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Reconstructive Tooth Enamel Repair - Replacement

Dental Enamel Destruction

Understanding Enamel Loss

Poor Hygiene
Oral Health Habits







Intrinsic Stain
Trauma







Purging Acid Damage
Bulimia Purged Acid Damage







Severe Tetracycline Damage
Tetracyline Staining







Chewing Tobacco Damage
Chewing Tobacco

Oral Health Habits

Sucking lemons, keeping candies and mints in mouths for hours or during sleep, sipping sugary drinks all day, chewing tobacco all day, snuff, smoking, dissolving medicines in mouth instead of swallowing. Sugary gum or sour gummi bears that have citric acid that dissolves teeth.

Oral Disease

Fevers at young age, antibiotics while teeth developing in utero, periodontitis leading to food impaction in crevices around teeth. Xerostomia - dry mouth due to medication or illness or age. Oral disease mirrors systemic disease. Leukemia, HIV, Diabetes, cancers, all can influence caries/cavities due to immunocompromised systems.

Eating Preferences - Habits

Excess candy consumption, lack of proper nutrition, high fructose corn syrup

Bulimia Purging

Acid attack, gasses from stomach, acid reflux, vomit acids

Trauma

Fracture, chips, missing tooth or fillings can lead to impaction of bacteria, decay and further breakdown

Friction

Fillings that are too high, poorly shaped, pitted, old ditched, can pack food leading to deterioration and decay.

Occlusal

Grinding, Bruxism (nocturnal grinding), posturing things between teeth, using teeth as tools.

Incompatability with Previous Dentistry

Leaking crowns that don't fit, cement that has leached out leaving gaps for bacteria to seep through, overhangs (rough fillings or excess fillings that tear floss and pack food) that trap bacteria.

Genetic Birth Defects

Ectodermal dysplasia

Developmental Growth Abnormalities

Amelogenesis or Dentinogenesis imperfecta are factors that can lead to pitting and decay.

Prevention - Control - Treatment of Enamel Damage

Loss or deterioration of enamel can have many causes, as outlined above. Whether or not there is a fix, cure (a misnomer, really), or method for repairing affected enamel is based on the original cause.

In many situations the treatments of choice that offer strong predictability of success, both functionally and cosmetically, are the use of restorative procedures recommended by a cosmetic dentist. New porcelain crowns for restoring deteriorating teeth to natural contours and function, buildups and fillings to test a new bite or restore lost biting relationships, implant crowns, bridges and quality feldspathic porcelain offer a variety of creative methods for overcoming the loss of enamel

In cases where enamel loss is arrested early (perhaps due to poor dietary habits) certain types of mineralizing agents in the form of toothpastes and rinses can be successfull.

Below is a very brief outline of anticipated treatments for each of the categories of enamel loss. Some are homeopathic, and can be done at home. Others require the expert help of an experienced dentist.

Oral Health Habits

Consciously changing behavior, biofeedback, splint therapy or appliances to change habits such as NTI or the Best Bite Discluder

Oral Disease

Cariology (study of cavities) bears out that it is a disease. Complete eradication is needed to stop the spread of the bacterial infection that is caries. Fluoride releasing fillings, mouth-rinses, and systemic medication can all be useful adjuncts to stopping carious lesions from spreading.Fluoride releasing fillings, crowns with fluoride cements, trays for at home fluoride treatments and behavior modification are all possible treatments.

Eating Preferences - Habits

High fructose corn syrup found in sodas, juice drinks, sports drinks as well as energy bars are bathing teeth in sugar. Blended coffee drinks and the decrease in milk consumption have been blamed in the increase in rampant tooth decay. Solution, see oral disease.

Bulimia Purging

Behavioral Psychologist, medication, and restoration with crowns and orthodontics when stable

Trauma

Root canal therapy if needed, large restorative fillings to restore teeth to high strength, and crowns or protective caps

Friction

Mouthguards, occlusal adjustments, equillibration or evening out of bite. Rehabilitiation or reconstruction of bite

Occlusal

Mouthguards, splints, adjustment of bite. Possible rehabilitation of bite with crowns or posterior porcelain or gold restoration

Incompatability with Previous Dentistry

replace it with modern state-of-the-art- restorative dentistry to include gold, porcelain,zirconium, pressed or feldspathic porcelain

Genetic Birth Defects

Restoration of missing teeth or pitted teeth with fillings or crowns. Missing teeth to be replaced with implant supported crowns or bridges

Developmental Growth Abnormalities

see genetic birth defects


Wisconsin Reconstructive Implant Dentistry
Richard Winter, DDS MAGD
Winter Dental Associates
5323 W. Hampton Avenue
Milwaukee WI 53218
(414) 464-9021


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Cosmetic Dentistry in this area is not a professional dental specialty but rather a conceptual entity involving restorative reconstructive procedures producing aesthetic outcomes Complex technique specific procedures offered by a preferred dentist or practice are best verified by the dental patient

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