Why do my teeth keep breaking?

Some of my patients do seem to break a number of their teeth. There are probably a number of factors in involved. 
        First lets look at back teeth that break or crack. Often the teeth that break have fillings that undermine the existing tooth structure. Even a small filling placed close to the edge ( the mesial or distal of the tooth) can make a crack more likely to develop. Many of these teeth really should  have onlays or crowns placed to protect them.

             Another factor is the occlusion and frequency of night time clenching and bruxism ( many people do this at times while sleeping). Patients that have worn their teeth flatter so that there posterior tooth surfaces meet quite broadly during excursions often apply more force to their posterior teeth. These are people who have "cow bites" (Dentists term). Often when I examine these peoples teeth they have multiple posterior broad wear facets from their forceful grinding and chewing.

                Destructive habits , such as chewing on ice cubes, bones and other hard substances can also cause teeth to break. I had one teenaged patient who had no fillings in her teeth but kept breaking her teeth. It turned out she had a habit of chewing on to a pen top (kids do the darnedest things!)

              I have also observed that older patients, whose pulps have receded (no pulps in their clinical crowns) seem to be more likely to experience tooth fracture. This is especially true if the have a deep overbite involving their anterior teeth.

                Some dentists advocate changing the occlusion of patients by extensive tooth equilibration or by reconstructive dentistry. My solution is simpler.  For  most of these situations is to recommend that my patients wear a nightguard while sleeping that will protect their teeth and help eliminate destructive tooth to tooth contacts at night. This seems to be the least invasive choice and to my mind it is a "DO NO HARM" solution to the problem.

Why Is Dental Treatment Expensive?

So am back after some hibernation with a sensitive topic which is on every patients lips whether in pain or not…

While Dentists are fortunate to be involved in a helping profession, they are also small businessmen who run a private for profit business.

Getting started in dentistry is expensive and can leave young dentist's with a large debt load of Lacs of rupees in debt. Opening a dental office is also expensive with real estate at all time high and rentals. Dental offices are costly to build and even well established dentists can feel financial pressures.

Fees are of intense interest to many people shopping for a dentist on the internet and often patients seem to be shopping for affordable dentistry. This is all well and good, but usually it is wise when seeking ‘bids’ to stay away from the low bidder (unless you’re our government?)

As one of my wise dental assistants once pointed out ‘Jitna sugar daaloge utni meethi cheez milegi”. Similarly where dentistry is concerned good work takes time and usually has a fee that properly reimburses the dentist for his time. And operating costs being the same in an area, quite naturally the ones doing at a low cost are cutting corners somewhere.

Most patients demand that their dentist stay current both with their continuing education and expect that their dentists use first rate materials. Similarly dental laboratories that dentists employ to achieve create beautiful and well fitted dental restorations are not inexpensive either. It is not surprising that that a high percentage of any dental fee goes to paying operating expenses. Most dental offices have operating overheads of 60-70 percent or more.

Salaries and benefits for well trained dental staff can be expensive since they expect compensation that is competitive with the market place and they most talented employees can easily find work with other dental or medical facilities.

Although dentistry can be treated like a commodity just like any other, it is an ART and also a science. Often in dentistry as in life, it not what you do that’s important, it’s how you do it! An excellent filling is better than a poorly fitted crown. Many dentists do things differently and invariably some offer better results than others. 

My crown broke, What should I do?

               If your crown breaks, you should call a dentist and get an appointment as soon as you are able. Hopefully your dentist will see you within a day or two. If they can't see you within a week, I would call a different dentist or better yet ask them 'nicely' if they can refer you to a good dentist who will be able to see you sooner.

               It is best to see a dentist soon, because it is often hard for a patient to evaluate the extent of his damage. Sometimes, a patient without much pain has sustainned a significant injury to a tooth. Fortunately, most times having your crown break isn't such a big a dental emergency. Most times when the patient is seen the crown either needs to be replaced or smoothed.

                Some times the remainder of the crown is sharp and can irritate or cut the tongue.
If the underlying tooth is exposed, sometimes the tooth is sensitive to air or cold liquids. That means the pulp inside the tooth is still alive(a good thing!). Although this is anoying and can be a pain, nothing will happen to the tooth in twenty four to 48 hours. Teeth do not decay in one week. It takes time for decay to develop

               Occasionally, when a patient calls and says "my crown broke", what actually has occured is the tooth under the crown has broken off and the crown has come out. This can be a bigger emergency. When the patient does come in, the remainder of the tooth has decay and sometimes it requires endodontic treatment. Often these teeth do not hurt, since the pulp is already dead. Some teeth have sustained vertical fractures and in a worst case scenario the tooth needs to be removed.