Desperately searching for a solution, but cannot seem to acquire treatment


Joined
Nov 16, 2022
Messages
3
Hi, first, thank you for reading this ridiculously long summary. I'm in severe discomfort and cannot express how much I appreciate any advice.

Problem:

The back of my top right incisor eroded and has lost a noticeable amount of volume. This is yielding speech problems with strident sounds and it's - literally - beginning to drive me crazy because I can't seem to acquire treatment. Additionally, I feel light pain under pressure or extreme temperatures.

Catalyst:

I had a deep bite and my bottom incisor lightly damaged the back of the top one - resulting in the initial damage that slowly expanded across the back of the tooth. I also supported the damage with a horrendous diet - energy drinks galore.

Context on the dental professionals:

I repeatedly visited the same dental practice, but was never able to meet with the same dentist twice because they kept leaving. The lack of continuity in my treatment means that nobody was able to see the initial problem escalate in real-time. Additionally, my orthodontist has not been communicating with the dental practice whatsoever - leading to a somewhat aimless treatment without a real end-goal or game plan.

Details about me:

- 31, male
- B.A. in English
- Writer that works in sales
- No lingering health problems whatsoever
- I don't drink or smoke

Timeline:

March, 2020 - Discomfort level: 2/10. I noticed a small divot forming where at the intersection between my top central incisors and my gums. It was pretty much a nonissue, but created a slight whistle on my 's' sounds that was somewhat annoying. I visited the dentist and they said that it wasn't worth fixing because the damage was minimal and they didn't want to remove healthy enamel. I agreed because it seemed logical and left without addressing the issue.

November, 2020 - Discomfort level: 5/10. The damage slowly spread across the back of the tooth throughout the subsequent eight months. 'S' sounds yielded a stronger whistle and harder syllables - d, t, - were becoming somewhat problematic when spoken in rapid succession - e.g. words like 'text,' 'didn't,' 'ordered,' etc. I returned to the dentist in search of a solution and they agreed that the damage was clearly evident and advised that I get aligners. Nonetheless, my dentist was convinced that the whistling 's' sound was due to uneven bottom teeth. I disagreed with this assessment and sought a second opinion. The second dentist also recommended aligners so I decided to move forward with them.

June, 2021 - Discomfort level: 6/10. Aligner treatment begins. I told my orthodontist that correcting my overbite without addressing the damaged tooth seemed like a bad idea because it would stack an array of new changes with my teeth onto the existing problem. He said that I'd be fine and we mutually agreed to move forward.

November, 2021 - Discomfort level: 7/10. Fortunately, I dove headfirst into an insanely meticulous hygiene routine and successfully stopped the enamel from receding further. Regardless, my teeth began to expand outward as part of the deep bite's correction and speaking was becoming progressively difficult. All strident sounds - including Ls, at this point - were problematic. I also began to feel slight pain when the tooth was pressured or subjected to cold temperatures. I expressed immense discontent, but my orthodontist said that we could not address the damage until the aligner treatment was complete. I agreed to continue, but was beginning to panic about how invasive the speech problem had become.

March, 2022 - Discomfort level: 7/10. My initial aligner treatment was complete. The deep bite was corrected and I progressed onto refinements. I reiterated my discomfort to my orthodontist, but he basically shrugged and wasn't sure about how to fix the issue. The entire problem left him perplexed throughout the majority of our interactions. During this discussion, he heavily implied that it might be a mental problem. I cannot emphasize how much I disagree with this notion. I noticed the initial damage on my tooth immediately, felt - and witnessed - the damage continue to spread across across a long duration of time, and felt my speech problem grow in correlation. My wife also monitored the situation and, additionally, co-workers and friends also made unprovoked comments about a weird hitch in my speech that I occasionally failed to hide.

Regardless, I have maintained that I am NOT a dental professional, nor will I act as an armchair dentist and sought treatment from a speech pathologist. The speech pathologist administered verbal and physical tests that both tracked with my complaint. Specifically, this confirmed my issue with strident sounds and also flagged a slight muscle reflex on the left side of my tongue that indicated that I was compensating for the lack of surface area on the upper right incisor. In other words, I was making contact with the left tooth when producing strident sounds, but not the right one.

