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    Old 01-03-2003, 10:38 AM   #1
    mahtab
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    Question dentist shaving down teeth

    hello everyone
    quick question:
    my dentist, whom ive been seeing for over a year for tmj, routinely shaves down my teeth to adjust my bite
    despite numerous treatments, my tmj hasnot at all improved and im beginning to question the irreversible changes he's making to my teeth
    has any one had success or failure with this type of tretment ( i wear a tp and bottom splint every nite too)

    thnak you!

     
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    Old 01-03-2003, 11:48 AM   #2
    GenDen
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    The American Dental Association says that no permanent changes should be made to the bite until the patient has worn a splint adjusted to the new bite position for several months and all symptoms have been eliminated. Once all symptoms have been resolved in the new bite position with a splint, then permanent changes can be made to adjust to the teeth to the new bite with confidence. Otherwise it is just a guess and permanent damage has been done if it does not work.

     
    Old 01-03-2003, 12:37 PM   #3
    mahtab
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    thank you
    maybe what i will do is ask him to adjust only my splint when i go in but not my teeth
    ive never gone months or even weeks w/o symptoms but maybe it will happen if i leave my teeth alone for awhile and keep wearing the splint
    thanks

     
    Old 01-03-2003, 03:53 PM   #4
    antoni
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    Hi,

    Six months ago I had an occlusal adjustment which involved shaving my front and back teeth down. What precipitated this course of action was having 9 fillings done (unnecessarily) to my top and bottom molars as a preventative measure by a new drill-less dentistry procedure called air abrasion. WIth this air abrasion(done over a year and a half ago), noone told me that the air abrasion machine doesn't cut teeth precisely like a drill, but cuts wide grooves into the tooth. After the air abrasion my bite was ruined and my teeth were too short. I also noticed facial changes like a sunken in look as my top and bottom teeth were shortened and my top bottom jaw moved closer together. I tried having one tooth refilled 3 times to no improvement. I also saw like 7 general dentists that told me adjusting someone's bite is very tricky business. FInally, I saw 3 bite specialits also called prosthodontists. I suffered from mild TMJD symptoms on and off. But mostly I hated having a bite that felt LOPSIDED. One prosthodontist refused to even try as it could make my TMJD symptoms worse. Another just said add more bonding material to build up the short teeth. Another said the simplest way would be to shave my front and back teeth down so that I could get contact points between my teeth(I had zero and he said shaving would give me 2). Even after all the shaving, the teeth were still too short although the overall bite was less lopsided. THis was last August. After the shaving, I noticed new TMJD symptoms emerged crunching on the left side, and popping blowing noises on the right. Now this comes and goes and I am use to it. I had arthritis before and am sure the additional pressure on the TMJD joints from the bad dental brought this on.

    I had bonding added to upper right molar a month ago. My prosthodontist said if the bonding didn't last a month he would have to do a filling/crown hybrid on three of my rear molars(called a porcelain ONLAY at a cost of 1,500. per tooth). OF course a month later only a part of the bonding is still on the tooth and he said there's no point in putting bonding on the other teeth as it will come off as well.

    I asked him what was the purpose of the 9 fillings to begin with as the teeth were cut lopsied, the bite ruined and all the original bonding came off, and now I need extensive repair work from it!!!! He told me don't dwell on it and just MOVE ON. The purpose was to ruin my teeth and make me a lifetime card paying member from quack dentistry. Dentists I guess aren't making money by working on bad teeth but they are ruining good teeth for the business now.

    But back to your teeth shaving. My prosthodontist told me that one would need like 2 millimeters shaved off of 9 teeth at once to caused like a "sunken in" look. In my case about 1.5 millimeters was shaved unnecessarily and he tells me it wasn't enough to cause the facial changes I described. ALso after the original air abrasion procedure was done, I couldn't even smile as I couldn't feel the teeth on my right sided. Now he said people who grind teeth over many many years can lose 2 millimeters. I would find out just how much your dentist has been shaving.

    Also genden, I read about your posting wearing a bite guard before getting any teeth shaved. I never heard of this before. It sounds like a good idea. In my case, I needed drastic measures to correct the lopsided teeth(left teeth were larger) and my bite is less lopsided but I still have teeth that are too short which is no fun. I decided against the porcelain onlays because it would involve more shaving down of the teeth in order to attach the porcelain. Also I am so disgusted that I cancelled my DENTAL insurance through my job. I feel this was the reason why the 9 fillings were done to begin with was to get at my insurance. I don't need to pay for a so called professional cleaning as there are many types of electric toothbrushes that can do the same. I am leary of any type of teeth shaving unless absolutely necessary. I would get some second opinions if I were you to see just how much has been shaved down already and what else can be done. THey say before any tooth shaving other non-permanent methods should be tried.

    Good Luck

    A

    [This message has been edited by antoni (edited 01-03-2003).]

     
    Old 01-07-2003, 04:16 PM   #5
    Pedro
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    mahtab,

    I had exactly the same problems for years, and so much so that rear molars had to be crowned, not once but twice.

    But your teeth are not the problem, trust me. You have a muscular spasm or malfunction, that makes you close your teeth, and the tension makes it feel to you as though the bite is the problem. It's a vicious cycle because you become totally conscious of it. The shaving I doubt will ever truly solve the problem, at least it never did for me. Try to get fairly level, and they see someone who can help you with your muscles (a specialist).
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    Old 01-07-2003, 07:39 PM   #6
    GenDen
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    When I finally got to a TMJ specialist who knew what he was doing, he took a tomogram of my jaw joints and many transcranial x-rays along with sending me for an MRI. What the radiographs showed was that because my bite had been altered by poorly done restorations and grinding down of the teeth, that my condyles were not seated in the proper place in the fossa. One condyle was impinging on the tender nerves and blood vessels that line the fossa. This is painful and causes my muscles to contract in order to protect the joint, then the muscles hurt. Ideally there should be 3mm of space between the condyle and the lining of the fossa. This radiographic information showed that my mandible needed to be moved forward with a repositioning splint and height had to be added to my molars. With the splint in place, the condyles are in the right position. A transcranial x-ray verifies this. My TMJ specialist wants me to wear the splint for several months with no pain or symptoms to be sure that this is the correct position for my bite. In my case, at that point I will have crowns on my teeth to achieve the right bite position. Others might have orthodontics. It depends on the patient. So far it is working for me. In the beginning, it is like two steps forward and one step back as the splint is adjusted correctly.

     
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