I’m recovering from bulimia and trying to save my teeth. I’ve seen four cosmetic dentists with good reputations in the state to see which one is the best dentist for a smile makeover. Two of the four dentists recommended porcelain crowns for a smile makeover because several of my teeth are severely decayed. They basically said that the crowns could correct my bite and give me a good-looking smile. The decay is severe in 11 teeth, 3 more have limited decay, and my remaining teeth don’t need major work. Their recommendation surprised me, and I wonder if I should let them grind down all my teeth when most of them don’t need aggressive action. I’m beginning to regret seeing so many dentists because the last two dentists recommended crowns. Or maybe I shouldn’t have told each dentist what the other one said. I’m confused. I also get nervous at the dentist, so I chose dentists willing to do sedation. Are the first two dentists I saw too conservative, or are the last two dentists too aggressive? Should I start all over and schedule consultations with dentists, maybe in another state? Thanks, Siobhan from VA

Siobhan,

Thanks for submitting your question to our office. It’s good to know that you are recovering from bulimia nervosa and concerned about your smile. Although Dr. Reddy would need to see you to examine your teeth and review your x-rays and dental history, the recommendations you received from the last two dentists concern us.

Conservative treatment is a priority for advanced, ethical cosmetic dentists. They want to preserve as much healthy tooth structure as possible. If you’re uncomfortable with aggressive treatment, a cosmetic dentist concerned about you as a patient certainly wouldn’t recommend it.

Will You Need Crowns on All Your Teeth for Bulimia Recovery?

Whether a dentist needs to place crowns on all your teeth as you recover from bulimia depends on the damage to your teeth. Choose another dentist if you sense that the last two dentists are more interested in selling you crowns than giving you a smile makeover that helps you feel good about recovering from bulimia. A conservative cosmetic dentist will recommend treatment that increases your confidence about your smile—not options that increase worry about your teeth.

Sometimes a full-mouth reconstruction with crowns on all teeth is required, though. Common reasons include:

• Many missing teeth and jawbone resorption that makes your face sag
• Severe, painful issues with your bite
• Most of your teeth are severely decayed or broken

How to Decide on Treatment

We recommend that you return to either of the first two cosmetic dentists who offer conservative treatment. The first two cosmetic dentists will explain their recommendation and the disadvantages of crowns on all your teeth. Without telling them about the recommendations from the last two dentists, ask about the pros and cons of dental crowns for all your teeth.

Depending on the extent of damage to your teeth from bulimia, the recommendation for your smile makeover might include a combination of treatment: orthodontic treatment, porcelain veneers, dental implants, cosmetic bonding, or dental crowns.

You stated that seeing four dentists might have confused your decision. If you want to return to each of the first two dentists you saw, hearing them confirm treatment recommendations might give you more confidence.

We wish you continued success in your recovery from bulimia and a smile makeover that will further improve your quality of life.

 

Dr. Rekha Reddy, a Dallas, Texas dentist, sponsors this post.