Malocclusion And Tooth Wear

Heart disease is common in America …
Hypertension is common in America…
Obesity is common in America…

Would you not agree that all the above statements are true?
Just because something is common does not mean that it is healthy or normal!!!

Enamel attrition (excessive tooth wear) is all too common in America. Millions of adult Americans suffer from some level of tooth attrition. Most of these people also have one or more of the following:

• Chipped teeth
• Gum recession
• Headaches
• Jaw joint (TMJ) pain and / or popping in the jaw joint
• Unexplained tooth loss

More than ever before, more and more people are losing their teeth from simply wearing them down.

• Your teeth do not have to wear with age…
• Your gums do not have to recede with age…
• Your teeth can and should remain youthful in appearance your entire life…
• Your jaw does not have to pop, click or be uncomfortable…
• You do not have to suffer from headaches.

The GOOD NEWS is that there is an exact and predictable way to diagnose and treat this disease that is affecting so many people. The results we are achieving are phenomenal.


In dentistry, each patient presents with a unique set of circumstances that affect their overall health. There are two divergent paths available to them.
1. Remedial Disease Management- believes that as things break and are damaged, they should be repaired as quickly, easily, and inexpensively as possible. People that choose this type of disease management often find themselves in crisis or emergency care.
2. Systems Based Dentistry- builds itself around the philosophy of prevention. In other words, the teeth, the muscles, the joints, and the overall general health of each individual must work together in harmony. When we examine the teeth and see chipping, gum recession, unexplained tooth loss, and excessive wear, we are seeing symptoms of a significant problem that can be corrected. Your teeth do not have to wear and chip, your gums don’t have to recede, your jaw doesn’t have to pop or click.
When you consider all of factors that allow you to chew, speak, swallow, and smile, systems based dentistry make the most sense. By preventing further breakdown from disease, you can control you costs, control your health and expect to keep your teeth for a lifetime.

Systems Based Dentistry has a very specific treatment sequence. It is:
1. Initial Systems – Based Dentistry Consultation and Conversation
2. TMJ Joint Therapy
3. Post TMJ Therapy Consultation
4. Restorative Treatment
5. Post Restorative Maintenance

Here is an outline of the steps:
1. Initial Systems – Based Dentistry Consultation – this is an informative appointment designed so that you can learn the basic principles of Systems – Based Dentistry, discover the current condition of your mouth and find out the probable consequences of continuing in your current oral health state or if you would choose to improve your current health state.
a. The objectives are:
i. To understand the current state of your health condition
ii. To understand the principles of Systems – Based Dentistry
iii. To understand the difference between remedial (traditional) dentistry and Systems– Based Dentistry
iv. To make sure that all of your questions are answered.
2.TMJ Joint Therapy – The objective is to stabilize the jaw joint and make accurate jaw movement records that can be transferred to a jaw simulator. This is accomplished by the fabrication of a custom made Condylar Centering Orthotic (C2O). This clear acrylic splint is worn in the mouth 24/7 until the joint stabilizes. This phase of treatment involves multiple weekly splint adjustment appointments to allow for proper seating of the joint back into its most stable position. When it is determined that the joint is stable (approximately 90 days of C2O wear), then a longer appointment is scheduled to take accurate jaw measurement utilizing a sophisticated instrument called an Axiopath.
3. Post TMJ Therapy Consultation – The objective is to show you the difference in your bite as it relates to the original unstable joint position vs. the new , stable joint position. Because the three areas (teeth, muscles, and joints) all must work interdependently, there is only one area that can be easily corrected. That is the teeth. As we look at the new, stable joint position, we will be able to accurately see how the teeth can be restored so that the bite now matches the stable joint position. This could include referrals to specialists.
At this point in the process, a decision must be made that either discontinues full time splint use, or we proceed to restore the mouth to its optimum healthy position.
4. Restorative Treatment – The objective is to establish a stable bite that correlates with the new stable joint position. The way that this is done depends on various factors including patient preference when indicated. We normally use crowns, bridges, tooth colored bonding, orthodontics or a combination of any or all of these. Sometimes, in rare cases, jaw surgery is indicated.
5. Post Restorative Maintenance – The objective is to maintain the proper bite / joint position. Usually it involves just checking the bite at a hygiene visit and then an occasional bite adjustment to compensate for certain dynamic changes that can occur in the bite / joint over time. These appointments are short and inexpensive but are invaluable in maintaining a healthy, comfortable and stable bite over your lifetime.
Systems – Based Dentistry – replicates the form and function found in excellent natural dental biology. It calls for a conservative, team approach to dental care. It can be considered Long Term Dentistry (sometimes as much as a lifetime). Meticulous comparative studies of your teeth and jaw position are used to develop an individualized plan specifically suited for you. This is accomplished utilizing digital x-rays of your teeth and jaw joints, photographs and models of your teeth mounted in a jaw simulator that is custom programmed to simulate your chewing and jaw movements.
I believe in SYSTEMS – BASED DENTISTRY so much that I am having my own mouth restored in this manner. I feel privileged and honored to be able to offer this gift to my patients. This may or may not be the right time for you – only you can determine that – but please know that I am here to help you to make the best decision for yourself.
—–Robin Steely, DDS

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