Advice please – all of a sudden, my teeth seem to be falling apart.

[Jan]

Hello,

I'm reaching out because I'm very worried about my dental situation and could really use some advice.

A bottom central incisor has suddenly become painful and sensitive. I initially thought the discolouration at the top of my lower front teeth was just staining from coffee, but now that one is hurting, I've taken a closer look and realise there are grooves in the top of these teeth and that one of them looks as though it has lost some of its structure. I attach some photographs. Even if I drink water at room temperature, I experience immediate painful sensitivity.

I do clean my teeth regularly, but I have Sjögren's syndrome and a very dry mouth. I also switched away from fluoride toothpaste for holistic reasons, a combination that I now realise may have left my teeth particularly vulnerable to decay.

My biggest worry right now is that I will need to have my front teeth extracted.

I have dental anxiety following a bad experience with a dentist who didn't seem to be concentrating at all, and kept leaving the room during treatment. She accidentally dropped a UV lamp on my face and filed down a minor chip to one of my upper front teeth to the point where I winced — it had been painless before. Unfortunately, the bonding she attached to it fell off after just a couple of weeks, leaving an even bigger chip. I have never gone back to have that upper tooth repaired because of what happened. While the chipped tooth looks a little unsightly, it is frankly the least of my worries right now.

My immediate concern is the sensitive lower front tooth. I am also concerned about the condition of the upper front tooth next to the chipped one.

Because of the above experience, I am particularly anxious about further drilling, filing or removal of healthy tooth structure, and would very much like to understand what conservative options may be available to me.

1. The painful lower central incisor and adjacent tooth
Can the lower front teeth be saved? What conservative options might be available? Does the tooth next to it look like it needs work as well?

2. The previously damaged upper incisor
Is it possible to repair the chipped upper tooth without filing it down any further? (When I had it repaired prior to the incident above, that bonding came off almost immediately too).

3. The adjacent upper incisor
There is a darkened rough area at the bottom of this tooth which I am concerned is decay. I'm thinking it probably needs a filling, although I was hoping the tooth might regenerate with appropriate dental care.

I would also like to know, if possible, why the lower incisor has lost some of its volume, as I’m finding it difficult to understand what has happened to it. I have circled the relevant bit.

Thank you

 

[Gordon]

1) There are 2 large cavities visible. The part you have circled is a decayed cavity. Yes, the tooth can be saved, it will need 2 fillings, possibly a root canal depending on the size of the cavity between the 2 front teeth. The other lower central incisor looks like it's got some early decay on the edge but it's hard to be certain from these photos.

2) Yes. For the best results I'd want to slightly "bevel" the edges of the defects, to give a larger area to bond to. Imagine the edge of the defect having a 30 degree edge rather than a right angle. The amount of enamel removed would be trivial but the resulting restoration would be much stronger.

3) There's some decay present on the upper incisor, that will need removed. It will not "regenerate" under any circumstances. Generally once enamel substance is lost, it's gone forever. The cells which make tooth enamel die off as the tooth erupts into the mouth.

You also have other decay, there is a cavity in the upper right lateral incisor, the upper right first premolar and probably the upper left lateral incisor. You really need to see a dentist soon.

I sympathise about the Sjogren's syndrome, it can be devastating to oral health, apart from the physical discomfort that a dry mouth can manifest.

Your health decisions are entirely your business but I really have to say that discontinuing fluoride toothpaste is pretty much guaranteeing you will have a large amount of decay in future.

 

[Jan]

Gordon,

Thank you so much for taking the time to explain.

It looks like I’m going to have to bite the bullet and find me a dentist before it’s too late. Yes, I think I may have read too many stories about fluoride calcifying the pineal gland. I do hope I can avoid a root canal.

Once again, thank you

 

[letsconnect]

Hi @Jan, just in case you haven't seen these pages on our website yet, they might be useful for finding a new dentist:

How to find a dentist for nervous patients

Discover how to find a dentist who is good with nervous, scared or phobic patients - and who to avoid!

www.dentalfearcentral.org

How to find a high-quality dentist

How do you know if a dentist really cares about the quality of their work? Here is what to look for and expect from a high-quality dentist.

www.dentalfearcentral.org

Best of luck with your search

 

[Gordon]

Yes, I think I may have read too many stories about fluoride calcifying the pineal gland.

Seems to be the current attack vector for the anti fluoride lobby Since everything else they've spouted over the years has been debunked.

This one is also pretty much BS, the main risk factors are:
1) Increase in age.
2) White ethnicity
3) Sex, males greater than females
4) Obesity

There's a pretty good systemic review here if you want to plough through it: https://pmc.ncbi.nlm.nih.gov/articles/PMC9987140/