Worn Down But Not Worn Out!
Q: Dr. Crapo: Twenty years ago I had a nice bridge and many crowns done to fix my teeth and my smile. Everything has been just fine until a couple of weeks ago; some of the upper front teeth that were crowned, chipped. It’s unsightly so I saw my dentist last week and he said I also had decay around the edges of the crowns so they’d have to be redone. However he said I’d worn down all my lower front teeth over the years and they should be crowned too.
The only problem he said was that because they were so worn down, my bite would have to be made “taller”, to replace the tooth substance that was worn off. He said that made the procedure more difficult because the lower front teeth had to be made their original length and that was like putting a shim between the front teeth which prevents the back teeth from touching, making it necessary to crown them too. He said I’d have to see a specialist. He also said that I’d wear my lower front teeth even more if I didn’t get them crowned because the porcelain of the uppers would continue to wear the lowers. I understand that, but the cost is going to be too much. I can’t live with my broken upper front teeth, so I don’t know what to do.
A: I see this problem often because patients don’t understand that porcelain is very abrasive, especially if grinding is a problem. Crowning your lower teeth at the same time your upper teeth were crowned may have prevented this dilemma altogether.
Making your bite “taller” as your describe, or “opening the bite” as it is known in the profession, requires careful analysis. Those trained to do this also know how much “taller” is acceptable and it’s different for every person.
Before any of this is done in the mouth, the dentist takes molds and uses an analytic instrument that duplicates your jaw movements. He then makes a mock-up of the new teeth on this instrument. Once this is done he has a blueprint of what must be accomplished.
From these blueprints, he can stage or even phase your treatment to meet your functional, esthetic and financial needs and desires. By that I mean there are ways to make part of the treatment permanent and part of the treatment transitional. This allows the correct bite opening to be made. It also controls the wear for a time until the transitional treatment is made permanent. Once you’ve been able to pay for the permanent work, another part of the transitional work can be made permanent so that you can pay as you go. Like a mortgage, it costs more overall but it’s best for your health and ensures you’ll never face your present dilemma again.
If we can help, we’d like to. Call 778-410-2080 for a consultation or visit us today.
Based on actual patient cases
© Calvin Ross Crapo
Victoria Implant Centre 778-410-2080