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.

The Other White Crown - Dental Crown Restoration

It is a common myth that silver amalgam fillings last forever. They are very durable but are not indestructible. There are several reasons why a silver filling can fail. Fillings have to endure an incredible amount of biting force and over time, they become worn and turn black, and their edges wear away. Moisture and temperature changes can also cause the filling to expand and contract. This expansion can create a wedging effect in the tooth, which can fracture or break off tooth structure. The expansion can also lift the surface of the filling slightly creating a gap where the filling meets the tooth and allow bacteria into the tooth.

Jamie had begun to have sensitivity when flossing in her lower right molar, which had a large silver amalgam filling. Dr. Adler diagnosed recurrent decay in the tooth and recommended that an inlay (dental crown) be placed.



An inlay is similar to a filling and lies in between the cusps of the tooth. They are custom-made to fit the prepared cavity and are then cemented into place. An onlay is a more extensive dental restoration that replaces one or more cusps of a tooth. Onlays are indicated in situations where a substantial reconstruction is required. However, more of the tooth structure can be conserved compared to the placement of a crown.
To repair damage to the tooth’s biting surface, rather than using a simple filling, or a crown, Dr. Adler will often use an inlay, or an onlay. Inlays and onlays are made from porcelain because of its strength and ability to match the natural color of the tooth.



Dr. Adler prepared Jamie’s tooth by removing the old amalgam filling and the underlying decay. He then painted a reflective powder over the prepared tooth. Using a special camera, he took an accurate picture of the tooth which was then displayed on a computer screen, where he designed the inlay. Then the CEREC crown machine took over and automatically fabricated and shaped the restoration. CEREC is an acronym for Chairside Economical Restoration of Esthetic Ceramics. With CEREC there was no need for us to make an impression and send it to a lab. The inlay was then permanently bonded to Jamie’s tooth. The whole process took about an hour and Jamie was able to leave with a beautiful and healthy white tooth verses the discolored and decayed one that she came in with.

For more information about Boulder restorative dentist Dr. Adler, DDS please visit our website or call 303-449-1119 to schedule an appointment.