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Medical Forum / General / Dentistry / May 2005

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Lost my bite, chipping my teeth!

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shempmcgurk@netscape.net - 22 Apr 2005 17:50 GMT
I'm male and 50 years old.  I floss and brush regularly and I think I
have pretty good teeth.

In december I had a root canal done on a back molar: top left, next to
last...I think they called it #14.  Then around two months after that
heat (food and liquid) started to irritate it.  At about this time, I
chipped the crown next to it and then subsequently to that, chipped two
other teeth, one requiring a crown.  When the dentist took out the old
crown that I chipped (the first of three teeth I chipped) from that
moment forward I lost my bite; that is, my teeth no longer align and,
even until today, they still don't.

Also, the dentist sent me to an endodontist to redo the root canal
about 2 weeks ago which has eliminated the sensitivity to heat.

My question: is it probable that the three teeth I chipped in the past
two months are a result of losing my bite and my teeth not being
aligned? And, if yes, what can I do about it...the dentist is
clueless...he keeps putting that paper with the blue dye in my mouth
and asking me to tap and grind and tells me that everything is okay
even though I tell him that I KNOW that my bite is no longer there...

Help...
W_B - 22 Apr 2005 18:14 GMT
>I'm male and 50 years old.  I floss and brush regularly and I think I
>have pretty good teeth.
[quoted text clipped - 19 lines]
>
>Help...

Check into getting an NTI
www.headachehope.com
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Shyster - 22 Apr 2005 20:51 GMT
It's your fault, the dentist is not to blame  lol

Scientists put men on the moon using computers that were about as powerful
as an average calculator today but a dentist can't get  impressions for a
crown to fit properly  haha

> >I'm male and 50 years old.  I floss and brush regularly and I think I
> >have pretty good teeth.
[quoted text clipped - 27 lines]
> Take out the G'RBAGE
> wubbabubbazG@RBAGEyahoo.com
shempmcgurk@netscape.net - 23 Apr 2005 15:42 GMT
> >I'm male and 50 years old.  I floss and brush regularly and I think I
> >have pretty good teeth.
[quoted text clipped - 22 lines]
> Check into getting an NTI
> www.headachehope.com

I took a look at that website but I don't see how it would help me.

What about my question of whether I chipped my teeth because of the
loss of my bite?

Can anyone answer that, please?

> --
>
> W_B
> Take out the G'RBAGE
> wubbabubbazG@RBAGEyahoo.com
Joel M. Eichen - 23 Apr 2005 15:48 GMT
> > >I'm male and 50 years old.  I floss and brush regularly and I think
> I
[quoted text clipped - 38 lines]
>
> Can anyone answer that, please?

REPLY

I say no, others may disagree.

Joel M. Eichen DDS

> > --
> >
> > W_B
> > Take out the G'RBAGE
> > wubbabubbazG@RBAGEyahoo.com
Charlie - 23 Apr 2005 16:42 GMT
The following is being posted with full knowledge that it could all be
totally invalid as it might apply to you (not bad, eh? I should be a lawyer!
) as I have not examined you.

If you presented in my practice with distress/discomfort over changes in
your occlusion (dentalese for "bite"), I would probably advise the
following:

1. Therapy with an appliance that would disengage or "deprogram" your
musculature from the tooth contacts you have now - this is what W_B was
suggesting you look into.
2. In the course of using this appliance or fabricating a new one as
needed, develop an occlusion you are comfortable with.
3. With 3 months or more of satisfaction on your part with the appliance
therapy, consider adjusting/provisional/final restorations as needed to
reestablish your occlusion.  This is called Occlusal Equilibration.

The issue of whether you chipped teeth because of alterations in your
occlusion is usually straightforward to diagnose.  The dentist needs to
determine whether or not you have prematurities that were caused by the
restorative procedures.  Prematurities are single (sometimes multiple)
tooth-to-tooth contacts that occur during mandibular motion, in a vertical
or horizontal (or combination) direction.

99% of humankind has prematurities.  OK, I made that number up, but I think
my colleagues would agree that they are normal, and usually not associated
with problems in and of themselves.  I have them, my wife has them, I think
my dog has them.

But they can be problematic, especially when generated in the course of
dental care.

I will finish with this - and I hope I'm not overstepping my bounds - I
would caution you against focusing too much on how your teeth feel when
they come together.  I, absolutely, agree that you need to have your
occlusal problems correctly diagnosed and treated.  Buuuuut, I have seen
many patients spend years looking for a "perfect bite", despite good dental
care.  I'm guessing you grind your teeth, perhaps some stress reduction
maneuvers would be of benefit.  I have "cured" patients' facial pain/"bite"
problems by getting them to exercise and cut down on caffiene.

