DENTAL CARE

Q: Why Are My Teeth So Short?(Part II) A: Last week we started to discuss this question. We talked about one of the problems that I frequently see as we have gotten better at saving teeth. What do I mean by this? We are now able to keep teeth for years and decades longer than ever. Our parents or grandparents lost teeth and many teeth starting at younger ages than we do. They went to full dentures quicker than my patients do today. As a result of keeping teeth longer, we are wearing them in a more extensive fashion. This creates the short front teeth appearance that brings so many patients in the door.

Last week I mentioned that we get excessive wear from upper and lower teeth biting right on each other. This wear may be intensified by acid in our mouths. Where does this acid come from? It could be our own acid as many people that I see have acid reflux. This is a complicated process where stomach contents, which is usually acidic in nature, backs up through our food pipe (the esophagus) and may enter our mouths. Acidic foods such as diet sodas or sports drinks take their toll over the years too. These foods strip away some of the enamel and then our tooth contact removes the rest. This tooth contact can come in the form of grinding or clenching, However, it is not limited to this. The wear can also be accelerated through normal chewing.

So now that we show up at the dentist with these short teeth that are chewing against each other, what do we do. First of all, we need to determine why the front teeth are chewing directly on each other. If you remember we call this “edge to edge” biting or occlusion. This may be due to the lack of back teeth. Without our back teeth, the jaw naturally moves forward a little bit when we close our mouths. The now creates a situation where the lower front teeth contact the upper front teeth directly. Directly means as opposed to being either behind or in front of the upper front teeth. Front teeth should function like scissors and rip food apart with a slicing motion, not grind against each other. In these cases, the simple fix is to replace back teeth and take the wear and stress off the front teeth. The replacement of back teeth could involve implants, permanent bridges or even something as simple as a partial denture. All of these fixes will result in saving the front teeth.

If loss of back teeth is not the obvious cause of the “edge to edge” bite, then we must correct the problem right at it’s source. Moving the front teeth out of this harmful position used to be very complicated. It took a long time and required braces to move the teeth. This was not something that most of my adult patients wanted to do. Today we have removeable aligners to move the teeth. These devices are easy to wear and impact a patients life minimally in terms of comfort, appearance and socially while the treatment is being performed. As long as the teeth keep grinding against each other the damage increases and fixing options become less.

Once the teeth are moved slightly in a short period of time to their new position, then conservative bonding techniques could be used to take years of their appearance and make them longer again. Normal chewing will not “break” or chip the conservative bonding option. It’s rather interesting that what was all the rage in the 1980’s in terms of cosmetics can be used again to save teeth and make them look cosmetically better in the 21st century.

In the event that moving teeth is not an option for whatever reason, then veneers or crowns can create this slight movement with a technique that I call rapid orthodontics. We can change a tooth position in 1 or 2 appointments and create a stunning smile. My patients can see the anticipated results before we even begin our treatment. This is an extensive subject and there is a lot to talk about. Unfortunately, space limitations require me to end today. If you are concerned about how your teeth have changed over the years and how they look today, please call me at

440.951.7856. I always enjoy speaking with each and every one of you.Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine. The Healthy Smile 34586 Lakeshore Boulevard (¼ mile west of Route 91 on Lakeshore Blvd) Eastlake, Ohio 44095 440-951-7856 Severance Medical Arts, Suite 603 5 Severance Center Cleveland Heights, Ohio 44118 216-371-2333 www.jeffreygrossdds.com