7/2022 - Discomfort level: 7/10. I returned to my orthodontist, expressed my continued discontent, and left without any game plan. At this point, I feel like I've been on a multi-year, $8,000 dental odyssey to nowhere.

9/2022 - Discomfort level: 8/10. My discomfort increased simply because it WON'T STOP. The hitch in my speech is attached to every word, of every sentence, of every discussion throughout every interaction in my day-to-day life. I began to squirm and went to a completely new dentist in a desperate attempt to fix the back of my tooth. The dentist added volume to the outer portion of the tooth - providing small relief - but refuses to touch the primary erosion - e.g. the intersection where my incisors meet my gums - until my aligner refinements are finished.

11/2022 - Discomfort level: 9/10. I NEED HELP. This issue is akin to having a thorn in your side; it doesn't hurt that much, but the pain grows intolerable when left unaddressed. I feel like I am speaking with a single front tooth. I literally don't make contact with my upper right incisor AT ALL when speaking. I want to reiterate that NONE of the dental or orthodontic professionals have addressed the erosion on the back of the tooth. None of them. This is seriously beginning to mess with me simply because of how long I have been forced to cope with it and I don't believe that my dentist or orthodontist are grasping how much a mental toll this is creating. I am constantly course correcting my speech and rarely feel 100% present in my daily conversations. Speaking is not effortless; it's a chore. My aligner treatment isn't solving the problem; it's worsening it. My dentist won't touch my issue without the treatment being completed, but I cannot continue with this issue in perpetuity any longer.

In summary: I called out a problem and was told to ignore it. I called out the problem again and was told to get aligners against my own judgement. I got aligners, but the orthodontist told me that the speech issue might be mental. I visited a speech pathologist and confirmed my problems. I returned to my orthodontist and was told to continue treatment. I feel like I am being dismissed and the severity of my problem is wildly unacknowledged.

What do I do here? Who do I see? What do I say? What are the magic words that can convince someone to help me replace the missing volume on the back of my tooth so that I can end this nightmare and return to normalcy? Two years ago, I couldn't fathom such miniscule damage becoming this severe and I'm truly going to have a nervous breakdown if I cannot find an imminent solution.



Photos:
 
Ad

Advertisements

Dr M

Verified Dentist
Joined
May 31, 2019
Messages
972
Solutions
112
Good day

Has anyone discussed crowning the tooth in question, with posssible root canal treatment( if prep risks involving the nerve)? This would add body or volume to the tooth, since you design it digitally, but you might then need to start with an adjusted treatment plan of aligners, which would increase the costs. This is because the initial treatment plan was based on how your teeth were intitially.
 

Vote:
Joined
Nov 16, 2022
Messages
3
Hi, thank you so much for your insight. During my last dental visit in September, the new dentist mentioned the possibility of adding a crown, but wanted to wait until aligner treatment was complete prior to exploring the option further. If I have to travel this route, I absolutely will. Nonetheless, I'm shocked - and admittedly frustrated - at how this evolved from ignoring the problem to getting a crown.

Forgive my ignorance, but is something as simple as adding resin to the indented area on the tooth feasible?
 

Vote:

Dr M

Verified Dentist
Joined
May 31, 2019
Messages
972
Solutions
112
Yes you can, although resin fillings on the smooth surface of a front tooth tend to dislodge quite often.
 

Vote:
Joined
Nov 16, 2022
Messages
3
Thank you for clarifying. Out of curiosity, does the damage to my right incisor look like something that I should be concerned about going forward? Speech issues aside, a substantial portion of the back of the tooth disappeared throughout a span of a couple of years and I fear that it might be symptomatic of a bigger problem.
 

Vote:
Ad

Advertisements

Dr M

Verified Dentist
Joined
May 31, 2019
Messages
972
Solutions
112
It might be related to the abnormal top and bottom incisor relationship prior to the aligner therapy. This could have been fixed with the ortho treatment, but I would suggest keeping an eye on it after the treatment is done. If it continues to wear, I would consider a crown or bite plate to sleep with at night.
 

Vote:
Ad

Advertisements


Ask a Question

Want to reply to this thread or ask your own question?

You'll need to choose a username for the site, which only take a couple of moments. After that, you can post your question and our members will help you out.

Ask a Question

Top