One of the most common rumors around the globe (true or not) is that English people often have bad teeth. Our British patient Murray actually had misaligned jaws, and had been told he would need to have surgery to correct the problem. Although surgery may be required in the most extreme cases, it is not advisable when other, less invasive, options are available -- particularly when the teeth have been worn down excessively and require porcelain restorations (such as crowns and veneers) even after jaw surgery has been done. So the question is: can we achieve the same, or even better, results with complete reconstruction alone? If the answer is yes, opting for restoration will save the patient years of rehabilitation and surgical fees. In Murray's case, in addition to his dental problems, he had complained of migraines and snoring. Although they might have been unrelated to his initial diagnosis, they still needed to be explored thoroughly to ensure the best course of treatment. We noticed that Murray had an overbite so extreme that his upper teeth completely overlapped and hid his lower teeth. This extreme bite closure forced Murray's jaw joint backward into an uncomfortable position, and had a falling-domino effect: it tugged on his facial muscles and caused additional symptoms. It also compressed the lower third of his face, shortening his overall facial height, making him look older than his years. Our first step was to determine the correct interrelationship of his upper arch against his lower arch, and then to create three-dimensional models of this relationship. This would become our blueprint and guiding tool to prepare his teeth for crowns. Temporary acrylic crowns were fabricated to test out the new position and retained for about six weeks, until Murray was comfortable with the new position of his upper and lower jaw. We then completed the treatment by placing the final all-porcelain restorations. The results: without surgery, Murray no longer has migraines, and his wife happily reports that he's stopped snoring and now enjoys a good night's sleep. He has more energy during the day, and looks and feels younger. It's what both dentists and patients would call a good outcome.
