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What’s the Squirrel in My Mouth Doing?




Question: 

Dear Dr. Crapo: I recently went to see the dentist. I’d moved so I decided to find someone in my new neighbourhood. The hygienist did a good job, in fact everything went well. The dentist was thorough, which I liked, but I learned some things I hadn’t realized. Its been two years since my last visit. I thought I was doing a good job, so I’d let my hygiene visits slide. He found some dangerous decay around my crowns – one might turn into a root canal! He wasn’t judgemental but the way he told me, I was all ears. Better yet, he explained why the decay was occurring and what I had to watch out for and what to do about it. He said I was “squirreling” food between my cheek and teeth and the bacteria had a food supply to grow up quickly and produce the acid that was eating my teeth. He showed me how to clean the buildup quickly. I have crowns on those teeth but the gum had receded and left part of the tooth and root exposed so bacteria could get in. I hope they don’t need to have new crowns. I’d lost all my six year molars many years ago and he pointed out the moving and receding of gums that’s going on around some of the teeth. About five years ago I lost my two front teeth in an accident. I got implants and crowns to replace them and they look great. The dentist said they were doing fine so I’m thinking maybe I should do more implants to fill in the gaps. The dentist said it might be possible or bridges to give me more chewing ability and hold the teeth in place. I’m not sure what is best.

Answer:
There are many variables here. It seems like the dangerous decay should be taken care of first. At the appointment where the decay is removed and an assessment could be made to decide whether fillings or crowns are needed, impressions could be taken to assess exactly what is involved in placing bridges or placing implants for crowns to fill in the “gaps”.

X-rays and perhaps C.T. Scans could be taken to see if your bone is ready and adequate to receive the implants or if grafting of bone would be necessary first. With grafting, implants can be placed in most all cases.

Another consideration would be the condition of the adjacent teeth. If the teeth are heavily filled or cracked, or perennially sensitive because of recession, bridging the teeth may make sense to correct all the problems.

Another consideration may be dental coverage and finances. Dental plans participate in bridges more than implants. Yet another consideration is age. As we get older our ability to get at hard to reach areas is sometimes compromised. Bridges in the back of the mouth are harder to clean than implants.

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


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