Treatment of severely worn teeth
(page 3)

Now that the preliminary (diagnostic) work is done, the time has come to prepare the teeth for the final restorations. These are usually crowns, veneers possibly combined with bridges or partial dentures if teeth are missing.

Prepared teeth.

Since the vertical height of the teeth is being increased, it is usually necessary to prepare all of the teeth at the same appointment. If only some of the teeth are done at a time, only those teeth will be lenghtened and the rest of the teeth will not contact. This can cause discomfort, broken teeth, sore muscles, TMJ problems and inability to chew food correctly. These types of treatment should only be done by a dentist trained to perform complex crown and bridge procedures such as a Prosthodontist.

Lab processed temporary crowns. (Provisional crowns).

Immediately after the teeth are prepared, plastic temporary crowns are made in the laboratory. Although temporary crowns can be made in the mouth for smaller cases involving a couple of teeth, the in-mouth technique does not work well in a large case. The procedure is very unpleasant for the patient, the bite and fit to the teeth is almost impossible to get correctly, the procedure can cause tooth sensitivity and the materials used in the lab technique are much more durable..

Lab processed temporary crowns cemented in the mouth.

The lab processed temporary crowns are cemented in the mouth using a temporary cement that allows the dentist to remove them easily..

Impressions are made of the prepared teeth. A very hard plaster is poured into the impression to make a model of the prepared teeth. The final restorations are made on this cast in the dental laboratory. This can take several weeks or months depending on the complexity of the case. Meanwhile the patient is wearing the provisional crowns.

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