Due to a teeth grinding habit, I’ve already got crowns on all of my teeth. (placed about 10 yrs ago). I’m only 32. They were not placed correctly and I grinded them down too eventually and now suffer pain and clicking. Now my jaw is crooked, I have a posterior crossbite, my gums are in bad shape due to the crown placements – not to mention they’re just plain ugly, dark and “chiclet looking”. Because of my jaw pain, out of desperation, and at the time, 7 months pregnant, I found myself in the hands of a “neuromuscular dentist”. At the time I had no idea this was not a specialty. I personally feel quite sickened by the whole experience believe that I’ve been taken advantage by charlatans. Now after 2 yrs in an orthotic that essentially opened my bite too much and moved my lower jaw forward (which didn’t work), I feel like my situation is even worse. Now, with this orthotic off, I have an open bite and my crowns are further grinded down – no anatomy. Obviously I need some restorations, but I’m torn between a prosthodontist and a cosmetic dentist. Do I have to choose between function and appearance? I’m worried that the complicated nature of my case – also, how does a dentist know where my natural bite in order to place the crowns? I did consult an orthodontist and he told me my case is complicated (clearly)and that I should see a prosthodontist. Any information is greatly appreciated. I am so incredibly skeptical of dentists after my experiences. I don’t know who to believe. Thank you so much.
- Rachel in Pittsburgh
Rachel,
You were on the right track with the “neuromuscular dentist.” The problem, as you seemed to be able to perceive it, is that this isn’t a legally distinct specialty in dentistry, and your dentist doesn’t appear to have had the needed expertise for your problem.
And if the appearance of your teeth is important to you, you’re in a particularly difficult spot. While prosthodontists have strong academic credentials, they tend to be indifferent to appearance-related issues, which is reinforced by their extra time in dental school.
It is tricky to find where your natural bite is supposed to be, but it can be found by a dentist who has true expertise in TMJ problems. That’s your key – finding the right dentist who knows what they are doing and also cares how your end result is going to look. They aren’t exclusive goals – you don’t have to sacrifice appearance to have a balanced occlusion. You just have to find a dentist with the proper expertise who actually cares enough about the appearance, too.
Look for a dentist who has been trained at the L.D. Pankey Institute. The Pankey Institute is a center of postgraduate dental education located here in Florida that teaches dentists excellence in dentistry in general, and the treatment of TMJ disorders in particular. This is where Dr. Kagan received his training in TMJ disorders, and they are recognized as a worldwide leader in this field. And then look for a strong interest in appearance-related dentistry. Cosmetic dentistry is partly a skill but partly a passion, and the big issue is how much a dentist cares about the appearance of his or her work.
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Read more about dental crowns.