have to be one or the other?

Kelly

Dear Kelly,

woman with a beautiful smile

You have been through so much. Both the dentists you went to were either in over their head or just plain incompetent. Most teeth grinding, also known as bruxism, happens at night while you are sleeping. It doesn’t sound to me like either dentist provided you with a night guard, which is specifically designed to protect your teeth from nighttime grinding. This is such a basic solution, I am floored it never happened.

The second dentist who called himself a neuromuscular specialist was being deceitful. There isn’t a recognized specialty in neuromuscular dentistry. I’ll try and give him the benefit of the doubt that he meant he had a lot of training in neuromuscular care, but based on how your treatment went I am having my doubts.

Full-Mouth Reconstructions are Advanced Procedures

Crowning every tooth is known as a full-mouth reconstruction. Though, every dentist is trained in doing a dental crown, crowning every tooth takes more specialized knowledge and training. This type of training in how the teeth occlude together can only be gain post-doctorally. You need a dentist who has invested in that type of training. I’d like you to take a look at Dr. Marion’s training credentials. You absolutely need a dentist who has invested in this type of reconstructive and TMJ Disorder training. Without that, things will not improve and could actually get worse.

You asked an interesting question about your bite being both functional and attractive. Absolutely it can, but you have to go to the right dentist. Most dentists, especially those who do a lot of crowns and other reconstructive work have a strictly engineering mindset. You want a dentist who is also appearance oriented.

How to get both Form and Function in your Full-Mouth Reconstruction

These procedures need to be done with temporaries first. Your dentist should make up provisionals and have you try them in. You need to have your jaw in a comfortable position, have no trouble speaking, and barely notice the crowns. Everything should feel like there are natural teeth there. You also want to make sure it is easy for your mouth to close when you are in your natural “rest” position. In addition, you need to love the way the temporaries look. Don’t let them tell you the permanent ones will look better or that they can change the appearance after they’re bonded. Those are not true. If you’re not pleased with the temporaries, the dentist needs to go back to the drawing board.

Once the permanent crowns arrive, the dentist needs to first put them on with a temporary try-in paste, so you can see and feel them in your mouth before they are bonded. If you’re still pleased and comfortable, you can have them bonded.

I hope this helps.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.