Functional anatomic filling of teeth worn down by grinding
Functional anatomic filling is the restoration of missing anatomical structures of worn-down teeth using composite material.
Functional anatomic filling is needed when bruxism (teeth grinding) wears away important dental anatomical structures that are essential for correct functional jaw movements and for maintaining the bite height and stability.
Bruxism is tooth wear caused by tension in the chewing muscles and uncontrolled excessive clenching. This parafunction is affecting an ever larger share of the population.
Grinding most often occurs at night, as bite control is lost during sleep. However, wear can also occur during the day (e.g. in stressful situations or during sport). The main cause is acknowledged to be the particularly intense pace of modern life and the psychological stress it brings.
At our clinic, functional anatomic filling is performed by Dr Gintarė Žmuidinavičienė, a dentist with many years of experience in this area. The procedure uses magnifying loupes and top-standard bonding and composite filling materials. All of this ensures maximum precision, restoration strength and the highest work quality, so that after just a few visits patients can enjoy a precise and lasting result with their newly restored teeth.
Recommendations before the functional anatomic filling procedure:
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- professional oral hygiene must have been done no longer than 6–12 months ago;
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- a panoramic X-ray no older than 6 months is required;
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- before restoration, the teeth must be healthy — all carious cavities must be treated;
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- come to the procedure with teeth and interdental spaces thoroughly cleaned;
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- come to the procedure after eating, so that salivation is reduced.
It should be noted that after restoration of worn-down teeth with functional anatomic fillings, a protective bruxism night guard must be worn every night.
Composite filling material is softer than tooth enamel, so without wearing the night guard, the fillings would wear down faster than natural teeth. Wearing the night guard is very important, as it is the only way to protect composite restorations from repeated wear or chipping.
Procedure steps:
Visit I. During the consultation (15–30 min), the dentist performs an examination and determines the degree of wear. It is decided whether an individual wax-up of the tooth surface and the resulting template filling trays will be required before the filling procedure. The number and duration of visits are also scheduled. Visits are usually planned to be as long as possible (5–6 hours), so that as many teeth as possible can be restored in a single session. The new bite is then more comfortable, more stable, and adaptation is faster.
Visit II. Impressions and bite registrations are taken for the wax-up (30 min) — individual impressions of both jaws, facebow and the future bite height (CO) registrations — and sent to the dental technician’s laboratory. Based on the material received, the dental technician creates virtual jaw models and performs a careful wax-up of the worn tooth structures, then makes template filling trays for the dentist.
Visits III and IV. During the first session, the aim is to fill as many teeth as possible for better bite stability and easier adaptation (5–6 hours each, of which 20–30 min per tooth). The surfaces of the teeth being filled are roughened with sandblasting, and filling is carried out using the dental technician’s wax-up and the template trays as a guide.
Visit V. A 30–60 min check-up, occlusion correction and, if needed, polishing, plus impressions for the protective bruxism guard.
F. A. Q.
What are the possible consequences of not restoring tooth wear in time?
- Unwanted tooth sensitivity or pain (as the protective enamel wears down, the deeper, softer, more sensitive dentin is exposed, which is not designed to be open).
- Increased muscle tension due to the lowered bite, and the unwanted jaw joint or headache pain that follows.
- Bite changes that may require orthodontic treatment with braces or aligners in the future.
How long does functional anatomic filling last?
Functional anatomic filling lasts 5 years or longer. The lifespan of a filling depends on the size of the defect, regular use of the night guard and individual oral hygiene. It should be noted that a filling is weaker than natural tooth enamel and so wears down more quickly. For higher degrees of wear, restoration with all-ceramic onlays is recommended for a stronger and more long-lasting result.
What should I do if I cannot get used to wearing the night guard? Is functional anatomic filling still worth it in that case?
It does happen that some patients cannot get a good night’s sleep with the guard and so do not wear it. In any case, functional anatomic restoration is necessary in order to avoid the complications listed above. However, it should be noted that fillings wear down faster than teeth, so without the protective guard they may wear or chip more quickly. This means the lifespan of the restorations will be shorter and more frequent refilling may be required. In any case, it is better for the filling to wear down than for the natural tooth tissue to keep wearing away with all the possible consequences.
Can I eat right after the procedure?
The latest generation of UV-light cured composite fillings is used, so you can eat straight after the procedure.
What sensations are possible after the procedure?
After the procedure, temporary bite discomfort, taste changes and lisping are possible, usually passing within 2 weeks. With teeth gradually wearing down over a long time, the muscles adapt, so usually no discomfort is felt. But when teeth are suddenly restored to higher anatomical fillings, it is normal for the muscles and brain to be shocked, so some adaptation time is needed.
What care is required after functional anatomic filling?
- Regular cleaning with a toothbrush, floss and interdental brushes just like for natural teeth.
- Wearing the bruxism guard every night.
- Regular professional oral hygiene and polishing of the fillings at least once a year.
- With more extensive restorations, avoid biting particularly hard foods (toasted bread, nuts, etc.) to prevent chipping. For higher degrees of tooth wear and to achieve the strongest, longest-lasting result, restoration with all-ceramic onlays is recommended instead of fillings.
How is functional anatomic filling different from regular tooth filling?
With functional anatomic filling, tooth drilling is not required, as this is not caries treatment. Only minimal roughening of the surface of the tooth being restored is needed for better bonding with the composite material.
Is the procedure painful?
The procedure is usually not painful, unless a very high degree of wear close to the nerve is observed. In that case, anaesthesia is given before the procedure to avoid discomfort.
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