How’s this for a situation? This tooth had a very nice crown that had been in place for over 5 years. Suddenly it becomes very bite and thermal sensitive (hot and cold bothered it alot!). A root canal was completed, and that relieved the symptoms. Then, a few weeks later, this happened:
Let’s look at some of the reasons for cracks. They can include:
1. Repetitive chewing on your teeth, day after day, which may develop cracks. Each time you chew on your teeth they flex slightly from the chewing force. This flexing over time can cause teeth to develop fine cracks (stress fractures).
2. A history of clenching or grinding (bruxing) teeth can result in cracks.
3. Chewing on hard substances or foods such as ice, popcorn kernels or candy.
4. Trauma to the mouth such as a blow below the chin or lower jaw.
5. As we’ve seen, large fillings, whether tooth colored or especially silver, can weaken the teeth resulting in tooth fracture.
If you grind your teeth or you chew on hard/chewy substances, as stated above, you have an increased chance of developing fractured teeth.
Katherine asked to have this other filling replaced at the same time. She didn’t like the way it looked and thought it would be easy enough to replace it while she had the cavity taken care of in the tooth in front of it.
Look at Cleo’s smile before and after she had her teeth fixed. She asked for teeth that were straighter and whiter. We completed this with a bridge and some crowns. What a difference!
You’ll recall the tooth Cleo had to have extracted. The temporary was used to ’shape’ the tissue in this area and aid the healing process. Here’s the original condition of her teeth, and the final results:
It’s difficult to even see where the tooth was extracted! The ‘fake’ tooth looks as if it emerges from under the tissue just like all the others. A beautiful result.
How then do we manage the area where Cleo’s tooth is coming out? If we leave the site alone the final result will probably look less than ideal, and could potentially be disasterous. To solve this we made a temporary bridge that was shaped anatomically correct, and placed slightly under the gum line. It therefore appeared to emerge from the gum tissue where the tooth used to be. The temporary restoration was used to actually shape this gum tissue as it healed. After a number of weeks we were able to continue with the bridge process.
Cleo had the non-restorable tooth taken out. When a tooth is taken out the body immediately starts to take away the bone. Basically the body is saying, “No tooth….no bone.” This is a problem we’ll look into further when we discuss dental implants. But in the esthetic zone of the front teeth this can lead to devastating results. As the bone leaves, the gum tissue goes with it. Soon the area where the tooth came out looks ‘caved in’ and the gum tissue has migrated to a higher level than the teeth near it. It looks horrible.
Here’s an area on a different patient that has had only a moderate loss of tissue after a tooth was removed. This is because a dental implant was placed in the area.
These were the complications we were working with after Cleo agreed to have her teeth crowned. The tooth shown below was not going to be kept. So she needed a bridge to replace and replicate this tooth. It should be straighter, as should all the others. And she wanted whiter teeth, too. She was tired of having dark, discolored teeth.
So Cleo wanted a change. And more importantly, there were functional and structural issues, too. The cavities she had developed were large and, after taking into account the size of the existing fillings, there were no other options than to crown these teeth. Also, she didn’t like to smile because her teeth were not straight and, as she put it, not pretty.
If you’ve read any of my other posts you’ll know I’m not a fan of so called ‘instant’ orthodontics. So often a little ‘real’ orthodontics will dramatically improve not only the final esthetics of the case but the longevity, too. However, there are times that the final solution is to ‘fix’ the teeth, and braces are not required.
Let’s look at Cleo. She had many older fillings in her front teeth and recently began to develop cavities around a number of them. Because of the location of one of these cavities she would also have to lose a tooth. She wanted to improve the overall appearance of her front teeth, too. She had always been unhappy with the way they looked.
