We are asked very often about the difference between dentists and prosthodontists, and when someone should see a dental specialist. One common question is:
“My general dentist says he does prosthetic dentistry, so why should I see a specialist such as a prosthodontist?”
One of the key differences between general dentists and prosthodontists is that prosthodontists are trained to treat the mouth as a whole, rather than a “one tooth at a time” approach. A prosthodontist also has a depth of knowledge of the jaw joint (or TMJ). An initial evaluation begins with making sure the jaw joint is aligned and functioning correctly. Then, the bite, facial size and shape (vertical dimension) are analyzed. An unequal bite on one side could offset and create muscle spasms leading to pain and tenderness not to mention create bruxism or grinding of the teeth. A collapsed facial dimension could suggest excessive loss of tooth structure from bruxism or other parafunctional habits.
The above shows a collapsed bite to due to grinding and parafunctional habits. The front teeth are no longer the same size due to excessive wear on one vs the other. The patient also reports muscle spasms and tenderness.
The photo above shows the same mouth after treatment- the teeth have been restored with prosthetic crowns to the correct height and the bite is now in harmony.
Treating the mouth as a whole does not negate the detailed examination of each tooth; in fact it enhances it. Each tooth should be evaluated for its supporting bone structure, wear patterns, and fracture lines. This could suggest abnormalities in the bite (also known as the occlusion). Imagine a tooth in your mouth that is out of harmony. It’s like having a pebble in your shoe, constantly hurting your foot until you mal-adapt and start favoring your other foot. Pretty soon, your other foot will begin to have muscle spasms and hurt. That is why each tooth in the mouth must have a bite that is uniform with the other teeth. Furthermore, the back larger teeth are designed to do the chewing, while the smaller front teeth are designed to cut. They work in harmony—premature loss of back teeth will cause excessive forces on the front, causing weakening of their bony support and then mobility.
We are planning more posts showcasing our work in dental reconstruction and prosthodontics; be sure to check back soon for our next article!
And if you are in need of such work yourself, be sure and call our office today to schedule an appointment- 703 – 532 – 7586