A practitioner has

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A practitioner has proposed that as i have occlusal symptoms that have resulted in heavy attrition of my lower anteriors and the only way to halt it from approaching my pulp cavities any more , is to open my bite .

His treatment proposes that I have my whole lower arch restored in composite chair-side in a day at the cost of £2000

I have had other solutions proposed, even one guy said I should have a proper occlusal evaluation and have my teeth restored carefully with porcelain but that bill would be over £15000 for my lower arch including what he called equilibrating and long term stabilisation of my occlusion .

I have researched this all very well but the price difference is so huge and i am on a tight budget and only want to spend my money once and have a quick as possible treatment as i am busy all the time .

What I do not want is to have to have the treatment done again and again as for obvious reasons this would be a waste of time and money and i might loose my teeth .

I have also been offered orthodontics etc but i am sure they will still need crowning , I was even offered crown lengthening instead of opening my bite?

Your profession seems to offer so much with such huge bills , All i want is a final solution .

Help i am so confused . The guy who offered me the £2000 option trains at Guys hospital surely that would mean it will be fine to go with his solution or not ?

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Asked on 04/09/2011 12:00 am
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Private answer

You have certainly done your research and the correct thing in getting a second opinion. A third opinion may provide another version of the solution ,perhaps to satisfy your concern about the variation of treatment plans!
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The solution will depend on the experience of the dentist, the limitation of your budget of time and money as well as the assessment by the dentist as to what you expect from the final outcome.
The one stage solution will give you and the dentist a chance to assess the comfort and result of the treatment possibly without an irreversible change to your teeth.

The other option you describe to use porcelain may also include this assessment stage which will involve the creation of provisional crowns /overlays to fully assess how you cope with the new way of closing your teeth together.

Orthodontic treatment may also feature as part of a treatment plan – the nature of such dental care is such that it cannot be carried out in one visit

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Posted by Dental Professional (Questions: 0, Answers: 1475)
Answered on 23/06/2011 12:00 am
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Tooth wear or Attrition is a condition that affects many people but they often do not realise this until there is a dramatic cosmetic change or teeth keep breaking

The most important thing for long term solution to work is to understand WHY your teeth are wearing

This is usually done by a thorough examination of your teeth and jaw function using study models and the fabrication of a hard acrylic splint to protect the teeth from further wear and reduce the tooth grinding that I assume is part of the problem

If you spend £2000 just building them up in composite white filling without knowing why, then expect this to last 2-5 years before they need doing again

Likewise a full occlusal analysis and equilibration with porcelain reconstruction does appear to be overkill as if you are grinding again you will eventually destroy this dentistry also at a much greater cost to repair if you are not wearing a splint

I would recommend finding someone who is a full member of www.bsos.org.uk who teach hands on training in treating such cases

They will probably recommend conservative treatment to understand when you grind your teeth and provide a correctly made and adjusted splint to protect the teeth from further wear with minimal repair to the worn teeth as appropriate to restore aesthetics, function and reduce the likelihood of further wear if you are not willing to wear the splint 24/7

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Posted by Dental Professional (Questions: 0, Answers: 1475)
Answered on 23/06/2011 12:00 am
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