We meet people all the time who point to one of their very front teeth and say they have a small chip or a couple chips. (It looks like the picture above.) I was guilty of the same thoughts when I was a patient myself; I told my dentist I had a small chip and asked if he could fix it. He said “of course” and began to file down my front tooth, ever so slightly.
At the time I was thrilled; my “chip” was gone! (I am sure not a single person noticed it other than me.) He did, with the best of intentions, end up removing healthy tooth structure. Looking back now, I wish he had added some material to the tooth, even if I risked it chipping off, rather than removing my oh so sacred enamel. Let me explain what this area on the tooth actually is and why I feel this way.
The teeth start to develop under the gums when we are children. They begin as a small tooth bud and then start to take on the shape of a legitimate tooth, much like a baby when it is growing in the womb; first it’s a little bean shape, then a fetus, and then delivered as a baby. When the teeth develop they go from a bud to a coalescence of several development lobes. Then when the tooth erupts and makes its debut in the mouth, it has these bumps on them called mamelons. The mamelons are projections that are part of the development lobes that the tooth developed its final shape from. The enamel is hard, but the tooth is thinner under there and more susceptible to wear. With time and function, the teeth are worn down. When the tooth isn’t in full function, the mamelons are not in contact with anything abrasive and they remain on the tooth. It is a signal to the dentist that maybe your bite isn’t even everywhere, or that when your teeth are moving, not all teeth are bearing an equal load.
Your mouth is dynamic and teeth have ligaments around them, so your bite will never be 100% even or equal everywhere. The two front teeth are especially hard to align perfectly. It is common for one of the two front teeth to be a little longer than the other (by microns) and thus more susceptible to wear, sothe mamelons will wear down a little more on that front tooth. This is when you notice the space between the less worn mamelons on the OTHER tooth and consider it a chip, when it isn’t that at all.
To address this concern, we can file the tooth down as I had done, but that has its consequences. Commonly, and in my case, the filed tooth appears slightly shorter than its counterpart, something we don’t want. Additionally there can be a change to the optical properties of the tooth, because as the edge should have some translucency to it, giving it the appearance of health, vitality and youth. When I whiten, this tooth has slightly different optical properties because it gets much more opaque in color and looks a little like I am at a rave... something else we don’t want.
At Katy Trail Dental, we can examine the area and add a small amount of white filling material to the end of the tooth (no anesthesia or needle required) and you will never even know that you have some material on the end. Our filling materials have come a long way and are very cosmetic and discreet. It is incredible what we can do with composite nowadays! We will fill in your “chip,” the space between those mamelons, and leave your smile healthy and you happier with it!
If you feel as if you have a chip and think it is just the space in between the remainder of your mamelons, come see us to be evaluated so we can address your smile concerns in the most conservative way possible!