Teeth worn down over decades of grinding present a specific problem: there is less tooth than there was, and the instinct to grind more away to make room is precisely the wrong move.
Why worn teeth are short on space
As enamel wears, the teeth erupt slightly to maintain contact. So the teeth get shorter but the gap between the arches does not open up correspondingly.
That means there is nowhere obvious to put a restoration without either preparing what little remains, or increasing the vertical dimension to create the space.
Why increasing the bite is usually the better answer
Opening the vertical dimension creates restorative space without removing tooth structure, which in a mouth that has already lost a great deal is exactly what you want.
It also tends to restore facial proportion, since decades of wear shorten the lower third of the face and deepen the folds around the mouth.
How it is done safely
Not in one appointment. The new bite is established with records, built in provisionals, and lived with for weeks or months. Muscles and the joint are given time to demonstrate they tolerate it.
If there is discomfort, clicking or difficulty speaking, adjustments are made in acrylic. Only once it is stable does anything definitive get made.
The part that has to continue afterwards
The grinding does not stop because the teeth have been restored. A night guard, worn indefinitely, is part of the treatment rather than an accessory to it.
Patients who abandon the guard are the ones we see again with fractured ceramic.
Worn dentition is one of the most rewarding things to treat and one of the least forgiving of shortcuts. The provisional phase is the shortcut people take, and it is the one that cannot be taken.
If you want to know how this would apply to your smile, book a remote consultation with us.
