A 53-year-old patient presented for the removal of a mobile deciduous tooth on the upper right. Interesting enough, when she occludes, as you can see in the photographs, she has only contact on her second molars and has had an open bite for her entire life. 

She underwent some form of orthodontics, probably to rearrange her teeth years ago, but certainly no effort was made to close the open bite, if that was even possible non-surgically. 

What is interesting about this individual is that she only contacts on her second molars. You can see that in the photographs and on the scan. 

She has no mobility of any of the teeth and, shockingly, has no difficulty eating and is unaware of the fact that the other teeth do not touch. 

In addition, as you can note, she has recession on #10 and #11 and lateral and on the right side there is no recession. 

There’s always been a conversation whether occlusal trauma causes recession, but here is an example where there is no contact, let alone trauma. The resulting recession is due to the width of the alveolus and the width of the teeth. 

What is most unusual is her ability to eat normally and have no awareness of the problem, despite having only two teeth that contact. 

Biological adaption is remarkable. 

As always, I appreciate your feedback 

Yours truly, 

Dr. Victor M. Sternberg 

By Westchester Center for Periodontal & Implant Excellence

December 31, 2023