Get a second opinion if you need it.  The Occlusion division of a dental
school might be an idea if you're near one.

Good luck

Charlie
shempmcgurk@netscape.net - 23 Apr 2005 20:02 GMT
Dear Charlie,

I cannot tell you how helpful your post has been to me.  Just reading
it gave me relief because I have felt ignored and abandoned by my
dentist and have not known where to turn to...and what you wrote below
answered many of my questions -- and, I'm afraid, have conjured more
that I need to ask! -- but I thank you for it.

I have read it just as I am rushing out for an engagement but I will
reread it later and post some more questions/comments...hopefully you
will still be predisposed to responding to them...

> The following is being posted with full knowledge that it could all be
> totally invalid as it might apply to you (not bad, eh? I should be a lawyer!
[quoted text clipped - 43 lines]
>
> Charlie
Charlie - 23 Apr 2005 20:20 GMT
You're welcome, not a problem.
shempmcgurk@netscape.net - 24 Apr 2005 18:20 GMT
> The following is being posted with full knowledge that it could all be
> totally invalid as it might apply to you (not bad, eh? I should be a lawyer!
[quoted text clipped - 7 lines]
> musculature from the tooth contacts you have now - this is what W_B was
> suggesting you look into.

What sort of doctors/dentists sell/provide such
appliances...orthodontists?

> 2. In the course of using this appliance or fabricating a new one as
> needed, develop an occlusion you are comfortable with.
> 3. With 3 months or more of satisfaction on your part with the appliance
> therapy, consider adjusting/provisional/final restorations as needed to
> reestablish your occlusion.  This is called Occlusal Equilibration.

"final restorations"...and I'm afraid to ask this...does that possibly
mean MORE CROWNS?

> The issue of whether you chipped teeth because of alterations in your
> occlusion is usually straightforward to diagnose.  The dentist needs to
> determine whether or not you have prematurities that were caused by the
> restorative procedures.  Prematurities are single (sometimes multiple)
> tooth-to-tooth contacts that occur during mandibular motion, in a vertical
> or horizontal (or combination) direction.

The diagnosis you refer to above, do you mean that blue paper I was
told to bite/grind, which the dentist did do with me, and concluded
that my bite was fine...which, of course, I know to be incorrect.

> 99% of humankind has prematurities.  OK, I made that number up, but I think
> my colleagues would agree that they are normal, and usually not associated
[quoted text clipped - 3 lines]
> But they can be problematic, especially when generated in the course of
> dental care.

...and this is precisely what I'd like to determine.

It seems odd that I would have the work done, have complications go
with it (which the dentist acknowledged and, indeed, sent me to an
endodontist to deal with, at his expense) and, at the same time,
develope the lost bite.

Co-incidence, perhaps, but my instinct is that there is a
connection...AND, at the very least, I feel the dentist has to have a
concern about this problem a wee bit more than just doing the blue
paper exercise (which took him all of 45 seconds).

Am I being unreasonable?

> I will finish with this - and I hope I'm not overstepping my bounds - I
> would caution you against focusing too much on how your teeth feel when
> they come together.  I, absolutely, agree that you need to have your
> occlusal problems correctly diagnosed and treated.  Buuuuut, I have seen
> many patients spend years looking for a "perfect bite", despite good dental
> care.

I'm not looking for a "perfect bite", just the one I had before the
dentist did the work.

Do you think it's possible to get back to that state?

>  I'm guessing you grind your teeth, perhaps some stress reduction
> maneuvers would be of benefit.  I have "cured" patients' facial pain/"bite"
> problems by getting them to exercise and cut down on caffiene.

...when you say "exercise", are you talking about general full-body
exercise or exercise specifically for the mouth muscles?

> Get a second opinion if you need it.  The Occlusion division of a dental
> school might be an idea if you're near one.

Anyone else?

> Good luck
>
> Charlie
W_B - 25 Apr 2005 17:26 GMT
>> 1. Therapy with an appliance that would disengage or "deprogram" your
>> musculature from the tooth contacts you have now - this is what W_B
[quoted text clipped - 3 lines]
>What sort of doctors/dentists sell/provide such
>appliances...orthodontists?

The web site has a listing of docs who make NTI's

headachehope.com
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
W_B - 25 Apr 2005 17:12 GMT
>99% of humankind has prematurities.  OK, I made that number up, but I think
>my colleagues would agree that they are normal, and usually not associated
>with problems in and of themselves.  I have them, my wife has them, I think
>my dog has them.

A dogs' mandible doesn't move side to side, just up and down.
YMMV
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Charlie - 25 Apr 2005 18:16 GMT
Hey, I did an endo on a Great Dane once, so I think I'm the reigning
Dogodontist!

arf
W_B - 25 Apr 2005 19:46 GMT
>Hey, I did an endo on a Great Dane once, so I think I'm the reigning
>Dogodontist!
>
>arf

Have done several on dogs, and even some pulpotomies on a cougar.
(No Joel, the cat, not the car.)

