Walking on Eggshells
Question:
Dr.Crapo: I’m a sixty-four year old man who will retire in five years. I have good health with the exception of my teeth. I have had an upper denture since I was twenty. My lower teeth probably should have been removed because I’ve had forty plus years of fillings, breaks and extractions. I now have a partial lower denture that is held in place by six remaining teeth. I do not have any pain but I’m wondering if something should be done before I retire. I saw a dentist and he said I have very long roots and my remaining teeth are solid. He noted that I have very large sinuses under my upper denture, about the size of large eggs and the bone is eggshell thin. I don’t feel any problem with my upper denture; it’s the lower situation I am most concerned about. Another comment he made was that I lose a lot of bone after a tooth has been removed. This concerns me and makes me think I should be reinforcing it somehow. Can you please comment?
Answer: Many years ago a distinguished gentleman sought me out because his upper denture would no longer fit comfortably or stay in place. His remaining lower teeth consisted of six front teeth. These were in a poor state of health but savable. He too suffered from severe bone loss when teeth were removed and this had left him with an upper floppy ridge of gum tissue opposing his lower front teeth. Loss of bone, due to tooth loss, coupled with years of lower teeth pounding the upper anterior teeth of his denture destroyed all the bone under his gums. I have yet to see a situation this bad. He also had very large sinuses so it was a big problem for him. This was the early eighties, before we had predictable sinus grafting. Today, grafting bone in large sinuses where sinus walls are as thin as an egg shell is a very good idea. Once grafted, this bone is as solid as any in the body and can be used to support implants (and no there will not be sinus issues - infection or breathing).
Though your upper denture is stable, your natural lower front teeth could erode the anterior bone under your upper front denture teeth, similar to this gentleman. While your concerns are not immediate, fifteen years from now you may be glad for having taken precautions that will allow you disease free, comfortable chewing and speaking. As for your lower jaw, your historic loss of teeth suggests more to come. Placing implants now will prevent problems of decay and gum disease in the future and maintain the bone more surely than your natural teeth.
If we can help, we’d like to. Call 778-410-2080 for a consultation. Based on actual patient cases