Can teeth get longer or move over time as tooth wear occurs?
This is a very good question because so many people grind their teeth or have extensive wear. If the teeth wear down and then nothing else happened, there would be gaps between the teeth and the teeth would no longer fit together! Can the teeth move as you grind them down – the short answer to this is, Yes! Teeth will continue to erupt as they wear so that they still fit together. Teeth usually do not wear evenly. Sometimes patients grind their front teeth much more than their back teeth, or one side more than another side which uis what happened for the patient here. The patient’s biggest concerns are the teeth not lining up and the uneven display of gums.
Can the bone around the teeth move when the teeth move?
When you grind your teeth, the wear usually takes place slowly over time. Teeth are pretty hard and it takes a while to create this much damage! As the teeth wear down and continue to erupt so that they remain in contact, the bone below the gums will usually follow the teeth. That is what happened to this patient! the teeth were lined up nicely when the first crowns were placed, then a pretty severe grinding habit caused extensive destruction of the lower front teeth and ‘super eruption’ of the upper teeth.
The patient shown here was ready to improve her smile and asked whether she would get ‘recession’ again like before once she has new restorations placed. We showed her the photos we had taken of her smile and she notes edges of teeth used to be better aligned when the restorations were placed! So naturally, she was concerned that this might happen again after new restorations were completed. What she meant by ‘recession’ was the tooth movement that had created the uneven plane of occlusion or the appearance of a slant to her smile and the front teeth now pushing on her lip.
These crowns were placed in another dental office about 10 years ago. And, when they were placed, the alignment was much better! It is very important to note here that the upper right lateral incisor ( the smaller front tooth next to the central incisor) is an implant crown. Implant crowns can never move! The implant is fused to the jaw bone. The teeth adjacent to the implant can and have moved considerably. As she was clenching and grinding the teeth the lower teeth -especially the front teeth and the left posterior teeth took most of the force of her bite and wore down. The lower anterior are less than half of their original length and the upper teeth and jawbone continued to erupt to keep the teeth in contact. Fixing a situation like this is the story for another blog. See, ‘What can be done when the teeth are severely worn and uneven?”
Note the extensive wear of lower anterior teeth and pt aware of severe grinding habits last 10 years. Or patient did not have a photo to show the initial position of the restorations but she knows that they used to look much better – more even and less gums showing. Showed her how teeth fit tightly on the models, so as the lower anterior teeth wore down the upper teeth erupted to close the distance. This happened slowly over time so the bone also came down as the teeth erupted. To get the teeth to appear to be back in the previous position, the excess bone must be removed to recreate the normal space between the new, more superior restorations and the bone. Also reviewed that this is variable between patients and sometimes it is the lower teeth that super erupt as the wear is taking place. Since it was mostly the upper teeth that super erupted, the uneven smile line that resulted from this is even more evident.
If only this destructive habit had been eliminated before this much damage had occurred!
Dr. Julie Gillis and her team care about you, your teeth and mouth, and your concerns! Treatment of a case like this would depend on the patient’s goals and the talent of the restorative dentist and dental laboratory. Specialists may be involved if the answer is a full mouth rehabilitation.
The goals should include treatment to prevent this situation from getting even worse. Our dental office is located in Grand Junction, Colorado and we would love to see you. we offer treatment from simple to complex and take care of you as we would like to be cared for. You can call our office at (970) 242-3635. Or you can find out more about our office on our website at www.juliegillisdds.com or on our Facebook page!
Yours for better dental health,
Julie Gillis D.D.S.
Restoring Teeth, Restoring Smiles