Worn Teeth & Bite Rehabilitation

Most people notice it little by little. A front tooth that looks shorter than it used to. An edge that chips for no obvious reason. A filling that has now broken twice. Teeth gone flat across the top, or aching to cold in a way they never used to. Each of these looks like its own small problem, and each usually gets treated as one.

Wear is not the same as aging

The assumption that teeth simply wear down with the years is the most common one we hear, and it isn’t true. Enamel is extraordinarily durable. A healthy bite doing ordinary work should lose very little of it across a lifetime. When teeth are visibly shortening, fracturing repeatedly, or growing more sensitive year after year, that isn’t just aging. It’s acclerating

What is usually driving it

Teeth withstand the forces they were built for and cope badly with the ones they weren’t. When upper and lower teeth don’t meet in a stable, even position, the jaw muscles keep hunting for one, for hours on end, and with more force than chewing ever requires. Over years that shows up as flattened surfaces, chipped edges, cracked cusps, notches at the gumline, and restorations that keep failing in the same place.

Which is why a broken tooth is usually a symptom rather than an event. The cracked molar your dentist noticed last month may be the first visible result of a pattern that has been running quietly for twenty years, and repairing it on its own does nothing about what caused it.

What a proper evaluation looks like

Before recommending treatment for wear, we want to understand the mechanism, and that takes more than a look at the tooth that broke. An evaluation here includes clinical dental history, photographs, digital scans, a careful look at how your teeth actually come together, and an assessment of the muscles and joints doing the work.

What we’re looking for is a pattern: which surfaces are wearing and which aren’t, whether the wear matches the way your jaw actually moves, and whether the process is still active or stopped long ago. Wear facets that stabilized fifteen years ago and wear that is progressing today are different problems with different answers.

Treatment is patient specific

The most common outcome of that evaluation is the least dramatic one. For many patients the entire recommendation is to fix the singe tooth that broke. No more, no less.

Some patients need more than that. Rebuilding worn teeth to restore lost length and function may sometimes involve restore a full row of them. Where that is warranted, we meticulously design, prototype, and plan for what is needed. Dr. Zhu’s training at the Kois Center is specifically in this kind of comprehensive, force-driven treatment planning.

Why we don’t lead with “full mouth rehabilitation”

It’s the clinical term, and you’ll find it across a lot of dental websites, usually attached to a photograph of a complete set of new crowns. We’d rather start from the other end. The goal isn’t to do more dental work. The goal is to figure out what is happening to your teeth, stop it if it’s still happening, and rebuild only what needs rebuilding.

If your teeth look shorter than they used to, if you’ve chipped or cracked something more than once, if you wake with a tight jaw or sore temples, or if a dentist has mentioned grinding to you before, it’s worth a proper look. Ideally before the next thing breaks.

About the case shown here

This is a complete full mouth rehabilitation of severely worn down teeth. In this particular case, the patient’s bite had a tendency to drift forward, as was shown in the before photo. After decades of this uneven bite, his teeth were breaking down. After much deliberation, and talking to a family friend who was a retired dentist, he decided to trust Dr. Zhu to complete a full mouth rehabilitation. We opened his bite by making his back teeth taller, and at the same time we restored what had been ground away in his front teeth. The final result is that all of his teeth contact evenly and predictably. We completed this whole process within a few appointments. Not only do his new teeth look great, they also function evenly. We are very pleased with the result.