Any teeth grinders ? Did you get the teeth fixed ?
 

So I'm gonna get a second opinion, but wanted to float that by the collective..
I've ground my teeth for a long time, stress probably.. Caused a couple crowns and re-crowns that cracked. I do not do it anymore, or rarely if at all as I have a CPAP and apparently that helps a lot. Also got a night guard if needed.

All of a sudden, despite my teeth not really having changed at all lately, my (good) dentist decided all of a suden that I need reconstructive work "for quality of life later".. That or she needs a new Cadillac, not sure. OK, I am sure professionally she is right about the mechanics of my mouth, but I am wondering how much is truly needed vs "would be nice to have a Hollywood smile" and teeth when I'm 90, which I don't care about (the hollywood smile, I'll never reach 90).

the best plan, and she seemingly put some effort into this, is for me to get braces (LOL, at 50+) to push my upper teeth back up in my jaw (apparently they descend when you grind them down) for over a year, followed by her rebuilding several front teeth to their normal length and shape (incisors are flat) to a) provide a more normal bite and b) avoid possible molar to molar contact and future damage.

So, one year looking like a 15y old + likely $10K of work, likely barely covered.. I am not sure, I'm no longer grinding, esthetically it's fine - could not care less - my teeth don't look horrible (very flat, LOL). Has anyone here gone through all that? Did you find it was worth it ? I'm not really sure how much I care, I already paid $10K for a couple implants in the past few years and I understood the need, but this ? I like my teeth, but I'm not trying to be Tom cruise... It's the "why now" thing that gets me...

If she's your regular doc, when's the last time you had a visit? Do you go for yearly cleanings ?

Not sure I understand... yeah I always go there, 6x a year probably... I'm just wondering if anyone else ever reconstructed ground teeth or just went "nightguard and F-it" - I'm not sure why this is an issue all of a sudden as I have not ground them in a few years..

I'd get a 2nd opinion on that. If you don't have TMJ, then maybe hold off until this becomes more of a real issue with the health of your teeth. That and the technology in dentistry seems to be advancing at a very fast pace. Expect 3D printing of crowns very soon. I'm sure this is happening now in a beta stage.

I had a guard made awhile back and then realized there are products to make your own for next to nothing. Not the kind you would wear in the boxing ring.

Likely a lot more than 10K.

I am a grinder. Or as my dentist tells me, I have bruxism. I grind and tap all night and clench all day. I have chipped and broken teeth, broken and worn out porcelain crowns down to the metal, shattered ceramic crowns and now my dentist will only install gold crowns since I can't wear them out.
My ex brother in law was my dentist for many years after I graduated from high school and he thought he could cure me by adjusting my bite and making night guards for me to wear. I probably helped him make a dozen impressions, plaster casts and vacuum form, trim and adjust guards out of different material. Average live span was about 3 months before I chewed through one. I got nauseated if I wore them top & bottom.
For several years after the divorce, I didn't wear a guard until my new dentist started to replace all of the broken porcelain crowns with gold.
I have been making my own that I buy from "The Doctor's Night Guard. They will last quiet a while. Plop the guard into a cup of boiling waster, let cool and put it in your mouth and bite down. If it isn't comfortable, I just reheat it and adjust until it does. I am guessing many dentists would have a problem with this, but It's better than banging my teeth all night and waking my wife up. My current dentist is just happy I wear it and they only cost about $20.00.
Rinse it off and soak it in white vinegar to remove build up.

The reason I ask is this is a cumulative issue, it didn't happen overnight. So has she discussed this previously?

I used to be a grinder - think it was work stress. My dentist fitted me with a guard to wear, which I did for a couple of years. I’ve since lost it, and never got another. I think the problem subsided over time, probably with retirement. I go 2x a year to dentist, and they haven’t mentioned anything in a long time, so I guess I’m good (zero cavities for life too - good teeth is my only good genetic quality!).

I was, but wore a cheapo mouthguard once the dentist told me it was becoming a problem. $7 at Wal-Mart. Then I did Invisalign for $5800. I finished the program about 18 mos. ago, but still wear my lifetime trays religiously when I go to bed and usually for most of the day when I'm not eating for several hours. Doesn't matter if I grind now, as I always have the trays on. If they wear out, they're not cheap to replace, but a lot cheaper than dental repair work.

I don’t have advice on current issue since hopefully I stopped the damage in time because I did the invisilign around 43 and have worn the retainer religiously at night for the last 12 years. I do think once a grinder, always a grinder so I’d stick with the night guard every night even with CPAP. I did have a childhood dentist recommend hypnosis but never tried it.

For sure get a second opinion. I'm a grinder. My dentist made night guards last years. I'm on my current on for probably 6-7 years. I've been wearing one since my 20's so probably 35 years or more now. I wore my eye teeth down years ago and the front ones are flat. Nobody has ever recommended preventative reconstructive work.

Yeah that's a first for me too... Especially 2y AFTER I kinda stopped grinding, Honestly she put so much effort into this (measurements, cast of my mouth, presented it to colleagues) that I feel she's decided to pick me as a book project but again, the teeth are fine. I'm gonna go back to a mouthguard to check if I even wear that down at all, which I doubt because back when I was grinding I could tell the next morning! Seems extreme to me. Especially when I see my british friends, next to whom I have Tom cruise's teeth.

I was a grinder also. My dentist fitted me with a night-time retainer that worked.
He told me that stress was prob the contributor.

He was right.
After eliminating the stress...no retainer needed and all is good.

(please don't ask me how I eliminated the stress) :D

These reconstructions on severely worn dentitions are big projects. To do them right they often require orthodontics b/c the teeth erupt as they wear.

You are correct in that your decision point is wear a nightguard or get the reconstruction (and still wear a nightguard, but look better).

There is not a cure for bruxism, so you will likely grind on the restored dentition as well. Sleep apnea may play a role, but no real evidence there, still controversial. Now grinding on a restored dentition (porcelain/zirconia) will not wear like your teeth did. Once you wear through enamel you are dentin on dentin, which wears 7x faster than enamel does, so that's why the wear gets so bad once it reaches a certain point.

One option for this is Botox injections in your masseter muscles, I have used this in several patients who are destroying expensive restorative care with success. But you have to be committed to doing it every 3-6 months.

Bottom line is you have to be committed to wanting to do this, and then maintain it and deal with the issues afterwards that are sure to come.

Opening your bite up w/ a reconstruction *could* also help your sleep apnea as well, as one other data point for you.

Hope that helps. I am not a restorative/general dentist, I am a periodontist but I am involved in a lot of these reconstructions helping build the necessary foundations.

Thank you, that was indeed very helpful.
I have no doubt my dentist wants to do the best possible option, in the same way I'd like all my friends to buy a Porsche instead of a corolla, but I was questioning if this was indeed worth the hassle and cost vs a mouthguard. I'm in the mouthguard camp.

Call me vain but braces at 50+ for over a year plus $10K + of reconstruction on teeth that look fine (not crooked, just slightly erupted flat incisors), vs a $25 mouthguard ??? I mean I already sleep with CPAP so what's another piece of plastic at this point ! Ironically I'm not even grinding anymore much (maybe 2-3x a year if work sucks)

It's good to know what you are getting into. Sounds like just staying in a night guard would fit your desires the best. Glad to help.