Restoring a Smile - Boulder, CO Neuromuscular Dentistry

Peter was unhappy with his smile and was having trouble with crowns that he had done (and redone) in the past. Like many of us, Peter turned to the Internet to find his new dentist. Peter thought that Dr. Adler’s website was comprehensive and discussed several issues that he wanted addressed. When Peter came to our office, his teeth were fractured, worn, discolored, crowded and filled with metal fillings that were leaking. He also had bleeding and inflamed gums. His bite was over closed and he had alignment issues. Peter complained that he had pain in his front teeth constantly and had for many years. He also felt that his smile was crooked, discolored and felt stubbly. Peter had spent enough time in the dental chair fixing one tooth at a time. Peter wanted teeth whitening in Boulder and his gums to be healthy, look great and last a lifetime.



Peter’s fractured teeth, constant pain, over closure and alignment issues were all indications to Dr. Adler that Peter’s bite was not right and would continue to cause problems with his teeth until the issue was resolved. Dr. Adler recommended that Peter have a full mouth reconstruction in Boulder that would consist of neuromuscular dentistry in conjunction with cosmetic dentistry to insure that his smile would not only look good but be functional and pain free. The phase 1 of Peter’s treatment was to find his ideal bite. The ideal bite places the patient’s plan of occlusion, which is an imaginary line that runs horizontally through the bite, at a 90 degree angel to the patient’s axis of gravity to insure that the forces of gravity and the bite force are distributed equally and don’t cause undue stress or stain on joints and muscles that can effect the entire body.



A bad bite caused Peter’s muscles to become overstressed and fatigued due to the constant strain of working in the wrong position. TENS or Transcutaneous Neural Stimulation in Boulder was used to send electronic pulses to specific muscles in the face, neck, and back that allowed these overstressed muscles to elongate and come into their ideal resting positions. Peter had several TENS sessions during the course of his treatment to insure that the muscles were relaxing into their ideal positions for the best bite. In addition to the TENS, a K7 evaluation was used to help determine exactly where Peter’s ideal bite was and to monitor the progress of his treatment. The K7 evaluation entailed a) taking diagnostic casts of Peter’s mouth, b) running EMG (Electromyography) that measured his muscles at rest and during function-clench, c) CMS (Computerized Mandibular Scan) that displayed joint function, habitual freeway space, swallowing, and range of motion, d) Sonography measured joint sounds, and finally e) Myobite registration, which was an impression of Peter’s bite in its ideal position after TENS has been done. From the myobite, an orthotic was made to keep Peter in his ideal bite. TENS and any needed adjustments were made to the orthotic to make the bite as comfortable and functional as possible. Once Boulder neuromuscular dentist Dr. Adler and Peter were satisfied with Peter’s bite, phase 2 of treatment began.



Phase 2 of treatment was reconstructing Peter’s teeth to his ideal bite so that the use of the orthotic would no longer be necessary. Every tooth was prepared for a ceramic crown, removing any decay or fractures that were present, and fitted with temporary crowns while the impressions of Peter’s teeth and bite were sent to the prestigious Aurum Dental Laboratory which is known for their quality and excellence. The ceramic crowns were individually crafted to not only look great but to also be functional and in the correct bite. Once the lab finished fabrication of the crowns, Dr. Adler removed the temporaries and cemented on the permanent crowns in Boulder. Peter’s treatment was conducted under the supervision of the esteemed Las Vegas Institute (LVI) where Dr. Adler was trained in the most advanced techniques of neuromuscular and cosmetic dentistry. Peter’s results are amazing and he is thrilled with how he looks and feels. He smile is now balanced, teeth look great, and his jaw is comfortable. He said that he is more confident and the look of his entire face has changed. He looks more youthful now that the atrophy on one side of his face is gone. Another change that Peter noticed was that he stopped biting his nails since his treatment started. Peter was a habitual nail biter most of his life, since treatment Peter has completely stopped chewing on his nails and cuticles. He believed it is because his bite changed and so it is no longer as easy to bite on his nails and also because he was using his figures as a subconscious crutch for his jaw that is no longer needed with his new bite. There is no question that Peter’s smile looks great and has greatly improved his life.



