Are your teeth wearing down from grinding?
Grinding removes enamel where the teeth meet, and as those contacts flatten the jaw finds new ones, so the pattern keeps moving and the wear accelerates. Rebuilding the shape is the second half of the work. Correcting the way the teeth come together is the first. Send us a photo of your smile and we will tell you what is involved and what it would cost.
- A call within two hours during office hours.
- A written cost from us, before you commit to anything.
- No obligation. Many patients take weeks to decide. That is normal.
What this case cost
$502/month
144 payments at 9.99% APR, on approved credit.
Total: $42,000 for the bite analysis, a full set of provisional restorations worn while he tested the new bite, and twenty-four ceramic teeth across both arches.
How full-mouth reconstruction works, and what it costs today →
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Treatment Plan by Dr. Mehdizadeh
- Occlusal analysis to establish where the teeth meet and how the bite distributes the load.
- Smile design derived from the occlusal findings rather than designed alongside them.
- Provisional restorations placed across both arches.
- Several weeks of the new bite in ordinary use, with adjustments made to the provisionals.
- Twelve porcelain veneers and twelve onlays in e.max, six of each in each arch.
- A night retainer to carry the grinding load away from the restorations.
The Patient's Journey
This patient came in because the edges of his lower front teeth had darkened and he had noticed the deterioration himself. He had been grinding his teeth for years without treatment. Several of the lower incisors were measurably shorter than they had been, with notched, irregular edges where the enamel had fractured away.
He wanted the deterioration stopped, and while we treated it he wanted his appearance improved. We kept the design restrained: twenty-four restorations give a laboratory considerable latitude, and we used most of it to reproduce proportions he would recognize as his own.
Understanding the Challenge
Teeth worn to this degree are a bite problem before they are an appearance problem. Grinding removes enamel at the contacts between the teeth, and because those contacts flatten progressively, the jaw locates new ones and the distribution of wear migrates across the arch until the pattern bears little resemblance to the one it started from. Reproducing the original shape without correcting the bite delivers new ceramic into the mechanism that destroyed the enamel.
Grinding is also not a condition that resolves. Improving and balancing the bite reduces it substantially, and we did that here, but the habit itself continues, and the restorations need protection from it afterward.
That determined the sequence of treatment: we analyzed and corrected the bite first, and the appearance of the teeth followed from those findings rather than developing alongside them.
Analyze the bite before designing anything. Restore the length lost from the worn teeth. Test the corrected bite in provisional restorations before committing to ceramic. Keep the proportions inside the range he would have had naturally. Protect the completed restorations from continued grinding.
How We Approached Treatment
Treatment opened with Dr. Mehdizadeh's analysis of the bite, and its findings determined the shape and the length available to every tooth in the design. The contacts between the teeth, the movements they make across one another and the distribution of load are all measurable quantities, and those measurements established the limits that the smile design afterwards had to work inside.
We placed provisional restorations across both arches, and the patient wore them for several weeks to test the corrected bite in ordinary use. Provisionals are the only reliable test of a bite, because a design can be correct on a model, measured and articulated exactly as intended, and still remain uncomfortable for the person who has to live in it. We adjusted the bite and the appearance during that period.
Once the provisionals were performing correctly, our ceramist reproduced their shape in twenty-four definitive restorations in e.max, a pressed lithium disilicate: twelve porcelain veneers and twelve onlays, six of each in each arch. Veneers rebuild the front surfaces of the teeth that display, and onlays rebuild the biting surfaces of the teeth behind them, which had carried most of the grinding damage.
Because the ceramist is our own, we adjusted shade and shape against the patient rather than describing them to an outside laboratory.
The Result After Eight Weeks
We have rebuilt the worn edges, the lower incisors have recovered their length, and the darkening he arrived with is gone. Six appointments across eight weeks covered the analysis, the preparation of twenty-four teeth, the provisional phase that tested the corrected bite in ordinary use, and the cementation of the definitive restorations. The completed restorations reproduce the proportions and the surface texture his own teeth carried before the deterioration began.
The treatment protects his teeth from the grinding rather than ending it. He wears a retainer at night, so an appliance absorbs the load instead of the new restorations, and he will keep wearing it for as long as the grinding continues.
Frequently Asked Questions About Grinding, Worn Teeth and Full Mouth Restoration
What causes teeth to wear down like this?
Bruxism, which is clenching and grinding the teeth, usually during sleep. Grinding removes the enamel at the points where the teeth meet, and because those contacts flatten as they wear, the jaw finds new ones and the pattern keeps moving.
Why was the bite analyzed before the smile was designed?
Because the bite sets the limits the design has to work inside. Where the teeth meet, how they slide across one another and where the load falls decide how much length we can add and what shape each tooth can take.
Can grinding be cured?
No. Improving and balancing the bite reduces it substantially, and that was part of this treatment, but the habit continues. What changes is that the bite spreads the force more evenly and the night retainer protects the restorations from it.
What is the difference between a veneer and an onlay?
A veneer rebuilds the front surface of a tooth, on the teeth that show. An onlay rebuilds the biting surface and the cusps of the teeth further back, where the grinding damage is usually worst. We used both here for that reason.
Why were provisional restorations worn for several weeks?
So he could test the new bite in ordinary use while it was still easy to change. A bite can be correct on a model and feel wrong to the person living in it. We adjusted the provisionals during that period, and only then did our ceramist copy them into ceramic.
Why were both arches treated rather than just the lower teeth?
Because teeth wear against each other. The upper teeth had lost length as well, and rebuilding one arch against a worn opposing arch leaves the new restorations meeting surfaces that are still the wrong shape.
What is e.max and why was it used on a grinding case?
A pressed lithium disilicate ceramic. It is strong enough for biting surfaces and translucent enough to read as natural tooth, which is why we used the same material for both the veneers at the front and the onlays behind them.
Will the ceramic wear or chip the way the natural teeth did?
Ceramic is a wearing part, and how long it lasts depends on how the bite loads it. That is why we corrected the bite before our ceramist made anything, and why the night retainer matters. We check the restorations at your routine visits, along with the gums.
How long does the night retainer have to be worn?
For as long as the grinding continues, which in most cases means indefinitely. It is a thin appliance worn during sleep, and it takes the load that would otherwise go into the restorations.
How much does a full mouth restoration like this cost?
This case was $42,000, covering the bite analysis, a full set of provisional restorations worn to test the new bite, and twenty-four ceramic teeth across both arches. $502/month: 144 payments at 9.99% APR, on approved credit.
