No one ever plans to have significant dental problems.  And while some dental problems are slow to form and chronic, others, like the case I am showing you today are sudden and unexpected.

It is one thing to break a back tooth.  It is something entirely different when a front tooth or in this case two front teeth fail.  If not panic, it gives you a sinking feeling and questions often come up, “Doc, is it hopeless?  What am I going to look like when I get this fixed?  Will it look natural?”  All perfectly good questions.

A Dental Nightmare!

Situations like this only affirm my choice many years ago to become a dentist.  Dentistry in 2012 is awesome.

There is so much we can do to restore a mouth to a naturally appearing and healthy state and many times give the appearance that there was never anything wrong to begin with.

Sure it takes a lot of additional training, a commitment to continual learning, and an investment in the right technology, but it’s a great feeling to see a situation like this that appears hopeless in the patient’s eyes and be able to tell them, “We can fix this.” 

A dental implant and porcelain crowns led to an awesome smile!

In this particular case, while we were able to rebuild the front tooth, the lateral tooth was not savable and a dental implant was placed.

To say this case was tricky is an under-statement.  But careful planning and execution resulted in a stellar outcome.  But most importantly, the patient was very, very happy.

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I am so blessed.  I’ve got the best patients, my staff is awesome and I am fortunate to work with some talented laboratories and specialists.

The case I am showing you today exemplifies the importance of the teamwork that is necessary for a stellar treatment result.

Congenitally missing front tooth

This teen patient initially presented with mal-aligned teeth and a missing lateral incisor tooth (the tooth next to the two front teeth).  The tooth was congenitally missing, which means it never formed in the jaw.  For this case, a dental implant was a great option to replace the missing tooth but long before the crown was placed, it was up to the specialists to “set the stage”.

A beautiful and natural looking implant crown

We consider this area of the mouth to be in the “esthetic zone” where appearance is very important.  Thus, we wanted to do everything we could to make sure the replacement tooth would appear natural in position, shape and color. 

As I have come to expect with the specialists I work with, the stage was set as perfectly as the clinical situation would allow.

Now it was up to us to bring it all home by creating a natural looking crown.  For this case we used our CEREC CAD/CAM one-visit crown technology to make the crown.  In the right hands, this technology can shine when esthetics is important because I can use various colorants and stain to customize the crown to match the adjacent teeth – and we do this right in our office.  While matching a single front tooth to the adjacent natural teeth is one of the more difficult things to do in dentistry, I have come to enjoy the process. 

As a team, we wound up hitting a home run with this case.  The crown looks like a natural tooth and not like – well, a crown!  The patient was very happy and can now smile with confidence.

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I’ve had interesting conversations with some of my patients lately regarding the topic of headaches and teeth grinding.  We all get headaches, some more frequently than others and some more intense than others.  

While there are numerous causes of headaches, few people make the connection that teeth grinding can cause headaches, specifically muscle tension headaches.  

Many times, it comes down to an unbalanced bite or one that is not in harmony with the proper position of the jaw joints (TMJ).  This misalignment causes the jaw muscles to become hyperactive and just like any other muscle that is overworked, they eventually become fatigued and sore.  The result is that we complain of a headache. 

It takes a trained dentist to determine if in fact the bite is in harmony with the jaw joints or it is not. 

It may have everything or nothing to do with how your teeth look.  I’ve seen what appeared to be a rather nice smile but the bite was off by a mile… without the patient even realizing it. 

Interestingly enough, headaches are just one of many signs and symptoms of a bad bite.  Other signs include worn teeth, loose teeth, chipped teeth or even teeth that have moved over time.  I have even seen patients with sensitive teeth who thought they needed a root canal, only to find that their bite was the culprit.  The bite was adjusted and the pain went away. 

For many patients the key is in balancing the bite with the proper position of the jaw joints.  There are several ways to do this depending on the severity of the bite discrepancy.  Only a comprehensive bite analysis will reveal the best route to take. 

Patients can typically find some relief with custom made bite guards.  However, it is important to note that these bite guards must be fitted properly or they can cause more harm than good.  And regardless, even a custom-made bite guard won’t correct the underlying problem.  In fact problems can still worsen. 

The first step in correcting the problem is a comprehensive examination and bite analysis by a dentist trained in this discipline to determine if indeed an unbalanced bite may be causing headaches.

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