Richard originally came to Adler Cosmetic & Family Dentistry because he was unhappy with his smile. He was concerned that his bite had been changing over the years including changing color, crowding, and problems with his gums. He wanted to keep his teeth and gums healthy and get an updated smile. He had spent a lot of time in the dental chair at other offices just fixing one tooth at time without getting the overall results that he wanted. At the time Dr. Adler had recently begun studying at the Las Vegas Instituted (LVI) expanding his knowledge of both cosmetic and neuromuscular dentistry. Instead of just evaluating Richard’s problems as individual teeth to be fixed independently, he looked at Richard’s mouth as a whole and addressed all the issues together. Dr. Adler realized that the training he had received at LVI was just the solution that Richard was looking for.
The first step to a healthy smile is healthy gums. Richard had periodontal disease, a chronic bacterial infection that affects the gums and the bone supporting the teeth. If left untreated, a serious infection can lead to bone loss and tooth loss. To treat his periodontal disease, Richard had scaling and root planning done. During this procedure, the hygienist, Susan, numbed quadrants of Richard’s mouth, since the gum tissue was inflamed and sensitive, and then scaled out the bacteria and calculus (tartar) that had built up under the gum tissue. After the procedure, Richard had to make sure to get his regular cleanings done every three months (as opposed to the usual recommendation of every 6 months) in order to maintain healthy gums and manage his periodontal disease.
Once Richard’s gums were healthy, then Dr. Adler focused on his bite problems. A K7 evaluation was performed to determine exactly what was happening with Richard’s bite and the best way to approach fixing the problem. The K7 evaluation consisted of running a series of test using non-invasive computerized electronic instrumentation. It began with taking diagnostic cast so we have an accurate model of his mouth and bite. The K7 produces scans that measure the muscles, range of motion, and joint noise among other things. EMG or electromyography measures the muscles at rest and during function-clench. CMS (computerized mandibular scan) measures joint function, habitual freeway space, swallowing, and range of motion. Sonography measures joint sounds. TENS or Transcutaneous Neural Stimulation relaxes the muscles in the face and neck to find their true resting state and establish the occlusion at that position. Material is then placed in the patient’s mouth to capture that ideal position, known as the bite registration. Based upon the information gather during the K7 evaluation, it was determined that the best course of treatment would be for Richard to be fitted with a fixed orthotic that would be bonded to his lower teeth that would reposition his bite and jaw into its ideal position. Once his bite had settled into the proper position to then do a full mouth reconstruction where all of his teeth would be crowned to rebuild his bite into the correct place permanently without the continued use of an orthotic.
Richard, who was Dr. Adler’s first full mouth reconstruction case, met Dr. Adler and his assistants in Las Vegas at the Las Vegas Institution to do the final restorations under the guidance of LVI’s highly trained instructors. During the first procedure, the fixed lower orthotic was removed and all of Richard’s teeth were prepared for the crowns. Temporary crowns were then placed while the impressions were sent to Aurum Ceramic Dental Laboratory where Richard’s crowns would be custom fabricated into his new bite and better looking smile. Once fabrication on the crowns was complete, Richard returned to LVI with Dr. Adler to have the case seated. The temporary crowns were removed and Richard’s amazing new crowns were cemented into his ideal bite with strong clear cement. Now Richard is smiling all the time and is proud to show off his teeth.