Repairing tooth wear caused by bruxism.
This digital smile makeover illustrates the type of wear that can be caused by bruxing. (Bruxism is a term that refers to the habit of clenching and/or grinding your teeth.)
Our “after” picture shows how dental crowns can be used to both repair the damaged teeth and restore the appearance of the person’s smile.
Case history and concerns:
Any dentist looking at this “before” picture would immediately come to the conclusion that this person has damage caused by a serious tooth-grinding habit.
You can literally see how the flat, worn biting edges of the lower teeth match the flat, worn surfaces on the upper teeth. (When this person does their grinding, they hold their jaw just slightly to their left.)
It’s a simple equation; prolonged tooth-to-tooth contact equals tooth wear. With this case, it looks like five of the six upper teeth have simply been ground off and, in effect, they have been.
No doubt you’ve also noticed that the “before” picture shows that one of the front teeth is noticeably darker than the others. This darkness is most likely an indication that the tooth has had (or needs) root canal treatment. In our case here, this cosmetic problem will be remedied by the same treatment required to repair this tooth’s wear.
“Before” photo submitted by website visitor.
1) The tooth grinding must be controlled. –
This person needs to discuss their bruxing with their dentist so a means of controlling, or at least minimizing, its effects can be found. After counseling, some people learn to control their daytime habit. People who grind their teeth in their sleep will need to wear a night guard appliance.
It’s only once that their bruxism has been brought under controlled that a dentist can predictably restore this person’s teeth. If it’s not controlled, the nature of the damage that takes place may change but some type of damage will continue to occur.
2) Restoring the teeth with crowns. –
Because of the great strength that they can offer, dental crowns (like porcelain-fused-to-metal ones) would probably make the most durable, lasting choice for treating this case.
One of the treatment goals here, just like with the case above, would be to use the crowns to restore the relative lengths of the teeth back to a more normal configuration. That’s what we’ve illustrated in our “after” picture. In reality, however, the extent to which the teeth can be lengthened will be dictated (and possibly limited) by this person’s bite.
3) Other treatment considerations. –
Dental bonding would probably make a suitable choice for closing in the spaces between the lower teeth. It’s not as strong and lasting as other types of dental restorations (like crowns). But most of the wear and tear associated with this mouth is on the biting and chewing surfaces of the teeth, not in between.
We’re assuming that the dark tooth has had the root canal therapy it requires. Placing a dental crown (possibly in conjunction with a dental post and core) will complete this tooth’s treatment.