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Equilibration?

K

Karenw

Well-known member
Joined
Dec 21, 2007
Messages
121
Location
Wales borders
Last week I had the follow-up appointment following my bite analysis. It seems my jaw muscles are exerting too much pressure on my back teeth which is causing them to break hence the cracked lower 6 & 7 molars to both sides. Also my front teeth are poorly aligned too which is causing wear on them and having an effect on my back teeth and the dentist has recommended I have an 'equilibration' to file down and reshape all of my teeth to give me an improved bite.

I was presented with two quotes: The first quote is for a huge amount of work and amounts to a whopping £17,639 (yes, nearly £18k!) to give me a 'perfect mouth'. This isn't even a consideration because I could never raise this sort of money. The second quote is for just equilibration and crowns on 4-5 of the mostly badly cracked teeth. He doesn't want to just crown the teeth because there would be a high risk of the crowns breaking.

I'd never heard of equilibration before and need to decide whether to proceed with it. The dentist talks sense and I think he is genuinely looking for a long-term solution to what has been a long-term problem for me with my teeth cracking and cusps breaking off. The cost is £1200 for the equilibration and will involve 2 hours in his chair (which I've no idea how I'll get through). It is a small fortune for me because I'm not working and in the current economic climate, I don't foresee this changing for some time but my husband has kindly offered to fund half the cost to help me out.

Does equilibration sound like the correct way to go and is £1200 a reasonable price? This would then be followed by 4-5 crowns at about £820 each.

Has anyone here actually had equilibration? I couldn't see it referred to on any posts here...
 
have you considered getting a second opinion? I have never heard of equilibration. But since it is costly I'd get another opinion..Or you can private message a dentist on this forum and ask them..they are very smart!
 
I'm hoping a dentist might see this and offer a professional opinion.

My previous (NHS) dentist could only offer a 'temporary restoration' (whatever that is?) followed by extraction for the worst of my cracked molars and said my broken teeth were 'nothing to worry about for at least 5-10 years' but having lost 3 cusps within the last year and and 6 of my 8 molars cracked both across and lengthways, I didn't have much confidence in his opinion. I've only been able to chew on one side for the last few years and even then it can be painful and I'm constantly worried about them cracking further.

Pics of my teeth and copies of the quotes are included on my original thread at https://www.dentalfearcentral.org/forum/threads/filling-crown-cerec-or-extraction.15578/
 
I am a big tooth grinder too and have cracked two upper molars.My dentist said infection could get into the crack and cause pain or break off so I had them extracted..I'm going for partial dentures next January..I will have to look at your first post...I'm sure a dentist will answer your questions soon...:)
 
Thanks. I've now had to book the appointment - a whole 2 hours in the dentist's chair to have my teeth ground down and reshaped.

I think I'm doing the right thing. At least I hope so because it's costing so much (£1200 plus the crowns).
 
Have you considered getting an NHS specialist opinion about this problem? it seems very invasive and you seem unsure about this option.
 
It IS a lot of money and I am worried about it.

But... I was on an NHS waiting list for nearly 10 years, reached the top last October and saw an NHS dentist. I wasn't very happy with his assessment - a 2 minute glance around my mouth without using any instruments and I was sent on my way. I asked for advice about being unable to chew properly, my teeth breaking and cusps breaking off but I was told it was nothing to worry about. Another tooth fractured a month later and I lost another large cusp which was patched up.

In April this year I had my 6-monthly check-up by which time my worst cracked tooth was turning grey and the tooth and its filling were clearly split with decay running along the gap. Again, I asked for advice and was told the only option now for the tooth was a 'temporary restoration which won't last' followed by an extraction. Again, I asked for advice re the rest of my cracked teeth which I can see are getting worse but was told they were fine and there was nothing to worry about for 5-10 years. I'm not a dentist but even I know my teeth shouldn't be breaking like this with cusps falling off every 6 months or so.

