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Figure 2: With retractors, we get a much better picture of the challenge
we are up against. When a young patient takes tetracycline
while their primary or permanent teeth are forming, the tetracycline
chelates, or binds, to calcium ions present on the hydroxyapatite
crystals in the dentin and, to a lesser degree, in the enamel.
Figure 1: My experience with tetracycline patients is that they have
spent most of their lives trying not to smile. Even though smiling is
an involuntary reaction to something that strikes us as funny, the
majority of these patients become adept at smiling with stiff lips to
cover as much of their teeth as possible.
Figure 3: This view of the maxillary arch reveals the abuse that
goes on in this patient’s mouth. The effect of his edge-to-edge
bite is clear from the wear on the unrestored teeth. The strength
of this patient’s musculature is also clear from the broken PFMs.
Kudos to the dentist who put the cast metal crown on tooth #15;
it’s doing fine!
24 www.chairsidemagazine.com