Most of us are lucky as youth. Nature provides us with beautiful enamel and a full set of teeth. Even if our teeth aren't naturally 100% perfect, we tend to take them for granted when we are young. Then, over decades of living our lives, our teeth slowly and steadily take a beating. The elements can render teeth discolored, worn, and misaligned. Gums recede. Dentists get involved, always with good intentions. But years of tooth-by-tooth dental care can result in teeth slowly running out of original enamel.
All dentists are accustomed to seeing molar teeth that have been patched with fillings four or five times over the years, and front teeth with 2 or 3 millimeters of height worn away. These changes happen slowly, so we don't always notice them. Even as dentists, sometimes we forget to take a step back and think about the overall condition of our patients' teeth, instead just focusing on some immediate specific problem (for example, a cavity or a chipped tooth) that we notice during a checkup. Maybe we all need to stop and appreciate that a molar you had at age six will very likely STILL be present, but maybe a little worse for the wear, 7 or 8 decades later. Very few things in our lives last as long as our teeth (how long does a set of tires last, for example?)
As the years gradually take their toll, even with regular checkups and routine care, sometimes we realize that the "drill and fill", tooth-by-tooth approach to dental care is leaving us with an increasingly disordered, random set of teeth. This is not to criticize routine single-tooth dental care. Most of what we do is single-tooth oriented, all day long, for most of our patients. But when the entire mouth has been damaged by decay or other problems, a whole-smile approach is going to be crucial to the treatment planning process.
Health issues and other "big-picture" factors (not always just a lack of brushing and flossing) can accelerate the deterioration of a set of teeth. For example, somebody who is taking blood-pressure medications might develop a dry mouth ... and saliva protects against decay, so cavities might begin to show up quickly in such a situation.
To comprehensively reconstruct a smile, we begin with a conversation. We need to get to know each other, not just as patient and dentist, but as humans. Then a thorough dental and oral examination is essential, not just to know where things stand, but also to understand how they got this way. Whatever dentistry we do for you, we want it to last as long as possible, so if we notice risk factors like a tendency towards gum disease or a high rate of decay, we address these BEFORE beginning treatment. This is never to scold or judge, but merely to help ensure the success of whatever we end up doing for you.
Treatment may include full-mouth reconstruction with crowns or onlays, changing the height of your bite by developing a new "occlusion" (relationship between top and bottom teeth relative to jaw joint movements), or perhaps replacing teeth with dentures, anchored dentures, or bridges supported by dental implants.
With complex, whole-mouth reconstruction, we do everything we can to eliminate unknowns BEFORE we begin working. Modeling the finished product for "try-in" stages is absolutely critical. We know that treatment like this must be done deliberately, never quickly. The planning process tends to generate its own excitement as a vision begins to form around the desired end result.
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