For more information about Boulder Dentist Dr. Adler please visit our website or call the office at 303-449-1119.

Icecapades - Boulder Teeth Whitening & Porcelain Veneers

Ice is one of the hazards of winter that has slipped us all up at some time or another. Adam was no exception to this. He slipped and fell hitting his face on the ice. His face took the impact of the fall and tooth #8 (upper right front tooth) was severely broken. He immediately sought treatment from Dr. Adler of Adler Cosmetic & Family Dentistry. Dr. Adler used x-rays and images from the interoral camera in his Boulder Colorado dentistry office to help determine the extent of the damage during his examination of Adam. Tooth #8 was severely fractured through the nerve space, causing pain. It is unusual to see damage to only one tooth when someone falls. The adjacent teeth need to be evaluated carefully for damage or trauma. The interoral camera revealed that the adjacent teeth also showed signs of fracture.

To relieve Adam’s pain, Dr. Adler preformed a root canal on tooth #8 and removed the damaged nerve. The root canal was necessary because the severe fracture exposed the pulp of the tooth to bacteria that live in the saliva. If left untreated, the tooth would continue to be a source of infection and eventually weaken the body’s immune system. The pulp is contained within an inner chamber of the tooth called the pulp chamber. Pulp is commonly referred to as the nerve but is actually a soft tissue make up o nerves, arteries, and veins. The pulp extends from the pulp chamber down through narrow channels, called the Boulder root canals, to the tips of the roots. The fear and pain associated with root canals are over rated. For most patients, getting a root canal is no more traumatic that having a filling done. During the process of the root canal, the doctor goes into the tooth and removes the pulp, cleaning the cavity. After the root canal, the tooth was temporarily bonded to give it a normal appearance while Adam was completing his treatment.

Prior to the crowns being custom made, Adam had his teeth whitened using our in-office Boulder teeth whitening by ZOOM. The main ingredient in Zoom is hydrogen peroxide, which works by oxygen enter the enamel and dentin was it breaks down. The oxygen bleaches colored substances and doesn’t harm the tooth structure. The Zoom light aids in activating the hydrogen peroxide and helps it penetrate the surface of the tooth. It is a simple procedure that can produce great results. With this new brighter smile, Adam was ready to have the shade taken for his new crown and veneers.

Once a root canal has been performed, the tooth is structurally weakened and prone to fractures and breaking if left as is. In Adam’s case, tooth #8 was crowned not only because of the root canal but because of the fractures caused by the accident. A carbon fiber post was placed on tooth #8 to adequately support the crown so the bite force would be properly distributed so that the tooth did no fracture.

Due to the fractures, teeth #7, 9, and 10 were prepared for porcelain veneers in Boulder dental office of Dr. Adler. A veneer is a thin shell of porcelain that is bonded to a tooth to improve its color or shape. A veneer generally covers only the front and top of a tooth. Veneers can be used to close spaces between teeth, lengthen small or misshapen teeth, or whiten stained or dark teeth. When teeth are fractured, as in Adam’s case, or beginning to wear, veneers can protect them from damage and restore their original appearance.

The teeth were prepared for the crown and veneers by removing any damaged areas. The teeth were then shaped to securely hold the crown/veneers. An impression of the teeth were then taken so the dental lab could make an accurate model of Adam’s mouth and then created a crown that precisely fit his mouth and bite. Unlike porcelain fused to metal crowns, all porcelain crowns are translucent and allow light to pass through the tooth like a natural tooth opposed to reflecting all the light which can make the tooth appear dark. Porcelain fused to metal crowns can also have a dark ring near the gum line which is not present with all porcelain crowns. The shade of the teeth is also very important to maintain the natural appearance. An underlying shade is taken of the prepared tooth, known as a stump shade, to better match the natural and subtle hues of the tooth. The shade of the crown made by this Boulder cosmetic dentist is also determined by the adjacent teeth. Whitening was done before this outer shade was taken to make sure the crown closely matched the other teeth and because crowns are not effected by the whitening process and so remain the same color as they are made.

Now Adam has a great new smile that he can’t help but show off and the results are dazzling.

For more information about Teeth Whitening in Boulder Colorado and Cosmetic Dentistry visit Dr. Adler's website at AdlerDentistry.com.