My good friend is a veterinarian.
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Joel M. Eichen - 25 Apr 2005 20:08 GMT
> >Hey, I did an endo on a Great Dane once, so I think I'm the reigning
> >Dogodontist!
[quoted text clipped - 3 lines]
> Have done several on dogs, and even some pulpotomies on a cougar.
> (No Joel, the cat, not the car.)

REPLY

So you did the root canal in THE COUGAR?

> My good friend is a veterinarian.
> --
>
> W_B
> Take out the G'RBAGE
> wubbabubbazG@RBAGEyahoo.com
Dr. Steve - 26 Apr 2005 02:39 GMT
>>Hey, I did an endo on a Great Dane once, so I think I'm the reigning
>>Dogodontist!
[quoted text clipped - 5 lines]
>
>My good friend is a veterinarian.

He is telling the truth. I have met the veterinarian in person & seen
images of the animal endo.
..
Stephen Mancuso, D.D.S.
Troy, Michigan, USA

I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting.
W_B - 26 Apr 2005 16:58 GMT
>>>Hey, I did an endo on a Great Dane once, so I think I'm the reigning
>>>Dogodontist!
[quoted text clipped - 10 lines]
>..
>Stephen Mancuso, D.D.S.

BTW Dogodontists only work on Canines <yuk yuk>
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Charlie - 26 Apr 2005 18:24 GMT
Hey, what's black and brown and looks good on a lawyer?

A Doberman!
W_B - 28 Apr 2005 17:03 GMT
>Hey, what's black and brown and looks good on a lawyer?
>
>A Doberman!

A shame:
A bus load of lawyers goes of a cliff.

A crying shame:
There were empty seats.
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Dr. Steve - 28 Apr 2005 23:56 GMT
>>Hey, what's black and brown and looks good on a lawyer?
>>
[quoted text clipped - 5 lines]
>A crying shame:
>There were empty seats.

What do you call a lawyer at the bottom of the ocean?

A good start
..
Stephen Mancuso, D.D.S.
Troy, Michigan, USA

I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting.
W_B - 29 Apr 2005 16:13 GMT
>>>Hey, what's black and brown and looks good on a lawyer?
>>>A Doberman!
[quoted text clipped - 9 lines]
> A good start
>..
Why can lawyers freely swim in the ocean ?
    Great Whites extend professional courtesy.
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
StovePipe - 01 May 2005 07:18 GMT
> >>>Hey, what's black and brown and looks good on a lawyer?
> >>>A Doberman!
[quoted text clipped - 12 lines]
>       Great Whites extend professional courtesy.
> --

???? Funny you should mention that last one:

http://tinypic.com/4smera
SP

Signature

Finally: take out the TRASHH

W_B - 02 May 2005 15:36 GMT
>> Why can lawyers freely swim in the ocean ?
>>       Great Whites extend professional courtesy.
[quoted text clipped - 4 lines]
>http://tinypic.com/4smera
>SP

Yikes !!!
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Joel M. Eichen - 02 May 2005 19:25 GMT
good one!

> >> Why can lawyers freely swim in the ocean ?
> >>       Great Whites extend professional courtesy.
[quoted text clipped - 11 lines]
> Take out the G'RBAGE
> wubbabubbazG@RBAGEyahoo.com
StovePipe - 30 Apr 2005 19:18 GMT
> >Hey, I did an endo on a Great Dane once, so I think I'm the reigning
> >Dogodontist!
[quoted text clipped - 6 lines]
> My good friend is a veterinarian.
> --
Have not done RCT on dogs; have done some on 'sons of bitches' though...
SP

Signature

Finally: take out the TRASHH

Roy Brown - 01 May 2005 05:55 GMT
| > >Hey, I did an endo on a Great Dane once, so I think I'm the reigning
| > >Dogodontist!
[quoted text clipped - 8 lines]
| Have not done RCT on dogs; have done some on 'sons of bitches' though...
| SP

What about the other kind of Cougar? Older women that prefer younger men?
--
Roy
StovePipe - 01 May 2005 08:22 GMT
> | > Have done several on dogs, and even some pulpotomies on a cougar.
> | > (No Joel, the cat, not the car.)
[quoted text clipped - 7 lines]
> --
> Roy

Don't think they usually have real teeth at _that_ stage...
Cheers
SP
Signature

Finally: take out the TRASHH

StovePipe - 30 Apr 2005 19:18 GMT
> Have done several on dogs, and even some pulpotomies on a cougar.
> (No Joel, the cat, not the car.)

