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South Jersey Cosmetic and Implant Dentistry

Collapsed Bite Makeovers

Dynamics of Bite Collapse

Normal wear and tear on our teeth will eventually cause gradual closing of a normal bite. An extreme example would be the tradtional "granny bite" we all associate with grandparents.

Collapsing Smile Since the average person has restorative or repair dentistry performed throughout the years, the physical properties of crowns, bridges, fillings, onlays will accelerate the process and cause uneven wear across different tooth structures.

Our featured patient, a sixty (60) something male, had the traditional signs of a collapsing smile. The wear and tear can easily be seen on the anterior teeth. They have become severely shortened. Notice how the patient's other natural teeth have similar loss in height. The discolored tooth structure in the upper arch is a crown and does not show the same amount of wear (porcelain wears differently).

Collapsing Smile Patients who are night grinders, daytime teeth clenchers and have not been treated for Bruxism have wear and tear issues that can become severe during early age, as early as the late 20's or 30's. The physical forces upon certain tooth structures can become destructive if the biting surfaces are uneven. Bruxers often complain of tooth breakage.

Left untreated, a collapsing bite can become worse and destructive in a short amount of time, depending on the characteristics of certain tooth structures

Smile Behavior

As our bites collapse, the ability to smile becomes more difficult. Typically, the upper lip does not move the way it did when our upper arch had normal height. As our bite slowly closes down, the upper lip reveals less of our upper teeth and may, for many patients, show more of the lower teeth. Efforts to force a normal smile may produce an odd appearance.

Bite Normalization

Most patients know something is missing when they have lost the ability to smile the way they did when bite characteristics were normal. Our patient had these issues along with some periodontal problems that most adult patients are faced with.

Our patient's change in bite required some attention for periodontal (gingivitis) gum disease issues and also orthodontic changes (alignment of certain tooth structures).

Collapsing Smile A custom combination of 6 Nobel Biocare dental implants, two 3-Unit bridges and a total of 12 IPS D.Sign porcelain crowns for creating the bridgework and restoring individual tooth structures were used to restablish the occlusal bite that was best normalized for the patient.

A custom palatal expander was used as needed to shift occlusal surfaces into an optimal position that would assure proper alignment of the upper and lower jaws. Contrary to popular belief, upper jawbone sutures can be altered in adults as they commonly are in pre-teen patients.

Occlusal studies performed by Dr. Petulla provided the technical data needed for recreating the lost bite and occlusion properties the patient once had... when his bite height (vertical dimension) was normal.

The technical analysis and ongoing monitoring provided by Dr. Petulla permitted the patient to focus on the cosmetic characteristics he wanted in his smile makeover while the details of maintaining near perfect dental health would be assured.

The functional and cosmetic outcome was quite dramatic... as seen in our last treatment photo.


Prospective patients are invited to schedule a makeover consultation. Specific questions about bite and occlusion or a suspected collapsed bite can be sent directly to our doctors via our on line Ask The Dentist form. Dr. Petulla will respond to you directly with the information you are seeking.

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Kristin Beth Petulla, D.D.S. - Jennifer Kazemi, D.M.D.

South Jersey Cosmetic Implant Family Dentistry
43 East Main Street Marlton, New Jersey NJ 08053 (856) 983-4846 - Fax (856) 983-1054
Cherry Hill Mount Laurel Moorestown Dental Aesthetics