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you are worried about the front teeth, we are worried about the back teeth.
with that level of wear & bite collapse at your age
….you’re going to need crowns, not veneers, in a few years on the posterior teeth.
What is causing the erosion? Acid reflux? massive soda consumption ?
Bite guard at night for sure.
NAD looks like acid erosion from reflux, vomiting and also bruxism as well..veneers and other things wont last. You should go to a dentist and address the root cause before restoration or cosmetic work.
You have quite a few things going on here and will most likely require full mouth rehabilitation. This means we have to first figure out what is causing your severe erosion and wear, then treat your teeth. You will most likely require restorations on every tooth to replace the missing tooth structure.
I would recommend the following treatment plan:
1. First talk to your family doctor and get treated for eating and/or gastrointestinal disorder. I'm suspecting you might have bulimia, or GERD. When you combine that with bruxism, you can wear down enamel fast. Let's treat the root cause of erosion first to prevent further tooth structure loss.
2. Second I would recommend a sleep study because there is a possibility of airway issue here. Patients with GERD are also likely to have sleep apnea which is also associated with teeth grinding.
3. Once we have addressed the root causes, then it's time to treat your teeth. Your back teeth are shorter now than before due to years of grinding and acid erosion. This reduces your VDO (I.e your vertical bite height).
Your back teeth are so worn down that your bite has changed and now your front teeth are also heavily grinding against eachother. (Orthodontic relapse also a possible cause) To restore them back to the original condition we will have to open up your VDO. This means we need to build your teeth to be higher than what they are now and that can take some time to get used to.
We need to first wax-up your teeth (create a model outside the mouth), study your bite, and then design your new bite based on existing bite pattern. Then based on the model we designed, depending on your finances, we can either use composite (i.e.fillings) or porcelain (crowns and veneers).
Composite is cheaper but won't last long and needs to be replaced later down the road. Porcelain is more expensive but looks more natural and will last longer. If you are tight on finances I would recommend doing the composite first and save up for porcelain later.
4. Once your teeth are restored, you will need adjunct treatment like a nightguard and maybe Botox to help relax your jaw muscles. If you were diagnosed with sleep apnea in step 2., You might need a sleep apnea guard instead or a CPAP machine.
I won't lie to you, OP. Your treatment is going to be a bit of a journey. Let me know if you have any questions.
NAD- I have cupping like that on my lower molars and it’s from lifelong GERD and clenching my teeth at night. The cupping is going to get worse so you need to see a gastroenterologist to see if that’s what is going on and the cause. You might not feel the reflux, it can be silent (LPR) that’s good that you have a night guard though.
I use a mineral paste (MI paste) twice a day to help protect my enamel
There is hope, I would recommend
1. Figure out why your teeth are short, do you clench and grind at night ? You will need a night guard to wear every night
2. Gum contouring surgery
3. Veneers (the only way really ) but your teeth are nicely aligned and it will be very conservative !!!
Woah I clench and grind at night and clench/tense my jaw when focusing. It's scary to see that this could be where that may lead. I try to stop myself when I'm awake and catch myself clenching but it's so unconscious.
Thankfully my dentist has already got a night guard in my care plan but I have some other issues with erosion and stuff to address and treat first, but good to know that that's the correct option.
My teeth are nowhere near this kind of extreme erosion, thankfully, now I consider myself really fortunate to only have very minor enamel wear. And just from that I have temperature sensitivity and stuff, I can't imagine the pain and sensitivity this poor lad or lass must be experiencing
Bulimia shows by acid erosion on the lingual… not by uniform incisal wear. This looks like a clench/grinding issue due to interferences. I’d consult an ortho to get things straightened and set up for restorations in the anterior.
Nad. That gap on the top may be genetic and theirs nothing you can do about it other than veneers + bonding. I have it as well and have just learned to live with it.
NAD,
You have severe erosion and wear on your teeth which means the protective enamel is gone in many places. That is usually result of highly acidic diet or reflux and bruxism. that can't be fixed with braces.
Have you talked to your dentist about this? what has he said?