Then who finished the Endos on the cougar?
SP
Signature

Finally: take out the TRASHH

W_B - 02 May 2005 15:26 GMT
>> Have done several on dogs, and even some pulpotomies on a cougar.
>> (No Joel, the cat, not the car.)
>
>Then who finished the Endos on the cougar?
>SP

They were primary teeth.
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Dr. Steve - 24 Apr 2005 04:24 GMT
>> >I'm male and 50 years old.  I floss and brush regularly and I think
>I
[quoted text clipped - 38 lines]
>
>Can anyone answer that, please?

Lots of clenching (even while sleeping) can lead to muscle spasm which
changes how your mandible closes.
..
Stephen Mancuso, D.D.S.
Troy, Michigan, USA

I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting.
Charlie  Oster - 24 Apr 2005 19:40 GMT
Don't take it personally, but you are years of university away from
understanding the theory and application of the "blue paper", simple as it
may seem.

I meant full-body exercise.  Meaningful (not a 3-mph stroll), 30 min x 4
day min.

The next thing you need is a diagnosis.  The appliance/follow-up was part
of my statement of what I would do if I made a particular diagnosis, which
may or may not apply to you.  You are jumping much too far ahead.

Copy and print out my initial reply.  Take it to your dentist and ask if it
applies to you.

If he/she does not seem convincing, knowledgeable or sincere to your
satisfaction then seek another opinion.  They may have an explanation that
will help, or you may continue to be frustrated.

And they may make a referral.  Good dentists have no problem when the
patient tells them they're seeking another opinion.  Regardless of where
this ultimately takes you (appliances, crowns or not, equilibrations) you
must, first, find a dentist competent in this area (I'm not stating that
your first dentist is necessarily not so.)

Doesn't have to be a specialist.  Ask around, commercial dental
laboratories can be a good resource, or ask your friends whether they have
confidence in their dentist.  You need - if you don't already have - a
dentist that is conservative, knowledgeable and honest.  This describes
most dentists.  The odds are with you.
shempmcgurk@netscape.net - 25 Apr 2005 01:47 GMT
> Don't take it personally, but you are years of university away from
> understanding the theory and application of the "blue paper", simple as it
[quoted text clipped - 28 lines]
> --
> Message posted via http://www.medkb.com

thanks for all of the above, it's very helpful.

now I just have to get up the nerve to bring your response for him to
read (I'm seeing him on Thursday...).
Charlie - 25 Apr 2005 11:18 GMT
Nerve, schmerve Shemp.  Sorry, but I have to ask this: where's Moe, Larry
and Curley?

Ahem, I must be in a mood.  I AM taking your concerns seriously, and I am
qualified to be giving counsel, honest!

Like I said, if your dentist takes offense, that's one more reason to seek
another opinion.  On the other hand, he/she may surprise you.

Good luck.

p.s. if you decide to seek a second op. and get stuck, you may want to let
this forum know what area you live in so we can brainstorm a possible
referral for you.
shempmcgurk@netscape.net - 25 Apr 2005 19:48 GMT
> Nerve, schmerve Shemp.  Sorry, but I have to ask this: where's Moe, Larry
> and Curley?
>
> Ahem, I must be in a mood.  I AM taking your concerns seriously, and I am
> qualified to be giving counsel, honest!

Hey, if I'm going to use an internet moniker like "Shemp" I gotta be
ready to take some ribbing, no?

And, of course, the last name -- McGurk -- is from the Hope/Crosby
"Road" movies...but I'm sure you knew that...

> Like I said, if your dentist takes offense, that's one more reason to seek
> another opinion.  On the other hand, he/she may surprise you.
[quoted text clipped - 4 lines]
> this forum know what area you live in so we can brainstorm a possible
> referral for you.
W_B - 25 Apr 2005 17:10 GMT
>> Check into getting an NTI
>> www.headachehope.com
[quoted text clipped - 5 lines]
>
>Can anyone answer that, please?

Parafunction.
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Charlie - 25 Apr 2005 18:14 GMT
Pair of what?

Just thought I'd get that in before Joel.
shempmcgurk@netscape.net - 25 Apr 2005 19:47 GMT
> >> Check into getting an NTI
> >> www.headachehope.com
[quoted text clipped - 7 lines]
>
> Parafunction.

What is "parafunction"?

> --
>
> W_B
> Take out the G'RBAGE
> wubbabubbazG@RBAGEyahoo.com
Steven Fawks - 26 Apr 2005 14:25 GMT
> What is "parafunction"?

If you could imagine going to sleep and during certain stages of sleep
lifting 20 lb. weights with both arms for 5-10 minutes at a time and
repeating that process 4-10 times per night, that would be close to what
you are doing with your teeth and jaw.  Do you think something would
get sore?

;-)
Fawks
 
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