Dental Blog - Portland, OR

When Josh, a 43-year-old professional, came to our office, he had grown increasingly self-conscious about his smile. His teeth showed signs of moderate to heavy wear, with visible chipping, breakage, discoloration, and dark spots. Functionally, the wear had begun to affect his ability to chew comfortably, and he experienced sensitivity in certain areas during meals. Josh’s concerns extended beyond aesthetics; he wanted a solution that restored his confidence and improved his dental function.

Diagnosing the Cause of Wear

To address Josh’s concerns, we started by gathering comprehensive diagnostic data. This included:

 

• Digital X-rays
• Intraoral and dentofacial photographs
• Intraoral scans

After reviewing these findings, we determined that the cause of his severe wear was a combination of bruxism (teeth grinding) and acid erosion. With this knowledge, we devised a plan that not only restored his smile but also addressed the underlying issues to prevent further damage.

Deprogramming and Treatment Planning

The first step in Josh’s treatment journey involved a period of “deprogramming.” Over a few weeks, we used a specialized appliance to relax his jaw muscles and reset his jaw relationship. This process was critical to accurately establishing a new bite position.

Using a digital smile design, we created a mockup of the proposed results. This mockup allowed Josh to visualize his new smile and ensured that we could proceed with precision and confidence. The mockup also provided the framework for restoring his bite to a healthier and more functional position.

Step-by-Step Rehabilitation

We adopted a phased approach, restoring one arch at a time to ensure stability and accuracy:

1. Upper Arch Restoration
   • We began by preparing the upper teeth using a minimally invasive technique. This allowed us to clean out decay while preserving as much natural tooth structure as possible.
   • Porcelain crowns were placed on all upper teeth to restore their shape, strength, and aesthetics.
2. Transitional Bonding for the Lower Arch
   • To stabilize Josh’s new bite relationship, we applied composite bonding to his lower posterior teeth as a transitional step.
3. Lower Arch Restoration
   • Once the upper arch was complete, we turned our attention to the lower teeth. These were also prepared conservatively and restored with porcelain crowns, ensuring harmony with the upper arch.

Ensuring Long-Term Success

To protect Josh’s new smile, we provided him with a custom-fitted occlusal guard. This guard is designed to mitigate the effects of bruxism, preventing damage to the restored teeth.

Life-Changing Results

The entire treatment took approximately three months from start to finish. When Josh saw his new smile for the first time, he was ecstatic. On subsequent visits, he shared how the rehabilitation had truly transformed his life. Not only could he chew comfortably and without pain, but he also felt a renewed sense of confidence.

Josh’s dedication to his dental health has been inspiring. He has become meticulous with his oral hygiene, stating, “I feel like I’ve been given a second chance with my teeth, and I’m not going to mess it up this time.”

Conclusion

Josh’s story is a testament to the transformative power of comprehensive dental care. By addressing both the functional and aesthetic aspects of his smile, we were able to give him back more than just a smile—we gave him a renewed sense of confidence and a pain-free future. If you’re struggling with similar concerns, we’re here to help you take the first step toward your own transformation.