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Shaping Up Teeth – Part 4 – Preventing Self-Harm of Teeth – Increase the Vertical Dimension – The Treatment

August 24, 2020

The treatment involves building up the bite of the teeth

The simplest and most flexible way is using tooth coloured filling material (composite resin). The material, after chemical preparation, can bond onto enamel. It can also be placed over filling materials. With fillings that are already tooth-coloured, chemical treatment will allow the build up to be placed. Other filling types are more difficult and sometimes we roughen the surface slightly to help hold the material. Often the deep bite into the tooth is enough to hold the material. With ceramic crowns the bond is more difficult and we may use the opposing tooth to build the bite up.

With dentures, we use a tooth coloured acrylic to build up the denture teeth. 

How much do we build up the bite?

This is often determined by the amount of wear ), and if there are any teeth need to be built up in shape to achieve a natural appearance on smiling and in function. We will not know the correct amount until the person lives with it for a period of time. We review the bite usually in about a week. This is the advantage of the material as it’s easy to adjust.

Worn teeth from a heavy bite, causing filling to be lost
Worn teeth causing overclosure of bite

How is it done?

All the teeth, generally in the upper jaw, are built up in one session. This is achieved by building up a section about four back teeth (usually the side with the most wear) on one side. Then check if the bite is even for this section of teeth. Once done then move onto to the next four towards the front of the mouth. Check the bite is even with all the teeth built up so far, and then move on around the arch of teeth till all the built up teeth are biting and grinding evenly.

Build up and fillings placed on teeth

What’s next?

Come back in a week to check that the bite is even and not too thick. If not, adjust or add more material. Check the shape of the built up teeth are acceptable and correct if necessary. Also make sure it’s smooth and easy to keep clean. Further adjustments or additions may be need at any time in the future.

Front view of build up & fillings - getting back to a normal bite & look

What happens next?

For heavily filled teeth, crowns & bridges can be placed as there will more tooth/filling to fit on. Denture teeth can be replaced with longer teeth and the denture base itself can be thickened to reduce breakage. This all can be done over time. Implants can be placed now there is more room. Too much pressure on an implant can cause failure.

Bridge cemented on the 2nd last molar on left and attached molar tooth in the space to right

Summary

As the bite is built up, the fillings are now thicker and less pressure can be generated by the jaw. More room can be made to create better shaped teeth and in some cases showing teeth when smiling!

Need an Appointment?

If you’d like to book an appointment with the dentist at Seymour Dental then call us in Dulwich Hill, Sydney on (02) 9564 2397 or
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