Question:

“Dr. Sam, I have a big overbite and my lower teeth are hitting the back of my upper teeth real hard.  My dentist wants to grind the back of my upper teeth to help my bite……. Is this a good idea?”

Answer:

Let’s Define a Deep Overbite

A deep over bite is when the upper teeth completely cover the lower teeth when the patient bites their teeth together.  Generally, the lower jaw is pushed back and appears small and additionally the entire face looks short and round because of the over bite.  The bite actually impacts the entire face and can also have a profound effect on the head and neck.  Patients with deep overbites generally get headaches but there are variables between patients.

Overbite Case Study

Should the Dentist grind the back of my upper teeth?

Generally . . . NO!  Grinding the backs of the upper teeth only makes the overbite even deeper or worse.  Additionally, it is not stable, meaning that the teeth will shift over time.  The best treatment for a deep over bite is to correct the problem.  Sometimes braces or orthodontics can be a solution and other times, building up the back teeth is another possibility.  Today, we have to think long term.  We have to realize that we may very well live to 90 years of age and have to get dental care that has your long-term interests in mind.  Many patients make decisions based on finances and will go ahead with the tooth grinding for temporary relief and deal with the over all health problem later when they may be financially more capable. 

 The Age of the Dental Patient

There are many factors in deciding if to grind teeth, put braces on them or build them up.  It requires a thorough examination of the length of the roots of the teeth, the strength of the bone, the time available and overall goals of the patient.  Example:  A younger patient may like the color and shape of their teeth and refuses to wear braces.  This patient may do better with a bite lift using porcelain over the back teeth.  It is generally better for patients to have braces but sometimes it requires both braces and porcelain to reach the best bite position. Other times an older person may also want whiter and longer teeth, in which case porcelain may be the best choice. 

 Porcelain Bite Lift vs Orthodontics

Orthodontics takes a year or two or three.  A porcelain reconstruction takes only a couple of weeks to a month or two, depending on the difficulty.  The porcelain reconstruction costs more but it has much greater potential as the shade of the teeth can be made whiter, the teeth can be made longer if they are worn down, the old fillings and crowns are replaced and infected gums can be treated simultaneously.  The braces have the advantage if the patient is satisfied with the shape and color of their teeth and have few restorations, the teeth can be moved in the best position. 

 Adult Dentistry

Many adult patients want to get their dental health improved by removing their old mismatched fillings and crowns while lifting their bite and getting straight white teeth at the same time.  The entire upper arch can be treated in only 2 weeks and the same for the lower.  The patient needs one half of a day for the first appointment and half of the day for the second appointment a couple weeks later.  The patient can have almost any level of cosmetic improvement instantly.  It can be a rejuvenation of their entire face without surgery.