November 2017 - Ryan Perry, DDS

I recently had a root canal and got a crown on a molar on the bottom and now my bite is off. It doesn’t feel like it used to. My teeth don’t fit together the same when I bite or clench my jaw. I think it needs to be ground down or something, but my dentist thinks I’ll get used to it and I just have to give it time. Will it ruin my crown if the dentist grinds it down? Is that why my dentist doesn’t want to fix it?

Kay, Denver, Colorado

Dear Kay,

That’s too bad that your dentist is asking you to be patient instead of trying to adjust your dental crown. Unfortunately, when dentists do that, it is often a sign that they aren’t comfortable or knowledgeable about the correction.

The way your upper and lower teeth meet when you chew, and how your teeth function together, is called occlusion. When you get a crown, the shape of the crown is similar to, but most likely not exactly like, the contour of the original tooth, and the occlusion may be different. Over time, you may get used to your new bite, but in some instances, when the bite is off, it can cause unusual stress on the teeth. This stress can lead to bone loss or contribute to TMJ disorders.

When a new crown feels off, most dentists will simply fix it so it isn’t so high. There is a special “registration paper” that the dentist would ask you to tap and bite your teeth together on. When there is a part of the tooth that hits before the rest of the tooth, the dentist will grind the tooth in that spot to fix it. It doesn’t hurt the crown to grind down small spots that may be causing discomfort. This is a common practice with crowns.

You have a couple of options. You can wait as suggested and see if your bite adjusts if you have had a good experience otherwise with your dentist. If you do go back and ask again to adjust the crown and he is hesitant, don’t push it. It may end up worse than leaving the crown as it is.

If you don’t have any ties that bind with this dentist, it may not hurt to get a second opinion.

This post is sponsored by Dr. Ryan Perry in Baton Rouge, Louisiana.

My smile is all gums and I hate it. I have small teeth, too, so whenever I smile, you see a little bit of teeth and a lot of pink gums. Is there anything I can do to change it? Could I somehow use porcelain veneers and at least have bigger teeth?

Sara, Grand Rapids

Dear Sara,

There is something you can do to fix your “gummy” smile, but it’s not a correction any regular dentist could accomplish.

If you have spoken to a dentist in the past about changing the way your gums or teeth look when you smile, it may have been recommended to see an oral surgeon to have your entire upper jaw shortened to fix it. This is a very extreme and unnecessary procedure that can lead to other complications. It can change your bite, which could then lead to problems with your upper jaw or TMJ.

Thankfully there are cosmetic dentists, dentists who have gone above and beyond the training of a regular dentist, who can perform what is called a “gum lift.” The dentist would remove a small amount of gum tissue and some of the supporting bone that was beneath the gum line for each upper front teeth. This would expose some of the roots of those teeth.

A porcelain veneer would then be placed over the tooth and the exposed root section. Cosmetic dentists can make the veneers look as natural as your existing teeth, with matching coloring. You then have a smile with less gums and more teeth that you desire.

Because this is not an easy procedure, you want to find the right experienced dentist to perform it. Don’t hesistate to call cosmetic dentists’ offices and ask if they have performed a gum lift before. If so, ask if they have a portfolio that would show pictures of the before and after cases.

This post is sponsored by Dr. Ryan Perry in Baton Rouge.

Will it ruin a new crown to grind down a high spot?

How do I fix my all gums, small teeth smile?

Archives for November 2017