My Bite Is Causing Tooth Loss?
Q: Over my life, I’ve had a lot of dental work. I’ve lost molar teeth for lots of reasons. About four years ago, after losing my upper left molars and a tooth behind my eye tooth, I got a bridge that hooked up my upper left eye tooth and the second tooth behind my eye tooth. A false tooth was attached between the eye tooth and this second bicuspid and then another tooth was suspended behind that tooth. So, two teeth are holding the four-tooth bridge. Last year I noticed the bridge move a bit so I thought that isn’t good but being the year it’s been, I left it. Now it feels like the whole thing might fall out any time. I saw a dentist and he said it would be tricky to do anything so he referred me to someone else who did a big examination and work-up. I don’t remember all that was said but he said I have an end-to-end bite. He also said I put a lot of pressure on my back teeth because my front teeth aren’t working as they should so all my grinding is tooth on tooth on my back teeth. He said my loose bridge is finished and I’m going to lose another tooth which means bone grafting. He also said that if I am to save the rest of my teeth long-term, I’d have to correct the way my front teeth work so my back teeth wouldn’t have to take all the pressure. I’ve never heard any dentist say this before. I’ve had this bite all my life and no one has said a thing. Is he right?
A: An end-to-end, or edge-to-edge, bite is a bite where, upon biting one’s teeth together, the edges of the bottom front teeth land exactly on the edges of the upper front teeth. Chewing wears down the front teeth and side-to-side grinding is transferred to the bicuspids and molars. In many who not only chew their food but grind their teeth in this position, it’s double jeopardy and puts extreme shear forces on their posterior teeth. This leads to cracking teeth, loosening of the posterior teeth, movement of posterior teeth, breaking of posterior teeth, etc. Loss of these posterior teeth is not unusual. Putting a bridge on posterior teeth without the guiding and force-distributing function of the front teeth leads to the same harsh forces on the bridge. In your case, a bridge that’s failing. Before any more posterior work, it will be necessary to see if the front teeth can be brought into proper function through the use of crowns. The front teeth (upper and lower) should be the first priority along with bone grafting. After the front teeth are put right and after grafting success, implants can be placed, then crowns after the implants are ready for them.
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Based on actual patient cases
Calvin Ross Crapo