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The Dental Detective

Case 12: What’s so right about a right bite?

A 56-year-old gentleman missing his upper front teeth due to an accident many years ago, wanted implants for a fixed solution to his problem. He also complained of a localised gum swelling in his upper left canine region just adjacent to the missing front teeth. 

What is a right bite? Imagine a building standing on a weak foundation. When it’s a normal day with great weather there may be no problem having a weak foundation. But come a storm or rough weather, what are the chances of the foundation giving way? The gums, bone and the way the teeth protect one another is the foundation of the mouth. Uneven forces on the teeth can result in weak gums and deteriorating bone levels on one or more teeth. It’s always the weakest link that gives way.

Back to our patient- the weakest link in his mouth was his upper left canine tooth. The canine teeth are the most important foundational structures of the mouth. They are strategically positioned neither in the front of the mouth nor at the back but in fact at the corners of the mouth. They have long roots extending almost up to the base of the nose in some instances. They hence make for very strong teeth and can resist “lateral” forces very well. They can be used to protect the front and back teeth when the bite is right. In our patient, this tooth was the one that had given way and was loose. This clearly indicated that the foundation of this patient was not right and prior to considering an artificial replacement such as a dental implant, the cause for this weakening foundation must be ascertained. I could not put the replaced tooth at risk from the same fate!

The drawing board (Yes, I do consider myself as the architect of the mouth!)- A complete occlusal analysis was carried out with 21 photographs; a jaw and bite record was also made. Once the cause was confirmed- an interference from a back tooth causing undue pressure on the canine tooth, the treatment plan was drawn up and discussed with the patient. 

The patient got on board and we corrected his bite with some filling material to even out the bite and the forces. Once this was accomplished, a removable denture to replace the upper front teeth was made. This was tested by the patient for a couple of weeks. The patient was now ready for dental implants as a definitive replacement for his missing teeth. I was confident that the teeth restored in this manner would serve him for a long time!

The right bite is the foundation for any long-lasting dentistry. Everyone understands the concept of harmony and dentistry performed with the jaw joint in harmony with the teeth and muscles is the best service rendered to a patient looking for a long-term solution.

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Case 1: Case of the floating teeth

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