ESTHETIC DENTISTRY – Full Mouth Reconstruction
by Clayton A. Chan, DDS, Las Vegas, NV
Aesthetic Orthopedic Rehabilitation . Craniomandibular-facial Pain Dentistry . International Dentistry
Today, the cosmetic dentistry and beauty industry has over the years increased the publics awareness of beautiful smiles. Who doesn’t want to have a great smile? Brighter and whiter looking teeth to enhance and change the yellowish, worn down look of chipped front teeth, crooked teeth, oversized teeth, dark undesirable spaces that can be distractors from achieving the look, appearance and sense of confidence that may be necessary for an improved self esteem or the extra dental boost to move up into the ranks of a higher paying job perhaps because of a better looking smile? Beware!
Altering one’s look may seemingly be appealing through dental marketing and cosmetic dental ads. Cosmetic dentistry could be simple for some, but it may not be that easy for others. Those individuals that may seemingly have a good bite and desire to improve the appearance of their teeth just a tad more to perfection may find themselves going down a nightmarish path of pain, frustration and despare. Be cautious, because if you are one of those patients who has had previous retractive orthodontics, feels bite changes after having your teeth cleaned and polished and you have the ability to feel the thinnest of a human air between your teeth (5 microns), you may be just one of those individuals that requires a high level of dental accuracy when you need any dentistry done on your teeth or bite.
If you have a bite that already is not stable, you have a history of previous tooth sensitivity issues, missing teeth (especially in the bicuspid and molar regions), you have a restricted narrow arch form with minimal overject and over lap of your front teeth….get ready. If your dentist doesn’t realize the detailed importance of how your teeth must function and how they must smoothly glide and move across one another free of any interferences when chewing or grinding your teeth after they have been lengthed to improve the short and worn down loo…..that is where your TMJ and temporomandibular joint dysfunction (TMD) troubles and pain can begin.
Words of Wisdom
- Make sure your cosmetic dentist understands what TMJ is all about and has the ability to treat it bio-physiologically if problems arise.
- Make sure your dentist has experience in treating TMD pain problems after he/she performs your cosmetic dentistry restorative treatment with veneers, porcelain restorations, implants and fillings. (Dentist who are attempting to perform comprehensive levels of cosmetic arch dentistry must be trained and understand a higher level of occlusion and neuromuscular dentistry than those who are trained in habitual bite dentistry.
- If you find yourself to be a detailed person and can feel a human hair between your two front teeth, make sure your dentist is as equally detailed and aware of your level of detail. Ask your dentist what level of thin marking paper he/she uses when checking the patient’s bite. Some dentist use 100 micron, 80 micron, 60 micron articulating paper. That may not be adequate for you if you are a 5-10 micron detailed aware patient. Reason: If your dentist checks your bite with thicker marking paper, everything will look like it is marking correctly when bringing the teeth together when in reality you need to have a finer marking paper of possibly 10-13 microns to identify the detailed prematurities left when placing a new filling or new crown.
- Do not let your dentist convince you after dental treatment that you are suppose to get use to your new bite when they have given you new filling(s) and crown(s). If your bite feels different and off, it most likely is off and not correct. Don’t let it go! If you procrastinate and think that the high marbly feeling in your bite is going to go away and you find that it doesn’t it will continue to cause the tooth or teeth to become pressure sensitive, sweet sensitive, mobile, ache and in some cases a combination of all of the above. If the tooth becomes achy sometimes the dentist will prescribe a root canal. That could have been avoided if the bite was properly managed and check in a detailed manner.
- If you came to the dental visit with no bite problems that you were aware of then you should leave the dental office with no bite problems….unless you had an unstable and uneven bite from the start. If so, your dentist should have recognized it and you should inform your dentist that you have a bite problem. The problem is most individuals and dentist don’t even know the various occlusal signs and symptoms to look out for to avoid the dental mishaps that can contribute to TMJ problems after routine dentistry is performed. You don’t have to be hurting to have occlusal signs and symptoms.
- Ask your dentist to check your bite in a sitting up supine positon before you start any dental treatment that requires any alteration to your biting surfaces of your teeth, fillings and crowns.
- Ask your dentist to complete a proper TMJ muscle palpation examination. Tender muscles of the head, face, lower jaw, neck and shoulders are often related to an imbalanced bite.
- Make sure your dentist understand how strained muscles are a result of occlusal prematurities in the bite.
- A few follow up visits will be necessary to refine any occlusal biting imbalances after restorative dentistry. If you have to return numerous times over and over again, something is wrong! Either your muscles, jaw joints and/or your bite is a very unstable making it challenging for you andyour dentist resolve your problem. Make sure your dentist is a detailed operator, especially if you discover that you are a demanding, high level precision type of person.
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