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A Compromised Choice


Dr. Crapo

Question: Dr.Crapo: I’m a twenty-eight year old student. I have two teeth that are black, one of which is broken off. I can see dark black halos between some of my other front teeth. I still have all my upper teeth, though as I said, two are black. I saw a dentist and he said I had decay in all my upper teeth but they could be saved. That’s great because I’d like these teeth cleaned up so they look nice. My bottom teeth – well that’s another story. I have eight teeth left on the bottom and the back is broken and killing me. I was told by this dentist that I had three cavities on the lower front teeth but they could be fixed. I asked him if I got the front teeth fixed on the bottom, could he hook up some teeth so I’d have back teeth to chew with. He took a look to see and then said “you don’t have very much bone left”. He said he was surprised to see so much bone gone on someone my age. He thought bone was taken when the teeth were yarded. He said there wasn’t enough bone to put in implants and a partial denture might not have enough grip to stay in. I’ve got to get something done but I don’t have any money. Where do I go from here?


Answer: Because of your age and circumstance, you present a challenge. Let’s deal with age first. If you have lost most of the bone that once housed the roots of your posterior (back) teeth, implants become much more involved and expensive. If you’re going to have posterior teeth, a partial would only speed the further loss of bone. If you lose another tooth and three of the remaining seven have decay, then removing the remaining teeth and placing 4-6 implants would keep the bone you have left and give support for all your lower back teeth.

While you could keep your upper teeth, you’d have to develop extremely good dental maintenance habits or you’d be throwing good money after bad. In your case, because of the extensive decay, have your upper teeth removed and go with an upper denture.

I don’t usually advocate taking teeth out but given your age and condition, future decay could/would undermine your investment.

If you are in otherwise good health, take this plan to parents or anyone who might help. Ask for a loan and faithfully pay it off. You’re in a tough situation. Do all you can to care for your dental health, it’ll pay dividends.


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