Placing crowns to repair the wear caused by tooth clenching and grinding (bruxism).

When looking at this digital smile makeover's "before" picture, any dentist would quickly conclude that this person has a bruxing habit. (The term "bruxing" means that this person clenches and grinds their teeth. This may be something they do subconsciously during their waking hours, or else while they sleep, or both.)

That's because the smile shown below displays the characteristic wear pattern that's often seen. This makeover explains how dentist's can repair this wear and restore the smile back to a normal (and more youthful) appearance.

Case issues and concerns:

This person's four upper front teeth have worn down, to the point where they are now even with each other.

Usually a person's center two upper teeth (their central incisors) are slightly longer than the teeth next to them (the lateral incisors). The eyeteeth are usually about the same length as the centrals.

When a person's teeth have all worn to a point where their biting edges are even, like with this case, their smile looses a great deal of its youthfulness.

The overall color of the teeth is a little bit dark.

Teeth worn due to tooth grinding.
Dental crowns have been used to restore the size and shape of the teeth.

Photo submitted by website visitor.

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Treatment solutions:

1) Restore the relative lengths of the teeth. -

Our "after" picture shows how a dentist might rebuild this person's teeth by placing dental crowns. The goal would be to return the teeth to lengths that give his smile a more normal and youthful appearance.

This length may not be their original one (the one that existed before the wear took place), or even the one that we've illustrated. It will be the person's bite that will dictate the dimensions that are possible.

But, in order to reestablish a normal appearance, an arrangement does need to be created where the central incisors and eyeteeth are close to the same length and the lateral incisors are just a little bit shorter.

2) Dental crowns would probably make the best choice. -

In situations where a patient's tooth wear has been caused by bruxing, a dentist may be limited as to what type of restorations they should place.

That's because those chosen need to be able to withstand extreme forces. With this case, dental crowns would probably make the most durable, longest-lasting choice (as opposed to porcelain veneers or dental bonding).

3) This patient's bruxing must be controlled. -

It's important for a patient to understand that whether or not they have new restorations placed, if their tooth grinding continues, some type of tooth wear or damage will continue to occur. The habit needs to be controlled.

It's possible that by bringing their problem to their attention, this person might be able to control their bruxing during their waking hours. More likely, and especially for use when they sleep, they should probably have a "night guard" appliance made.

4) Whiten the teeth. -

Routine teeth whitening treatments (either at-home or in-office) could be used to lighten the color of this person's teeth, if they so desired.

If this option is chosen, the treatments would need to be performed prior to the placement of all of the above mentioned dental work. Then, once a pleasant coloration has established, the patient's new restorations would be made to match the new color of their teeth.

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