Dental Problems - Help

IndyLady

Well-Known Member
#1
I realize this is danceforums and not dentalforums... however I recall there is at least one dental expert on this forum so I’m hoping she (?) can provide some insight…

Exec summary: the bonding/filling on my front teeth is chipped *AGAIN*. Should I: (a) find a new dentist, (b) find out if current dentist can use better materials or different procedure?

See attached photo.

Background: my two front teeth (8 and 9) have had bonding (that may not currently be the correct terminology, though I believe it was the first time) since I was 16. First bonding from hometown dentist lasted until I was 20ish, when I chipped it on a blueberry bagel. Had it fixed, no issues until I chipped it again in my mid-20’s, don’t remember how/why but was fixed satisfactorily by Indy dentist, who retired a while later.

About a year ago, I chipped it rough-housing with my kid, and current dentist re-did it. The current bonding/filling was definitely subpar compared to the prior repairs. The inside edge of the tooth looks somewhat translucent (you can kind of see it in the photo – the same tooth with the crater), not opaque like previous jobs. The EOB has it coded as “resin” filling, not sure if that is accurate or was done to max reimbursement/minimize my cost. And now it has been chipped again, this time I believe by a poppyseed (from salad dressing), which I did not even notice until I was brushing my teeth this morning.

I have another filling in the back that was done by the current dentist which also chipped, and it was sanded down at my last visit, as well as a different back filling that had to be redone altogether. I've had other fillings and had sealants for years that were "one and done". I’m getting frustrated by what feels like either use of cheap materials or shoddy workmanship. Any trends in dentistry or differences in practices that might explain this? I can’t recall if they said that they couldn’t actually "bond" my teeth (don’t recall the exact reason) – is it time to just look in to veneers (I recall this was an option years ago but I was too cheap/not ready) or some higher end solution? Thanks for any insight.

P.S. - sorry, I cannot get this image to display right side up here. Every app I open it in on my PC auto-rotates it.

IMG_4571.JPG
 

JoeB

Active Member
#2
I'm just waiting for a totally chemical resistant, chip and crack resistant material so they can finish carving out the rest of my teeth and replace them with some that have a 100% lifetime guarantee.
 

cornutt

Well-Known Member
#3
Professional dental patient here. Allow me to be your guide...

There are definitely different kinds of materials that they can do repairs with these days. I've had pretty good luck with Ketac, which is the stuff that is set with an ultraviolet lamp. That said, Ketac generally isn't recommended for front teeth, because it's hard to get the colors to match. (I got a lesson on this from my previous dentist, who was fanatical about color matching... she had a whole box of color samples and she went over the whole thing with me.)

I've been told that most of the fillers do not work well with filling large surface areas like you have on your front tooth. There isn't mechanically anything to hold the filler in. So you might want to consider veneers. That said, you have to take care of veneers. You have to be a little bit careful about how you chew, and you have to avoid things like jawbreaker gumballs, and chewing on ice (a bad habit I had). The ultimate solution is crowning, but once you go down that path the decision is irreversible, so try anything else first.

And yes, if your dentist can't come up with a better answer, and doesn't seem to be able to match colors, find another dentist.
 

mindputtee

Well-Known Member
#5
I am a dental student, not a dentist yet, so take this with a pinch of salt.

Repairing a broken filling is not going to be as strong as a new one, and even less strong than a porcelain veneer because it cannot be chemically linked in the same way.

Filling material generally does have some translucency because natural enamel is translucent so it's made to mimic that, and your dentist probably didn't take into consideration the fact that your bonding wasn't translucent already.

Resin filling sounds just right for that small size repair.

A porcelain veneer is probably your best option as far as longevity and esthetics. The problem with fillings on the front teeth is not the surface area, larger surface area actually makes for MORE bonding because the material locks into the enamel, the problem is lack of depth. A thinner layer of resin filling is less strong than a similar thickness of porcelain or a thicker layer of resin.

A crown is much less conservative than a veneer and probably not necessary unless there is decay. They can do a veneer now and if time comes where you need it, they can do a crown later.
 

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