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All He Wants for Christmas Is His Two Front Teeth


Dr. Crapo

Question

Twenty years ago my husband and I were married. He was a very handsome man then and is to this day. Over the years of our marriage he has been self-employed. He has always done well because he is a very hard worker and good with people. If I were to make a critique at all, it is that his work is never far from his mind and because of that I think he’s stressed. When he’s unaware that I’m watching him, I see him grind on his front teeth – his facial muscles contract and his lower jaw moves almost rhythmically back and forth. It happens whether he’s watching T.V., reading a book or at the computer. In the past five years, it seemed like he wasn’t smiling as much and when he did, I noticed his upper front teeth seemed shorter. Wanting to help, I asked him to show me his teeth. Reluctantly he did and I was shocked. His front four teeth were worn almost to his gums and were very ragged - like the teeth of a saw. When he bites, his lower front teeth fit right up into the most worn area of his upper front teeth. It was then I realized why he wasn’t smiling, or when he did, he put his hand to cover his mouth. What can he do? Can his teeth be made longer? Will he lose his teeth? He knows he’s got to do something. His back teeth seem to be okay but I’m not a dentist.

Answer: A small percentage of tooth grinders grind exclusively on their front teeth. I have seen pristine posterior (rear) teeth with no wear whatsoever and the front teeth ground to the gum line. When these people bite down, their back teeth fit tight together at the same time their front teeth (which are ground flat) come together. In every case that I’ve seen like this, space must be regained to give the front teeth their anatomically correct shape and position (make the teeth longer). This is possible using measuring devices for shape and dynamic functional instruments to duplicate the original bite. After this has been completed, teeth are artificially created on his teeth molds starting with the front teeth. This step re-establishes the lost space. Once completed the posterior top and bottom teeth will not touch (they are held apart by the newly created front teeth). With this knowledge, the back teeth can then be lengthened so that all the teeth hit at the same time. Once the new bite is created, a bite guard system will help prevent this destructive process from reoccurring.


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