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Mandibular crowding / possible bite issue (see pics)

 
Mandibular crowding / possible bite issue (see pics)
Added: September 24, 2008 - 5:27 PM
By: Patient Email Withheld, Phoenix Area, AZ
Need Dentist / Specialist: Yes  
Provide Cost Estimate: No  
X-rays Available: Yes  
Case Summary

Teeth: 21,22,23 
Last Full Mouth X-Ray: August 08
Last Cleaning: April 08
Case Description
I'm 26 years old, and I've had non-stop oral pain every day for three straight years. Until I started having problems three years ago, I'd only had one filling in my entire life. Now I've had countless restorations. Two root canals, all four wisdom teeth extracted (a partially impacted and fully impacted pair on the bottom, removed in separate surgeries a year apart), and an abnormally positioned bicuspid on the upper right extracted as well.

To be fair to the dentists, they've probably saved a few of my teeth, and my mouth doesn't feel as bad as it once did. Unfortunately my mouth still doesn't feel good, either.

I've had quite a few people look at this problem. What I can tell you is this: most general dentists look at the x-rays (like they care what I say, I'm just a silly patient, of course) and conclude that my caries have been addressed and I should be fine. Maybe they think I'm a hypochondriac, who knows.

Orthodontists analyze my malocclusion and conclude that it is quite considerable, requiring at least one, if not more teeth to be extracted; this in addition to two years of torture and risk of dental caries with their over-rated, low-tech orthodontic appliances.

My teeth are not in the best of shape, but I think that they are not so bad that I should need to endure great hardship to recover from my dental pains. I'm not seeking perfection here, I just want to cut my long term risks a little bit, and get my mouth feeling good again.

As I've said, many general dentists would have me think I have no major pain-causing problems, and orthodontists would have me think that I would have to endure a boatload of crap from them in order to feel good again.

I suspect that there might be other options that would work reasonably well, and cause me much less grief than the alternatives of non-treatment or full-blown orthodontics. So if you've got any good ideas, I'd love to hear them.

Here's a link to a flickr page where I have uploaded recent mouth and x-ray pictures:

http://www.flickr.com/photos/30404992@N08/

I do have higher resolution versions of these images, flickr just doesn't go higher than 1024x768. And I apologize for not shaving the day of the pictures. ;)




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Reply: Mandibular crowding / possible bite issue (see pics)
added: September 24, 2008 - 7:23 PM

Hi there,

I am sorry to hear about all the dental pain you have had to deal with over the years. I would agree by looking at the pictures that in general your teeth are in a pretty good shape ( but would need to see xrays to confirm that). I did notice significant amount of enamel wear which could be one of the reasons for your continued discomfort. As far as you bite, has anyone discussed Invisalign ( invisible braces)? Just looking at the photos, it would appear that Invisalign might help you improve your bite and alignment. It might not give you perfectoin, but certainly great improvement. With Invisalign you would be able to avoid brackets and wires which significantly reduces your risk of developing decay and/or peridontal issues during orthodontic treatment. I would be happy to see you for a complimentary consultation to confirm my initial assesment. Hope this helps.

Sincerely,

Dr.T

 
Reply: Mandibular crowding / possible bite issue (see pics)
added: September 24, 2008 - 7:48 PM

Dear 1982OK

Thanks for all the detailed photos you sent. I wish everyone did that! You definitely have some crowding issues - but I have treated patients who have even more crowding than you have and we have achieved great results - without orthodontics.

To get a better idea we would need to do some more diagnostics. I''''m sure you''''ve been through a lot already - but a good baseline is the best place to start. We cannot treat what we cannot diagnose.

Please give our office a call when you get a chance - 602.954.8200 - we will go over all the options with you. You may be right - you may not need orthodontics.

The Biltmore Dental Center Team

 
Reply: Mandibular crowding / possible bite issue (see pics)
added: September 25, 2008 - 6:58 AM

From what you describe, it sounds like you need aomprehensive work up and evaluation of all teeth. Pain is the main concern and esthetics second. The crowding can be taken care of either by orthodontic movement or difiitive restorations.

If you would like to have a specialist in restorative dentistry give you an opinion , call my office and set up an appointment for an exam and diagnostic workup. I look forward to meeting you.

 
Reply: Mandibular crowding / possible bite issue (see pics)
added: September 25, 2008 - 12:14 PM

Please contact our office to schedule a complimentary consultation.

480-785-9191.

We look forward to hearing from you.

Thank you!

   

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