Probably need crowns for upper cuspids/canines but nervous

[aaronpdx]

A little less than a year ago, the intense pain from bruxism I was having had me seek out a specialist. I was hitting 85% on my right side; I could barely touch my left teeth because of crowns on the right that were way too big. As part of Disclusion Time Reduction (DTR) therapy, the specialist shaved down parts of the crowns and added new material (composite filling) to the backs of my upper canines/cuspids so that when my mouth came together, they discludes off the back of the teeth more quickly. I'm doing 100x better than I was. I used to have pain so bad I couldn't sleep at night and I couldn't chew on my right side.

BUT I'm told the composite material won't last forever and the specialist recommends putting crowns on. It's on the front teeth not back, so not tons of pressure on them, but, still, I grind my teeth some still and it'll eventually wear out.

I've read 5-7% of crown preparations need root canals due to the trauma against the exposed dentin. But these are teeth I don't believe I've had fillings in, which is what most of those root canal teeth end up being from (deep fillings/multiple fillings).

Still, I'm kind of avoiding getting the crowns because even the chance of pulpal "insult" and root canal has me scared. I've had six crowns on root canaled teeth, but those were already "dead" teeth. These ones are healthy!

I don't know.

 

[jadon77]

Hi, do you wear a nightguard?

 

[aaronpdx]

I used to. The specialist who did the DTR says I shouldn't. My regular dentist says I should. I'm not sure how much bearing it has on the crown issue.

 

[drhirst]

Dear Arronpdx

It is really great news that your pain has improved. Bite related issues are complex and most dentists struggle to understand and manage them.
Personally, I too would be concerned about having teeth without fillings crowned for the reasons you state.
One option which has not been mentioned, is to bond porcelain or metal veneers onto the inside surface of the teeth in question to replace the composite buildups. This would be more robust, and would involve minimal or no drilling of the healthy tooth. I think if I was in your position this is definitely the way I would go.
Best wishes
Lincoln

 

[aaronpdx]

Lincoln, thanks for the reply! That's a great idea. I hadn't thought of that. Thanks very much.