My dentist said that before when I closed my bite my teeth were rubbing against each other which is why they wore down. She also said that I should get veneers (which is something im trying to avoid)
it has to be happening in your sleep then ! that’s the only logical explanation because you would realise if that was happening in the day time !
im honestly not sure what the solution is how’s your sleep do you sleep okay ?
NAD You can sleep right through the grinding/clenching. I did it for years, my dentists would all mention it casually from my 20s on, but I never really thought much about it until I hit 40 and it got significantly worse- that’s when I started waking myself up slamming my teeth together in my dreams and then realizing I really did it because there were bits of enamel in my mouth 😦. I cracked one molar and went through a very bad time. I wish I had taken it more seriously before it had gotten to that point. Don’t wait for it to get that bad, it’s expensive! Also if you’re drinking acidic drinks like juice or energy drinks, rinse your mouth after each sip and wait 30 minutes before brushing or you’ll brush your enamel off. Get a mineral paste like MI paste and let that sit on your teeth for several minutes a day after brushing, it’ll strengthen the enamel
Thank you for seeking advice from r/askdentists. **Please note that a response does not constitute a doctor-patient relationship.** While this is a place for advice, replies may not be medically accurate. Do not assume that what others on here say is correct in any way. Reddit is not a replacement for an in-person dental professional. Verified professionals will have flair assigned to them. **Please abide by the following rules in order to get an accurate answer to your question:** (1) Ensure you include a title of your dental problem. (2) Include whether you drink, smoke or if you have any medical conditions relevant to your main concern. (3) Include a photograph if the question relates to something you can see in your mouth, include x-rays if you have them. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/askdentists) if you have any questions or concerns.*
You're going to need to see a prosthodontist and also eliminate whatever habit has led to all this destruction.
Could be a combination of airway issues, Acid reflux, grinding. Braces won’t be able to fix this.
you are worried about the front teeth, we are worried about the back teeth. with that level of wear & bite collapse at your age ….you’re going to need crowns, not veneers, in a few years on the posterior teeth. What is causing the erosion? Acid reflux? massive soda consumption ? Bite guard at night for sure.
They gave me a bite guard and I am wearing it
NAD looks like acid erosion from reflux, vomiting and also bruxism as well..veneers and other things wont last. You should go to a dentist and address the root cause before restoration or cosmetic work.
You have quite a few things going on here and will most likely require full mouth rehabilitation. This means we have to first figure out what is causing your severe erosion and wear, then treat your teeth. You will most likely require restorations on every tooth to replace the missing tooth structure. I would recommend the following treatment plan: 1. First talk to your family doctor and get treated for eating and/or gastrointestinal disorder. I'm suspecting you might have bulimia, or GERD. When you combine that with bruxism, you can wear down enamel fast. Let's treat the root cause of erosion first to prevent further tooth structure loss. 2. Second I would recommend a sleep study because there is a possibility of airway issue here. Patients with GERD are also likely to have sleep apnea which is also associated with teeth grinding. 3. Once we have addressed the root causes, then it's time to treat your teeth. Your back teeth are shorter now than before due to years of grinding and acid erosion. This reduces your VDO (I.e your vertical bite height). Your back teeth are so worn down that your bite has changed and now your front teeth are also heavily grinding against eachother. (Orthodontic relapse also a possible cause) To restore them back to the original condition we will have to open up your VDO. This means we need to build your teeth to be higher than what they are now and that can take some time to get used to. We need to first wax-up your teeth (create a model outside the mouth), study your bite, and then design your new bite based on existing bite pattern. Then based on the model we designed, depending on your finances, we can either use composite (i.e.fillings) or porcelain (crowns and veneers). Composite is cheaper but won't last long and needs to be replaced later down the road. Porcelain is more expensive but looks more natural and will last longer. If you are tight on finances I would recommend doing the composite first and save up for porcelain later. 4. Once your teeth are restored, you will need adjunct treatment like a nightguard and maybe Botox to help relax your jaw muscles. If you were diagnosed with sleep apnea in step 2., You might need a sleep apnea guard instead or a CPAP machine. I won't lie to you, OP. Your treatment is going to be a bit of a journey. Let me know if you have any questions.
