Treating Severe Tooth Wear Cases
When patients seek treatment for severely worn teeth, treatment takes a multifaceted approach. Dentists and labs must work closely together in order to assess the treatment method that will work best to help the patient achieve the desired results. In some cases, periodontists and orthodontists must also be brought in to assist with treatment.
Determining Cause of Wear
The cause of the tooth wear may have an impact on the effectiveness of chosen treatment methods, so this is the first factor that should be considered. Grinding or clenching habits, chemical interference, and occlusion forces may all work to cause severe tooth wear. If wear is caused by misalignments on the jaw and teeth, correcting misalignments may help to free up space in the mouth for tooth restoration. Treating habits such as clenching and grinding and recommending the avoidance of certain chemicals may also help patients to prevent wear from recurring after treatment.
Examining Photographs and Casts
In order to determine the best way to treat severely worn teeth, dentists should take photographs and casts to carefully analyze a number of critical factors, including:
- If eruption has kept up with wear
- If the teeth need to be lengthened
- If both the upper and lower arch are worn
- If both the anteriors and posteriors are worn
- If there is enough occlusal space to restore anterior teeth
- If function is limited
- If exostosis is present
- If there is any drifting, tilting, rotation, or crowding
Determining Best Treatment Methods
After examining the photographs and casts in depth, dentists should work with a lab to create a digital or wax mock-up of the desired final occlusal scheme. Presenting the patient a mock-up can help the patient to understand the possible results. Patients can also examine the mock-up and communicate any misunderstandings or undesired aspects before treatment begins. Dentists can use the mock-up to give a clearer illustration of how each step of the restoration process will work.
Administering Severe Wear Treatment
First and foremost, any acute conditions or issues that are causing the severe wear should be addressed and treated. Given the details of the case, future tooth wear should be prevented as well as possible. Prevention methods may include prescribing mouth guards to prevent teeth grinding, recommending counseling for dietary habits if bulimia or poor eating habits lie at the root of tooth wear, and installing braces or recommending surgery if misalignments are the cause of wear. After addressing these issues, dentists may begin a treatment plan that can include gum contouring and the placement of dental implants, crowns, or inlays.