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Question:
Dr. Crapo: Yesterday I saw a dentist who gave me a where-the-heck-have-you-been—this-is-the-twenty-first-century-look! I’m forty but my dental situation looks like it’s ninety. I’ve broken teeth all my life—largely because they’d get decay and then break. I have a very high pain threshold, or so I’m told, because I never seem to have pain even when the decay goes right into my nerves. My problem is that my right front tooth is broken and decayed to the gums; it looks terrible. I grew a mustache to hide it. I’ve got two side teeth broken on my upper right side behind my eyetooth, so when I smile—I don’t anymore—it looks like a black abyss. My back teeth are gone on the lower left side and the lower right. The dentist said I might not have enough bone for implants on either side. He said I have an extremely hard bite, a bad bite, and a disastrous trend to decay. He thought I’d need to get some implants for the upper teeth (front and side) and maybe a partial for the lower. I’ve also got a tooth behind my upper left eyetooth that’s got decay to the nerve that he said needs a root canal and a crown. I don’t like the idea of a partial. I’d like to get a better bite too, but where do I start?


Answer:
Your treatment is multifaceted. Some things need addressing immediately because of organic disease and other things need treatment and a time for healing.


Once two- and three-dimensional X-rays are taken and models (molds) are made of your mouth, a treatment plan can be created. Usually decay is removed as well as tooth/root fragments. During this period if bone allows, implants can be placed. Unsaveable teeth can often be replaced with implants.


You will go through a healing period of about three weeks after the decay is taken care of and the implants placed. From there, you would start with your front teeth—upper and lower. Establishing a proper bite begins with front teeth. They will ultimately guide the rest of the teeth and help ensure that you stop the propensity to break back teeth. If you decide to have an implant replace the right front tooth, the work on the front teeth can stay in temporary form until the implant is ready to be crowned.


Make sure this step happens first. Hopefully the three-dimensional X-rays will show enough bone and implants are placed. Once the front is completed, you can proceed with fixing crowns to your remaining natural teeth and implants one side at a time. This will allow you to work within a budget and be on your way to a great bite and beautiful smile.


If we can help, we’d like to. Call 778-410-2080 for a free consultation.


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