Q: I’m a tradesman and I’ve been fortunate to have continued employment for the past twenty years. I enjoy my work. It’s often intense and physically demanding. I have found right from the time of my apprenticeship that I thrive in a demanding schedule. However, I have a stress breaker that I’ve known about for quite a few years, I grind my teeth as I work! I mean I really grind my teeth. Because I work every day, I haven’t seen visited a dental clinic as faithfully as I should so when I went several years ago. I thought about it then got busy and didn’t go back. As time has gone by my front teeth are ground down to less than a quarter of an inch – they’re just barely visible and when I look in the mirror it looks terrible so I don’t smile at all. Lately I don’t even talk much so people won’t see. I went to a dental clinic the other day and consulted the dentist. The interesting thing is, as he pointed out, I’m just grinding my front teeth. My back teeth, though I lost two to decay, show no grinding at all. He said my situation was complex because my short teeth need crowns – at least twelve front teeth but what’s going to happen to the back teeth. I didn’t quite understand that. If the front teeth are made taller won’t that affect the back teeth. I fit precision work everyday so I wonder how everything will come out. Can you shed any light on that?
A: From your description, you belong to a small percentage of the population that grind excessively only on front teeth. I have seen this type of grinding take the teeth right to the gum line so the gum starts to grow over the teeth.
Your situation is complex so it starts with good dental records and impressions. The dentist will have the front teeth mocked up to restore your teeth to their original height, shape and inclines. When he does that, you are right, the back teeth will no longer touch.
In the beginning, he will apply a shim or platform stop on your back teeth so when your front teeth meet together the back teeth will touch at the same time. He will monitor your response to the treatment to ensure comfort and stability in your joints, muscles and teeth. Once that has been verified he will then convert your front crowns to permanent porcelain-like material. The shims in your back teeth may stay in as long as they do their job. Finally, he will fit you with an orthotic or bite guard that will protect you against your front tooth grinding habit.