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Braces ruined my bite, so my dentist says that I need crowns on all of my teeth.

I had braces when I was younger. I thought orthodontic treatment was supposed to fix my bite, but my current dentist told me that my bite was “off” and he says that I now need full-mouth reconstruction. There’s nothing about my bite that bothers me, though. And I can’t afford to get the number of crowns my dentist suggests I need.

Could I be missing something? Do I really need all those crowns to fix my bite, or is there an alternative?

— Grant from Sanford, ME

Hi Grant,

While it’s not unheard of for some people to have bite alignment issues after wearing braces, it doesn’t sound like that’s what you’re experiencing.

Most people who really need full-mouth construction are in pain or discomfort and need to have their teeth physically altered to take the stress off their TMJ. These people have bites that are so off they cannot chew, speak, yawn, or smile comfortably. And it isn’t as simple as placing a crown on each tooth. Full-mouth reconstruction requires both technical and artistic expertise to design crowns that are the perfect size, height, shape, and color for each tooth. When done well (and when it’s truly necessary) full-mouth reconstruction can be life changing.

What this means is that there should be a really compelling reason for you to get full-mouth reconstruction. We have no idea what your dentist saw in your mouth that made him feel obligated to recommend crowning all of your teeth. But, again, full-mouth reconstruction is an extensive and complex process which isn’t usually needed for people who don’t have any issues with the way their teeth fit together.

If you don’t feel like your dentist is giving you enough diagnostic evidence to justify the investment of a full-mouth reconstruction, then you should seek a second opinion.

In your particular case, you should consider seeking out a dentist with special training in TMJ treatment and full-mouth reconstruction. Such a dentist will carefully evaluate your bite, will let you know if there are signs of trouble, and can recommend more conservative measures to try correcting your bite before going the route of full-mouth reconstruction.

This post has been published on behalf of Dr. Heng Lim, an Owasso dentist who has received training in creating balanced bites at The Las Vegas Institute for Advanced Dental Studies.