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Dental fillings - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Dental Health
Answered by

General & Family Physician
Practicing since : 2009
Answered : 540 Questions
User :   I had multiple fillings replaced on opposing molars on one side of my mouth in one day. He filled all of them and then proceeded to adjust the bite. Should I have gotten the top done first and then the opposing ones later? Because now my bite is all messed up.
Doctor :   Hi,
User :   Hello
User :   I am wondering if this was appropriate for him to do my fillings in this way
Doctor :   no, its better to get all at once
Doctor :   because it helps to get a good occlusion
User :   shouldnt he have tested the bite on the top before proceeding to the bottom?
User :   he filled them all first
User :   and then started the "grinding"
Doctor :   no, both filled teeth are needed to get a good occlusion
Doctor :   that is fine . he is grinding to adjust the occlusion
User :   Because filling to filling, how could he match the natural anantomy of my teeth pls help me under stand
User :   I would think to top first then adjust to the anatomy of the bottom teeth, then do bottom and adjust to the anatomy of the top teeth
Doctor :   if the filling in the upper jaw is adjusted to the ones which is not filled in the lower , later when the lower are filled mal occlusion can be expected
User :   So you would fill top and bottom, and then do ALL the adjusting at the end?
Doctor :   if you proceed as you say then the upper teeth may be falsely grounded more
User :   I see well it has been a year and my bite still feels off as in I do not have as much occlusion as I did before
Doctor :   since the filling is the treatment , first its done and then the effect of it improved by grinding
User :   my back teeth dont have as much contact anymore
User :   he says this is a GOOD thing is that true?
Doctor :   no , i do not agree with him
User :   Well he says I was biting too hard before and it was damaging my teeth
Doctor :   if not occluded well it may have effect on the mandible and hence the shape of the face
User :   I am upset because he never told me he was going to decrease my bite he just did it
User :   The problem I am facing now is I have marks on my cheeks because my teeth do not come together all the way and my cheek gets squeezed between the teeth a little
Doctor :   thats not good , it can cause ulcers and rarely cancers get it corrected
User :   I consulted with a dentist, he said I need to either have my bite raised again with crowns or extrude the molars with braces do you think either of these are correct?
User :   or how would you recommend getting it corrected
Doctor :   RCT with crown replacement, would be a better choice
User :   what is RTC
Doctor :   its Root canal treatment
User :   So you would not adjust teeth to get light occlusion on a patient if they were damaging teeth due to biting too hard, clecnching and grinding etc.?
User :   like what he did to me?
Doctor :   yes.
Doctor :   RCT would be the best for you
User :   why would I need RTC, I think my roots are fine
Doctor :   the indication of RCT is t not the infected roots
User :   oh okay what is it then?
Doctor :   caries in any stage can be treated by this
User :   I couldnt just get crowns with no RCT?
Doctor :   yes , you can but it will not ensure the caries not proceeding to the roots
User :   ooh ok
Doctor :   Caps are temporary and have complications
User :   So if not occlusional adjustment, what do you do with patients who clench and grind
Doctor :   but if after RCT they are safe to be used without any pain or infection for life time
Doctor :   i did not understand your last question
User :   well occlusional adjustment is what he did to me to lighten the forces of my bite
Doctor :   ok,
User :   you said this is not good to do correct?
Doctor :   yes,
User :   so what should he have done with me is my question
Doctor :   ok, i get it
User :   I was clenching bad like cracked teeth, damaged fillings, and even a missing cusp from clenching and grinding my teeth
Doctor :   i would have considered good for you where the eligible teeth go for RCT and fix them with the crowns , then fill the other and adjust the occlusion
User :   by adjust do you mean grind off heavy contacts?
Doctor :   long term of mal occlusion and clenching will lead to masster variability and bed look for the face shape
User :   yes I had enlarged jaw muscles which are now shrinking due to the adjustment he gave me
Doctor :   yes, grind the heavy contacts but to a lesser extent and adjust better by filling more
User :   the problem now is the cheek biting, and one of my back molars has drifted to the side which is why I was thinking about braces do you think braces would be a bad idea?
Doctor :   yes,braces will help
Doctor :   but they need lot of time
Doctor :   may be years to serve the purpose
User :   Right
User :   I had the evaluation ortho said 14-16 months
User :   $4220
User :   no insurance
Doctor :   its always subjective
Doctor :   cannot be accurate

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