DENTAL CARE

Q: I Want My Front Teeth to Look Good for My Reunion A: Interestingly enough we were not talking about the upper front teeth. We were talking about the lower front teeth. As we age, our teeth get shorter. I have written about this in a previous column. The upper front teeth are no different than any other teeth and get short too. This is accompanied many times by the upper lip starting to droop a little and get longer. It doesn’t take much to totally cover the upper front teeth and make them invisible. In fact, I just made a denture for a lady this week whose had not seen her upper front teeth when speaking for years. I needed to customize the appearance of the denture to give her the look that she preferred and felt the most comfortable. The point of all this discussion about the upper front teeth and their diminished or negative visibility is the fact that the lower teeth take on the limelight when smiling. This was the concern with my patient this week. She was a reader of this column and knew that she has other problems aside from the appearance of her lower front teeth. Let me take a moment to describe those lower teeth. They were also worn, just like the upper teeth. They wear occurs on the tops of them where they chew and grind. Oftentimes in the case of lower front teeth brown lines appear on the tops of these teeth. When one looks at them casually, it appears as if someone took a brown pen or marker, and drew a line on the tops of those teeth. Some of these brown lines turn into cavities. This really draws attention to them. . .attention of the unwanted kind. The reason that this brown line appears is due to excessive chewing on these teeth. These teeth are her main chewing teeth as she did not have any back teeth with enough chewing efficiency to let the front teeth rest. The front teeth do their job and also do the job of the back teeth. This is the source of the brown lines or marks on the tops of these teeth. This very pleasant lady knew that she needed back teeth support and back teeth to take the load off of these front teeth. Our plan is to get her to that point. Our problem at the moment was figuring out how we get her looking better at her reunion. Oh, I forgot to mention that it is a few weeks away towards the end of July. I recommended 2 approaches for her. One approach was one that allowed me to change the shape and color of those teeth. The other approach allowed me to change the color, with minimal impact on the shape. One approach would solve the problems for years or even decades to come. The other one would break down in a much shorter time. Both of these approaches would solve her cosmetic problem. One technique needed 1 visit and the other technique involved 2 visits.

The one visit approach involved specialized bonding of the lower front teeth. Typically it involves a relatively brief appointment giving outstanding results in usually an hour or so. The before and after are rather remarkable and can often be done without numbing the patient. The downside is wear and tear on this bonding if nothing is done in the back of her mouth to give her back teeth chewing. Color stability can also be affected over time.

The two visit technique will involve cosmetic, all ceramic crowns. This visit is longer and the final result takes more than one visit. The good news is that with this procedure, the results at the end of the first visit also solves the cosmetic problem. The shape change and color change are not subject to alteration over time with this approach. We can get by with less back teeth support with this method as the lower teeth not only look good but are completely protected. Back teeth are still needed as whole tooth is still overloaded, but their appearance and color are stable. In either event the reunion will come and she will be much happier with her teeth. If this situation sounds like you, please call me and we can talk about it. Many modern dental techniques allow us to turn back the hands of time. Also July is a great time to work on looking good for fall and take advantage of my July Tribute to Veterans. Call Megan at 440.951.7856 and set up an appointment to learn more. I look forward to meeting 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

Jeffrey Gross, DDS, FAGD