More complex and expensive work such as crowns, root canals etc don't seem to be available on the NHS here which has now been confirmed by other NHS patients at the practice. NHS treatment seems to be limited to just simple patch-up jobs as short-term 'solutions' and extractions when they fail, hence my posting pics and a thread here followed by this thread hoping that somebody might have experience of 'equilibration' but it looks as though nobody does (or hasn't seen this thread).

Today I've paid a £200 deposit towards the appointment next week. I know that something has to be done, and fairly quickly too because my teeth are falling apart and another is rotting away. The dentist talks sense but it is a very invasive procedure and such a lot of money as well having to face 2 hours on his chair. I want to be 100% certain I'm doing the right thing in order to save my teeth.
 
I'm not a dentist and I haven't heard of equilibration either. I have had some success with a hard splint, the dentist called it a 'Michigan' splint/appliance I takes a long appointment to have it custom made. It has protected my teeth from my grinding habit I believe to some degree although I don't use it at present. I have lost 4 back teeth all fractured for one reason all another and cope well without having them replaced. Maybe because their loss is symmetrical on either side of my mouth. I can chew food without problem and remain pain free! That wasn't always the story though and I have had a long dental journey to get to this point. DFC has been a good source of information and support.

Good luck :)
 
IANAD, and I really wish one would reply on this thread for you. I have heard of equilibration, I read a little bit about it when I had lots of jaw pain after some fillings/crowns. What I read was very mixed, it sounded like the dentist really needs to know what they are doing because if it is wrong, your teeth are permanently altered and not in a good way.

My only advice would be to get a second opinion. Even if it costs a bit of money, if the equilibration does not go well, it may cost you waaaaaaaay more to fix the damage.
 
This is my concern. I wish teeth could be built up rather than ground down so that any changes made could be reversed.

Getting a second opinion isn't really a practical option because so few dentists in the UK seem to offer this. Time isn't on my side either because my worst tooth is getting worse by the week and can't be repaired until after the equilibration, which is to form the first step in my treatment.

I think I trust the dentist and his opinion but I just wish I could find someone else in the UK who's either had this done due to teeth breakages (rather than grinding) or an opinion from a dentist who offers it.

Just 2 working days to go before my teeth are ground down.... :hmm:
 
How many crowns are proposed and will these be prepped as part of the equilibration?(=Bite balancing)
 
Yes - two crowns each side to replace cracked LL6 & 7 plus LR6 & 7 and these will be prepped as part of the bite balancing.

Does this sound like the correct procedure?
 

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NO idea if this is good advice but it does discuss dos and don'ts.
 
Re: Equilibration? Need to decide whether to go through with it.

Thanks for this.

It's left me even more confused though! Like most of the other articles I've read, it refers to tooth grinding, tender jaw muscles, headaches etc - none of which I have. My only problem is my breaking molar teeth.

I'm due to have this procedure on Monday so time is very short now and, when facing having all my teeth drilled, spending £1200 and enduring 2 hours on the dreaded chair, I need to be 100% confident that I'm doing the right thing - but I'm not. There seem to be pros and cons including reducing tooth enamel making my teeth more prone to decay in the future and the risk of vertigo (which I suffered from for years and have no desire to repeat).

Originally, I understood the bite analysis I had done was to help the dentist design optimum-shaped crowns so that my bite would be adjusted via these, or possibly I misunderstood.

Can any of the dentists here offer an opinion on this please? Time is running out and I need to decide by tomorrow (Friday) if I'm going ahead with it.
 
Is it possible for you to reschedule your appointment for another week or so, and get a second opinion? Even if they don't do equilibration themselves, an orthodontist might be able to give you an evaluation since they specialize in bite problems....
 
I don't think so. I've already had to pay a £200 deposit towards to the equilibration appointment and the few local orthodontists I've found don't appear to do equilibration (braces, cosmetic work etc but no mention at all of this).

I'm happy about the pending crowns but not certain at all about this.... My crowns are urgent (first are booked for 16th July) but can't proceed until the equilibration has taken place.
 
