My porcelain veneer is broken from grinding.

I have dealt with grinding my teeth for a long time. I’ve seen a TMJ dentist that had me get a night guard. This TMJ treatment has helped a lot.

Well, several months ago, I decided I wanted to improve the look of my smile. So I went ahead and got porcelain veneers done. One night I didn’t wear my night guard and I woke up to a broken veneer. I guess it cracked while I was asleep. Do you think the dentist will replace it for me without charging me?

– Lidia in Florida

Lidia,

As far as getting the porcelain veneer replaced, it is truly up to the dentist. Since the grinding is something that you have dealt with for years, there is no obligation that the dentist must replace the veneer, from a legal perspective. But there are many cosmetic dentists or TMJ specialists that also do cosmetic dentistry that may sympathize with you. Hopefully your dentist is one of these, since it has only been a few months.

There is always a possibility that you will only pay the lab fee, as long as you agree to continue wearing your night guard. That said, it all depends on the directions your dentist gave you when the veneers were placed. If you were already warned about the cautions of forgetting to wear the night guard for your TMJ treatment, they may not feel too bad about the situation. Then again, if there was no warning about the mouth guard given, than you may be able to make a stronger case for yourself.

It also isn’t out of the realm of possibilities that the porcelain veneer that broke can be repaired. A good cosmetic dentist may be able to use dental bonding to reapply the veneer. This all depends on how and where the veneer broke and if it was a clean break. It is also extremely important to see a cosmetic dentist that has an expert skill level.

I hope this information is helpful to you.

This post is sponsored by Newton MA cosmetic dentist.

Tooth pain from Invisalign treatment

I am using Invisalign to straighten my teeth and am currently on my forth tray of aligners. I have a total of nine sets to complete, so I guess I’m about half way there. Anyway, I noticed a pain in a premolar. This tooth is one that has an old filling in it. So I think my dentist would like to get a new filling but he used a temporary filling with medication in it. He said the medication would help to ease the pain in the nerve. But it’s been a few days now and the tooth is killing me. Do you think the increase in aggravation is from the temporary treatment he just did?

– Louis in Oregon

Louis,

Any kind of orthodontics treatment, including Invisalign, places pressure on the teeth to move them into the correct position. And this increase in pressure may make your teeth more sensitive while chewing. The Invisalign system places pressure on the soft tissue around your teeth, as well as the tooth itself. Some pain from this treatment is not uncommon. Although, it sounds like that old filling is really bothering you.

The treatment your dentist did is more of a precaution. He or she is probably wanting to see if that helps with the tooth pain. There is always a possibility that the old filling may have a small crack or may even be beginning to leak around the exterior of the filling. Bacteria can get into the small crevices that surround the filling. This could also be what is causing you discomfort. And if that is the case, it will be difficult to clean it out.

A temporary filling will help to reduce the sensitivity and may seal the tooth better to protect the nerve center or pulp of the tooth. If the decay has reached the pulp, than you may require additional treatment. This is because if the nerve dies, you will need a root canal treatment to save the tooth. All that said, the pain may take several days to subside. It would be good to followup with your dentist in a week or two if the pain is still lingering. An x-ray will be able to provide better information to treat this issue properly. If the filling is okay it still sounds like a replacement filling may be in order. White composite fillings are a great solution for the replacement treatment. They bond to the tooth to make it stronger and they are mercury-free. Ask you dentist if he or she does white composite. There are many mercury-free dentists out there that don’t even place silver amalgam fillings anymore.

Hopefully this answered your question.

This post is sponsored by Newton MA cosmetic dentist Dr. Steve Bader of Ultimate Aesthetics.