33072 Sea Bright Drive, Dana Point, CA 92629, us
Case Presentation #4
Chipping Edges of Upper teeth
This example is taken from a consult that Dr. Duggan did a couple of years, but illustrates some important considerations.
The edges of the patients top teeth look like saw-blades – ragged and jagged. Her dentist told her that he could NOT polish away the irregular enamel, but would have to rebuild the edges with composite.
Observation shows that the edges are breaking because the lower teeth are wearing away the upper teeth near these edges, and the residual enamel is simply breaking away. Another useful piece of information is that the patient reports that this started happening 8 – 10 years ago, and at the same time the spaces that she had had between the front teeth all her life, disappeared around that time. She was happy that the spaces were gone, but not happy about the roughness.
Since her dentist wants to rebuild these edges, BUT the lower teeth are wearing into the space where the composite would go, if he simply built them back up, the lower teeth would hit the composite, and she could not close her mouth completely into the normal bite. This is not satisfactory.
Her dentist suggested moving all of the upper teeth outward, toward the lip and away from the lower teeth by tipping them with Invisalign treatment. This is an orthodontic treatment using plastic splints rather than brackets and wires. The cost of Invisalign can run $3500 to $6000 and she can afford it. The problem is that if he tips the teeth outward, forming a larger circumference of the arch in that area, the teeth will also separate – so the SPACES will be back again! He will have made room to place composite on the edges of the teeth without disturbing the bite, but her primary cosmetic complaint for her lifetime will resurface.
IF she allowed him to do as he wants, then she would complain about the spaces, and his solution would probably be to do porcelain veneers over the teeth, allowing the spaces to be filled and the teeth to look as if they are in the usual contact. Cost for this would be $1000 to $2000 per tooth, with six teeth required – total $6000 to $12000. AND, the veneers cover the edges, removing the composite that the dentist had placed there in the first place.
So, considering that the dentist COULD have simply polished out the rough edges in the first place and the patient would have been happy, and charged her something like $300 – how is she supposed to deal with a plan that ultimately will cost at least $10,000 – even if she can afford it?