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Dr. Crapo

Q: I have a tooth problem. My wife says this to me all too often. My retort is, “I have all my teeth,” to which she says, “Really? I can’t see them they’re so worn down.” In reality, she’s mostly right. I had my upper front teeth capped a number of years ago and since then it seems like my lowers are getting smaller and shorter. So, they’ve gotten shorter with some spaces between. My wife says she hears me grind my teeth and so I guess I do. I don’t get headaches or have sore jaws or muscles. I do chew my food very thoroughly because I believe that helps in digestion. I have good health and I eat lots of vegetables and foods that are grain-based. That’s how I was raised, and I believe it contributes to all phases of health. So now the question; what to do? Well, I had a very thorough going over by a dentist and when he told me what I needed done, I really didn’t want to go that route. Maybe it was the expense, but he said I needed a complete overhaul. Maybe I’ll have to do it but I’m having a hard time getting used to the idea. On top of that, I’ve got no pain so it’s hard to get my head around crowning when there isn’t a reason other than worn teeth. And why are they wearing so fast?

A: Good questions, good considerations, and lots to digest – pun intended. Those who grind their teeth unconsciously wear their teeth. When a dentist looks into a “grinder’s” mouth, he instantly sees it, or should. What he doesn’t know is when this is occurring. But basically, grinding is divided into nighttime grinding – done unconsciously, daytime grinding – done unconsciously, and functional grinding – also done unconsciously. Your teeth need restoring to length so function is restored. That’s when front teeth can return to guiding all the forces that are destroying your tooth structure, front and back. It is especially important in your case because functional grinding can be more damaging than episodic day and night grinding. How do I know you’re grinding all your teeth so badly when you eat? Because your front teeth are responsible for separating your back teeth in the side to side chewing stroke (think bovine chewing). When your front teeth are worn to stumps, the back teeth and front teeth all grind tooth to tooth (think bone-on-bone grinding as in an arthritic joint) when you eat. This is functional grinding and is very, very damaging. The reason your lower front teeth are wearing faster now is because your porcelain crowns on the upper front teeth are seven times more abrasive than enamel to enamel. It’s like sandpaper grinding while you eat. Run, don’t walk, to the solution that reestablishes your correct bite.



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


Dr. Crapo

Q: I have a beautiful daughter, she’s twenty-one. When her permanent teeth were coming in as a child, we found that she was not going to get the upper lateral incisors (the ones just beside her front teeth). Our dentist said when the rest of her teeth came in, she should have braces. One idea was to move her eye teeth into these spaces, but we didn’t want her to have fangs beside her two front teeth. We chose the route where the teeth were straightened and gaps for those laterals were created for future teeth to be put in. This was done as a teenager and then when the orthodontist said the spaces were adequate for the teeth to be put in, we took a temporary measure and had filler teeth bonded in place to the teeth on each side. She’s worn these for six years and they’ve been okay. Now it’s time to put permanent teeth in place and we have been told the space is right for implants. We got a good opinion after having x-rays and models taken of her teeth. We found, however, that the bone thickness is really not adequate and must be augmented before or at the time of implant surgery. We also found her bite doesn’t really mesh properly. When her joints are in their correct relationship, her teeth don’t fully mesh. We also discovered that her front teeth aren’t as long as they should be and aren’t working as front teeth are supposed to work, protecting and guiding her bite. We didn’t know any of this but that explains why she was always breaking her bonded bridges. We didn’t know that, because of her bite, her teeth came forward and broke the bridges repeatedly. It was frustrating to say the least. We have several options; all include correcting the bite and getting front teeth properly aligned. Do we go with regular bridges that are permanent or do we go with implants?



A: Bridges or implants – that is a popular query. If the bite is in good balance, it may come to these factors. Are the teeth on either side of the space virgin – meaning they’ve had no decay or fillings? If they’re virgin teeth on either side, I recommend implants. Having said that, her teeth have already been reshaped by the bonding of the special temporary bridge. In that case, filling those spaces with conventional bridgework will protect her teeth and make a pleasing appearance as well as help with the bite. When individuals don’t want bridges, implants are the answer but the altered teeth in all likelihood will need crowns for protection and functional reasons. In conclusion, care must be taken in the total treatment to ensure harmony between her bite and the related chewing muscles and joints. Unhappy joints and muscles because of bite imbalance will lead to future pain and ultimate breakdown of the bridgework or implant restorations.



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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