QUOTE ARTICLE: 'WHEN TO GRIND and WHEN EQUILIBRATION IS ACCEPTABLE

  • When the patient is not experiencing any masticatory pain or discomfort. (This means, no tender muscles of the temples, facial muscles, lower jaw muscles and shoulder muscles, prior to any dental procedure).
  • When there exists a solid stable habitual bite and routine single tooth dentistry is performed and the dentist needs to adjust the new filling or crown only into position.
  • When there is no clicking or popping of the jaw joints prior to any dental procedures. (Patient’s and dentist should be aware of this)!
  • When there is sufficient vertical height and dimension of tooth structure available.
  • When there is sufficient enamel to adjust.
  • When a single tooth is hitting or contacting prematurely and is sensitive or having tooth pain.
  • When it has been recognized that jaw joint degeneration does not exist. (No clicking sounds, grating sounds (crepitus) exists)'

It sounds then that you do fall more into the 'equilibration' camp but of course it is the skill of the dentist that really counts. PM one of the dentists on here but of course they can't say for sure since they cannot know what the quality of care will be.
I am always suspicious of 17k treatment plans - full mouth rehab etc but he is currently saying this limited 2k treatment should deal with your most pressing issues...it is a leap of faith.

Have you checked his GDC listing? When did he qualify? Has he any qualifications over and above the BDS? Past work done? Maybe he can discuss his thoughts in more depth - it is an elective procedure you are allowed to stall and re-group.
I think I am right in saying that the specialist which would do this kind of work would be a Prosthodontist as part of restoring bite when replacing missing teeth?
 
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I raised my concerns at the cost and whether it is necessary, also re my failure to find anyone who has gone through this procedure and been advised that it is essential to reshape my teeth to improve my bite before the teeth are crowned.

I'm not a dentist and I'm having to put my trust in him. On a positive note, he can see that I am not going to be an easy patient to treat and it's going to be rather like watching a jack-in-a-box in dealing with me on his dental chair so I don't think I'm being viewed as a cash cow. He could earn money much more easily from more relaxed and conventional patients.

I've been reading about his background online via LinkedIn and other sources and it seems he is a mentor for students learning the equilibration process, which is reassuring. I don't feel he is a typical High Street dentist and does appear to have undertaken further specialist training:

He is a director on the board of the British Academy of Cosmetic Dentistry, a member of the American Academy of Cosmetic Dentistry, the British Academy of Cosmetic Dentistry, The Association of Dental Implantology, the British Dental Association and others. He is a graduate of the Dawson Academy UK. He has a keen interest in cosmetic and aesthetic dentistry, and has lectured internationally on cosmetic dentistry.

From the first assessment when he looked at my teeth, this consultation was like no other I'd had - it took 20 minutes rather than 2 minutes and my concerns re the cracked molars were not brushed aside as 'nothing to worry about'. I was unprepared for the cost and the process though at £1600 for the bite analysis and this equilibration though.

So, on balance, I probably am doing the right thing in proceeding. The nerves are starting to kick in a little now, but he has promised to be gentle with me and the work will all be at my pace.

If this goes well, I might just have struck gold in finding a dentist who's a cut above some others and couldn't be further removed from the NHS dentist I saw last October then April which triggered my search for a more helpful dentist.
 
Hi,
It does sound like you could use some treatment to prevent your teeth continuing to break. Occlusal equilibriation needs a very skilled dentist to carry it out effectively. An alternative is to wear a nigjtguard ( a hard plastic covering worn on either the upper or lower jaw
Your dentist sounds like he knows what he is doing. However, if you feel unsure get a second opinion. If you pm me I can suggest some suitable practitioners.
Lincoln
 
Thanks. I'm going to go along with it.

Any doubts I've had have been related to the procedure rather than any doubts re the dentist whom, so far, has seemed like no other I've ever met and very professional in his 'do it once - do it right' approach.

I was concerned about the cost, the time on the chair and possible further weakening of or damage to my teeth by a procedure I'd never previously heard of and one which nobody I know has been through themselves. I'd understood the bite analysis was to enable the dentist to make my replacement crowns in a shape which would improve my bite but it seems that it's so far off that all my teeth need to be drilled/ground and reshaped.

Now on the countdown to Monday....
 
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