Q: Dr. Crapo: I’m a hard working forty year old who owns his own construction business. I’ve been in construction since I was a teenager. When I’m not working and planning, I’m into strenuous sports, biking, hiking and working out etc. Three years ago I saw a dentist and after looking at me he said, “Do you know what you’re doing to your front teeth?” “No” I said. “Have you been sick and throwing up a lot?” he asked. “No” I said. “Well something is eating the inside of your teeth, like acid” he said. Over time he discovered I had a very deep overbite and in all my intense lifestyle activities, I was grinding right through the back enamel of my front teeth, leaving half the thickness of my front teeth. He decided to send me to an orthodontist to see if my deep overbite could be corrected. I went through braces for two years and it’s much better but my overbite is still significant. Yesterday I saw a different dentist who picked up on my history quite quickly and said I was still grinding through my teeth – in fact he thought I might be bulimic – no chance. He said bulimics throw-up and the thick mucus from the stomach is very acidic. He said the person then scrapes their tongue loaded with acidic stomach mucus against the back of their front teeth and that’s what eats their enamel and tooth away – not my problem. But my problem is I’m still wearing my teeth away. Can my overbite be made less and how can I get back my front teeth thickness? He was quite concerned and said if the teeth were protected with crowns I might have to get root canals first. That, I don’t want. Where do I go from here?
A: You have several choices to address the wear. If you are not prepared to treat the situation definitively, managing the situation entails a bite splint system that prevents wear. At first you will need to wear the splint (bite-guard) frequently during the day, as well as at night. Wearing the splint during the day helps you realize when you grind or clench. It helps you educate the conscious mind to not grind. If you clench during strenuous activity you will need to wear it during that activity. This type of management will help you when you treat the teeth definitively.
Your deep overbite can be made less through careful analysis and then “opening the bite”. It’s like placing a modest shim or spacer on your back teeth so that the front teeth come apart. The space gained not only decreases the front overbite but also restores your teeth to their original thickness. New materials are harder and wear better than your own teeth and are very natural looking.