The Trouble with a Snaggletooth…
Question:
Dear Dr. Crapo: Ten years ago I saw a family member who is a dentist but lives clear across the country. She said I needed to come out there and she would fix my teeth. She showed me that I was wearing out my back teeth. It was quite concerning because the enamel on my back teeth is almost gone. She said I had a hooked tooth in the front that caught when I chewed or ground my teeth. It is one tooth of the lower front teeth that goes in front of my upper front teeth when all the rest of my lower front teeth go behind my uppers like they’re supposed to. Since that visit to her dental office ten years ago, I’ve worn away more of my back teeth, I’ve had fillings and three crowns because my teeth were breaking and getting sensitive. This family member has retired and sold her business, so that option is out. Besides there would be many trips, it sounded like, until I would have all my work done. Now something must be done and I don’t know what to do. I don’t see a lot of wear on my front teeth and they seem ok, it’s just the back teeth.
Answer:
You have what is referred to in dentistry as partial anterior cross-bite. It’s not terribly uncommon and some people function just fine all their life. The condition always causes imbalances in the biting and chewing function but our jaw muscles learn to work around the problem and it usually isn’t a conscious ailment. It doesn’t always promote grinding of one’s teeth but it can and it can cause a great deal of damage. Sometimes braces can fix the problem but in adults it is not always just putting the tooth back into its position that will fix the problem. From your description, you are able to put destructive force on your back teeth without affecting visible damage to your front teeth. The first step will be to have an accurate work-up of your dentition (tooth to tooth wear analysis), with imprints on a bite simulating apparatus. The key to future dental function and prevention of posterior tooth wear lies with your front teeth. Once this is worked out and performed in your mouth, there will not be the same impetus to grind your teeth. Your chewing will be much easier because the cross-bite will not lock up your bite when you’re eating. This approach is important because you’re dealing with the cause and not the effect. Once the front teeth are doing their job, it will be apparent how the back teeth need to be treated.
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