Q: Dear Dr. Crapo: I’m in my mid-forties. I’ve had very few cavities in my life which was a bonus as a young adult, not having to come up with a lot of money I didn’t have.
School is behind me, I’ve got a good job as does my wife. We’ve got great dental plans, so now I thought it’s a good time to get the dental problems I do have taken care of. I have a slight underbite and some crowding. It’s not terrible but the problem is the way my bite lines up, or should I say doesn’t line up. I’ve seen everybody. Years ago my dentist said I’d need braces, maybe even my jaw broken to get the best results. He thought that would help my headaches. About five years ago I saw a dentist and he helped me with my headaches because he was able to see that my bad bite was the cause. I’ve worn a night guard for the past five years and then one day it went missing. Long story short, I found pieces of it in our dog’s house. Yes my dog ate it! Now the headaches are back and I know I have to deal with the bite. I don’t want braces or surgery, so I’m wondering is it going to be another night guard or can I get this problem fixed for good. The real challenge is that I work with people and I can’t wear the guard during the day. By five o’clock my head hurts and I get short tempered because I’m extra tired too. Is there something that can be done for permanent relief?
A: Without very thorough records you present a real challenge. If your class III bite (your underbite) is minimal it might be possible to create a solution with crowns as a whole mouth reconstruction. Careful measuring of your jaws will be necessary, both x-ray images of your jaws and measurements on your molds set in a dynamic bite analyzer.
Once this is done a mock-up of the projected reconstruction must be completed to see if the work on the analyzer (called an articulator) is transferrable to your mouth with function and appearance that looks right.
Now you’re half there. If your teeth are basically without fillings or cavities, your dental coverage may not necessarily pay or even contribute to the reconstruction. An office that has gone to the effort to get you to this point will submit the treatment plan to your dental insurance company. Even though Canada has one of the best dental insurance policies in the world, one doesn’t usually see this kind of participation. However with the concerns you present it’s worth your best efforts. When your teeth are in the right place, functioning as they should, it’s likely your headaches will disappear.