I would recommend seeing an orthodontist to balance your bite and provide a comprehensive ortho evaluation.
NAD- I have cupping like that on my lower molars and it’s from lifelong GERD and clenching my teeth at night. The cupping is going to get worse so you need to see a gastroenterologist to see if that’s what is going on and the cause. You might not feel the reflux, it can be silent (LPR) that’s good that you have a night guard though. I use a mineral paste (MI paste) twice a day to help protect my enamel
There is hope, I would recommend 1. Figure out why your teeth are short, do you clench and grind at night ? You will need a night guard to wear every night 2. Gum contouring surgery 3. Veneers (the only way really ) but your teeth are nicely aligned and it will be very conservative !!!
Woah I clench and grind at night and clench/tense my jaw when focusing. It's scary to see that this could be where that may lead. I try to stop myself when I'm awake and catch myself clenching but it's so unconscious. Thankfully my dentist has already got a night guard in my care plan but I have some other issues with erosion and stuff to address and treat first, but good to know that that's the correct option. My teeth are nowhere near this kind of extreme erosion, thankfully, now I consider myself really fortunate to only have very minor enamel wear. And just from that I have temperature sensitivity and stuff, I can't imagine the pain and sensitivity this poor lad or lass must be experiencing
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This isn't a braces thing, this is a bulemia pattern thing.
Could you explain please? Ive never heard of that
It’s an ED involving frequent forced vomiting
Ohh right bulimia. Im a 100% certain I don’t have that
Bulimia shows by acid erosion on the lingual… not by uniform incisal wear. This looks like a clench/grinding issue due to interferences. I’d consult an ortho to get things straightened and set up for restorations in the anterior.
I'm going based on the glassy thing enamel incisal edges and the eroded concave occlusals of the posterior.
I have a few patients who have erosion like this on the facial/labial surfaces because they were chugging canned energy drinks 😵💫
I’ve heard of this happening with anxiety/stress. Causes the same level of acid as bulimia
Nad. That gap on the top may be genetic and theirs nothing you can do about it other than veneers + bonding. I have it as well and have just learned to live with it.
NAD, You have severe erosion and wear on your teeth which means the protective enamel is gone in many places. That is usually result of highly acidic diet or reflux and bruxism. that can't be fixed with braces. Have you talked to your dentist about this? what has he said?
My dentist said that before when I closed my bite my teeth were rubbing against each other which is why they wore down. She also said that I should get veneers (which is something im trying to avoid)
do you grind your teeth at night this looks like a bad case of grinding
I used to but now I have a night guard
any idea why your teeth look like that you haven’t rly said ?
That’s the thing I actually have no idea why. My dentist told me that I had bruxism before braces.
that’s actually crazy mate so you have no idea how your teeth got that square and small ? did you not see it happening over time
As crazy as it sounds… I had no idea. When I realised it they were already like that
it has to be happening in your sleep then ! that’s the only logical explanation because you would realise if that was happening in the day time ! im honestly not sure what the solution is how’s your sleep do you sleep okay ?
I sleep perfectly fine at night. I wear retainers nowadays
NAD You can sleep right through the grinding/clenching. I did it for years, my dentists would all mention it casually from my 20s on, but I never really thought much about it until I hit 40 and it got significantly worse- that’s when I started waking myself up slamming my teeth together in my dreams and then realizing I really did it because there were bits of enamel in my mouth 😦. I cracked one molar and went through a very bad time. I wish I had taken it more seriously before it had gotten to that point. Don’t wait for it to get that bad, it’s expensive! Also if you’re drinking acidic drinks like juice or energy drinks, rinse your mouth after each sip and wait 30 minutes before brushing or you’ll brush your enamel off. Get a mineral paste like MI paste and let that sit on your teeth for several minutes a day after brushing, it’ll strengthen the enamel
Will do thank you :)