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Q: Dr. Crapo: Twenty years ago I had a nice bridge and many crowns done to fix my teeth and my smile. Everything has been just fine until a couple of weeks ago; some of the upper front teeth that were crowned, chipped. It’s unsightly so I saw my dentist last week and he said I also had decay around the edges of the crowns so they’d have to be redone. However he said I’d worn down all my lower front teeth over the years and they should be crowned too.


The only problem he said was that because they were so worn down, my bite would have to be made “taller”, to replace the tooth substance that was worn off. He said that made the procedure more difficult because the lower front teeth had to be made their original length and that was like putting a shim between the front teeth which prevents the back teeth from touching, making it necessary to crown them too. He said I’d have to see a specialist. He also said that I’d wear my lower front teeth even more if I didn’t get them crowned because the porcelain of the uppers would continue to wear the lowers. I understand that, but the cost is going to be too much. I can’t live with my broken upper front teeth, so I don’t know what to do.



A:  I see this problem often because patients don’t understand that porcelain is very abrasive, especially if grinding is a problem. Crowning your lower teeth at the same time your upper teeth were crowned may have prevented this dilemma altogether.

 

Making your bite “taller” as your describe, or “opening the bite” as it is known in the profession, requires careful analysis. Those trained to do this also know how much “taller” is acceptable and it’s different for every person.

 

Before any of this is done in the mouth, the dentist takes molds and uses an analytic instrument that duplicates your jaw movements. He then makes a mock-up of the new teeth on this instrument. Once this is done he has a blueprint of what must be accomplished.

 

From these blueprints, he can stage or even phase your treatment to meet your functional, esthetic and financial needs and desires. By that I mean there are ways to make part of the treatment permanent and part of the treatment transitional. This allows the correct bite opening to be made. It also controls the wear for a time until the transitional treatment is made permanent. Once you’ve been able to pay for the permanent work, another part of the transitional work can be made permanent so that you can pay as you go. Like a mortgage, it costs more overall but it’s best for your health and ensures you’ll never face your present dilemma again.


If we can help, we’d like to. Call 778-410-2080 for a consultation or visit us today.

 

Based on actual patient cases

© Calvin Ross Crapo

Victoria Implant Centre 778-410-2080




Q: I have tried to keep my oral health under control all my life. I still have all my teeth but they are almost all filled with fillings that are of various vintages. I have been meaning to address the discolouration and what looks like decay in my front teeth, but life happens and others have needs that exceed my own. In the past year or more, I’ve experienced mild but consistent headaches that from day to day I manage with ibuprofen when the ache gets in my face.


The headaches can jump around. Sometimes on the side of my head, sometimes in the back of my skull, sometimes I wake up with my whole head and neck and shoulders feeling like I’d been in a “strongest man” contest and I’m not a man. I mean, my head and neck muscles are tired and tender. Well, I was wondering if it could have anything to do with my teeth, which to me look like they’re in a poor state of repair. So, with that question, I went to go see the dentist that my sister recommended, and I got a lot of what I’d call prep work. When I went back, there was a thorough review of my teeth and their condition.


It so happened that there were recommendations that I thought might address my problem of headaches, but I didn’t say anything to the dentist. He talked of decay and my bite and my gums, which are receded, so I just thought well, if I do all this, maybe if my teeth have anything to do with it, it would just get fixed as a matter of course. I did want to break up the treatment a bit, so we’ll see how it goes. Should I have said anything about the headaches?

 

A: To answer your last question first, the answer is definitely yes. Not all headaches are of dental origin of course, but headaches of dental origin certainly make up a significant percentage and can be treated.


Yes, tooth position, jaw position, joint and muscle position are all part of head pain associated with a tooth/joint incoordination. In other words, the teeth must work in harmony with the muscles that position the joint at rest and under function and parafunction (grinding and clenching). When the teeth, the muscles, the joints, and its ligaments are working harmoniously, the pain from strain disappears, the high lactic acid levels abate, and relief is quite permanent.

           

Go back and ask those questions and get the answers that will not only fix your teeth but relieve your headaches. As to the sequencing of treatment, be sure to ask about what can be broken up and what can’t.


If we can help, we’d like to. Call 778-410-2080 for a consultation or visit us today.

 

Based on actual patient cases

© Calvin Ross Crapo

Victoria Implant Centre 778-410-2080

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