Treating Severely Worn Uneven Teeth
What can be done when the teeth are severely worn and uneven?
Sometimes the damage to the teeth is so extensive that the only way to make a significant change is to complete what we call “Full Mouth Restorations.” This blog describes how completing full mouth restorations provided a solution to the problem of severely worn and uneven teeth.
So what are Full Mouth Restorations?
When teeth are severely worn, the goal is often to get the length back. When the teeth are in full contact, there is considerable overlap of the teeth. Imagine making just a couple teeth longer and straighter. If just a couple teeth are lengthened this could significantly change your bite. Depending on the situation, those teeth could become the only teeth that are in contact!
Opening the Bite: Opening the bite often means restoring the teeth back to where they used to hit before the severe wear occurred. Opening the bite can also mean restoring the teeth so that they are in a slightly different, more open position and tiny changes make a huge difference! The body easily adapts to this change in the bite if it is managed by a skilled dentist. If length is added to the teeth without opening the bite or creating space for the added size and length, the teeth may be much more likely to break or fracture. If length needs to be added to teeth, often all the teeth – or at least all the teeth in one arch – will need to be restored. Full mouth restorations really just means some type of restoration must be completed of all the teeth or most of the teeth to keep all the teeth in proper occlusion or in a proper bite and to achieve the desired result.
For the patient below, severe day and nighttime grinding
The lower anterior teeth are worn extensively from clenching and grinding.
Severe anterior wear of lower anterior teeth and left posterior teeth and compensatory over-eruption of the opposing teeth.
To help our patient see what could be accomplished, we took impressions of the teeth and recorded the existing bite and arc of closure to duplicate in model form what is going on in the mouth. Models like this will also be used to guide treatment for a more ideal result.
Our office evaluated the space available for our restorations and the options to correct the smile. It is always good in a complex case like this to have your dentist first evaluate the options before any irreversible changes are made to your teeth!
Severe wear combined with super eruption.
Models of teeth and tissue have been modified to evaluate possible result.
By completing gingival plastic surgery and osseous recontouring we were to dramatically improve the arch relationships and esthetics for our patient. The options were presented to the patient and she was excited to proceed with treatment!
Our office wanted to make sure the relationships between the teeth, the gums and the bite were stable and esthetic. Also, wearing treatment restorations for a period of time allowed the patient to ‘test drive’ her new smile and bite. The severe damage that had been done in the past was due to clenching and grinding. It is very difficult to predict if these destructive habits will continue. So it is often best to account for the continuation of the habit and how to manage the habit in the future.
Our patients must become partners in the success of their treatment. By understanding how their habits can effect the outcome and longevity of their dentistry, success is much more predictable!
These crowns were placed in another dental office about 10 years ago. And, when they were placed, the alignment was much better!
This image taken right after periodontal plastic surgery completed and temporary restorations placed. Notice improvement in tooth alignment and less gum display in the smile!
We will keep you updated of this case as treatment progresses! 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! Please see the follow up blog to this called Full Mouth Restorations & Periodontal Surgery.