Blisters after white fillings

Dr. Nelson,
I recently had a few silver fillings dug out because I was told they were loosening up. I had the teeth filled with the white composite. I really did not have a lot of pain/sensitivity afterwards, however on a few other teeth (unrelated to the ones that were worked on) I am experiencing a lot of pain and I noticed the gums look red. I also have a few blisters on the inside of my bottom lip. All this happened within just a few days of getting the white composites.

Can you help me?
Michele

Michele,
It sounds like the inside of your mouth – your lips and gums – have been irritated by materials that were used in your dental appointment.

Many of the materials dentists use, such as the bonding resins and etchants used to place white fillings, can be slightly irritating. Even the cotton rolls used to keep the area dry are irritating. And sometimes, because of stress or hormones or nutrition or low-grade infections, the tissues in your mouth can be hypersensitive, to where these slight irritations will produce blisters or soreness inside your mouth.
There’s no evidence that I see here that your dentist did anything wrong or that your mouth has a problem with white fillings. I think this just happened to you on a day when your gums and lips were extra sensitive and you would have reacted this way no matter what was done.

Grinding problem and porcelain veneers

I had not been to a dentist in about 12 years when I decided to get something done about a chipped front upper tooth and discoloration due to chewing tobacco. I also bite my nails and had worn down and chipped my teeth due to a tooth grinding problem and clenching. Upon choosing a dentist and getting an exam, I was told that I had very healthy teeth and gums.
My issue is that the only fix offered for the chipped tooth was to place 6 veneers on my upper front teeth, and I agreed to do this. But the first evening I had them, one fell out. Then during the next week, I felt cracking while yawning or blowing my nose. I thought I felt a hairline fracture with my tongue along the inside of half the veneers. My dentist said this was normal, but I feel that they are fundamentally loose and will start falling out at any time.
I feel as if I never got these properly installed and I will incur further expenses to have them replaced in the upcoming months; not to mention the fact that I am disappointed that no other solutions to fix a chipped tooth were offered to someone like me with a history of oral fixations/nervous habits.
I had calmly stated that I guess she can’t do anything else for me and I made an appointment with another dentist on the way out.
Should I be incurring any further expenses to resolve this situation? The dentist offered using crowns because, she may have underestimated my level of bruxism, and she said this may require root canals.
Dan

Dear Dan,
There are other options for fixing a chipped tooth, and I think your dentist should have mentioned them. A dentist has an obligation to tell you all of your options. And if you have been grinding your teeth, it wouldn’t be wise to have porcelain veneers placed until the tooth grinding issue has been resolved. TMJ disorders like tooth grinding can sometimes be quite complex.
But it’s possible your dentist got in over her head because of your grinding. Her admission (”The dentist offered using crowns because, she may have underestimated my level of bruxism, and she said this may require root canals.”) seems like it could be a nice way of saying, “I didn’t know what I was doing.” She very well may have never done porcelain veneers for a bruxer before. I’d wait and see. She’s right that you can possibly feel a little margin on the inside of the tooth near the biting edge. That doesn’t mean the veneer is cracked or is going to fall off. But if you do have others fall off, you may need them re-done. And the dentist bears some liability for this, if they fall off. I would NOT recommend going to another general dentist. Your case is over the head of 98% or 99% of dentists. But I’ll warn you–it could be involved. Her problem, if it turns out you continue to have trouble, was that she just dealt with your six front teeth, which doesn’t address your bruxism problem at all. But the good news is that you are in a position to pressure her to help cover your expenses, because of the problems you had afterwards and because she didn’t explain all your options.

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