This statement was how I met my new patient. He was quite upset with the way his smile looked, and rightfully so. One of his large front teeth, which we call a central incisor, was broken halfway up the tooth. He experienced no pain, just aggravation. He could not understand what happened to his tooth. Front teeth, especially the central incisors, are often damaged due to trauma. Young children hurt themselves when falling off bikes or at the playground. Older individuals can fall and injure their teeth. I saw a woman today who just started to have seizures and falls. She knocked her front tooth loose. Although these are shocks when they happen, we can understand that a significant force will damage a tooth. Our question is why a tooth fractures in the absence of overt trauma.
Part of the answer to this question comes from an observation made by the patient. He told me that he noticed that his teeth were getting very thin. He felt that he could almost see through them. The appearance of thinness is a pheomenon that we call translucency. Translucency develops when one of two things happens. The first cause of thinness in the front teeth is due to the reduction of the back teeth. The reduction can be in number or size. In number means that we are missing our back teeth. When back teeth are missing, the job of chewing switches to the front of the mouth. We have discussed in previous columns that chewing is not the job of the front teeth. Yes, when they are called upon to chew, they rise to the occasion. However, chewing with your front teeth will result in no teeth in the front.
The other type of reduction, which leads to breakage in the front is due to wear. The wearing away of the tooth structure happens to some extent to all of us. When the back teeth wear, the front teeth come into play in the chewing department. Those patients who have many crowns in the back of their mouths will not experience this phenomenon. The crown will never wear down. Crowns on back teeth save the front teeth from excessive work.
The other reason for the thinning of the front teeth is closeness. What do I mean by closeness? The top and bottom front teeth are very close to each other. There is no way to chew at all without the top and bottom teeth grinding on each other. Spaces in a vertical and horizontal direction are crucial for the long term health of the front teeth. Creating space used to be challenging to create. I utilize tooth movement with removable devices to make this procedure very easy.
Let us get back to our patient with the fractured front tooth. I needed to fix him up as soon as possible because he had meetings and other business dealings. He never expected me to help that day. I told him that I could fix his problem in 30 minutes with the use of a crown. A crown would recreate the thickness of the tooth and look phenomenal. Using state of the art materials and digital scanning technology, I finished the procedure efficiently.
I want everyone to take a look in the mirror at their front teeth. If you see signs of chipping or wear, maybe it is time to visit your dentist. Proper evaluation and taking steps to prevent a fracture is the way to go. We all know that an ounce of prevention is worth a pound of cure. If you fit into this category, please call us at 440-892-1810. I look forward to helping 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 • 27239 Wolf Road, Bay Village, OH 44140 • 440-892-1810 • www.jeffreygrossdds.com