Overwhelmed!

Question:

I’m from Poland. Two years ago, I moved to Canada. Last week I went to the dentist because a filling fell out. I also have other problems with some broken pieces, I don’t know if tooth or filling. He looked at my mouth then told me about other problems I wasn’t aware of. He told me I had a very strong bite. He said my bite was too strong for the fillings. He said my teeth would keep breaking. He told me my wisdom teeth were bad to keep. He said they make my bite even harder for my fillings. He told me one of my root canals was not working and I might need surgery on it. He told me my front teeth were dissolving and wearing very fast for my age. I am thirty-five. I don’t know why my teeth are dissolving and breaking. He said I would need crowns on my teeth. It sounds expensive and confuses me. This is the first time I have heard of these problems. I don’t know if it’s right all of these things. Can you tell me if this can be right? What do I do if it costs too much money?

Answer: 

Though the experience you’ve had may seem overwhelming – and it is – a careful and thorough approach is best. From what you’ve related, three forces are operating aggressively that must be checked. Mechanical forces are causing breakdown of your white fillings. Chemical forces are causing the erosion (dissolving) to your teeth and bacterial forces are causing your root canal to fail.

Mechanical forces (your bite forces) need to be managed with protective care. This will prevent destructive wear. Also, your dentist may well be right about your wisdom teeth. Many times, their removal decreases the mechanical forces in your mouth.

Chemical forces may be diet-related or part of your makeup. It will be very important to keep a written record for at least two weeks (a month is better) of everything you eat. Soda, sports drinks, and energy drinks can produce devastating breakdown in combination with grinding and clenching. It is also important to note the manner in which you drink. Swishing these drinks throughout your mouth is especially harmful. Front teeth are more affected by acidic drinks that are swished. Another source of acid is stomach acid that gets regurgitated up and into the back of the mouth and starts dissolving the inside and top of back teeth.

Finally, the bacterial problems associated with root canal failure may have to be solved surgically. This is done when there is no other route to eliminate the bacteria.

Start carefully, proceed from most urgent to least urgent, one step at a time. A good plan and consistent effort will save your teeth.

A Tall Order But That’s What I’d Like

Question:

I grew up in a remote village in Northern Alberta. Few amenities were available to us and because we were a large family, there was not a lot of money for my teeth. At a relatively early age I decided, after being persuaded by family members and a bad dental experience, to have my teeth out and get a denture to replace my top teeth – anyway, it would be so much cheaper, went the reasoning. Many good teeth were simply pulled out. Because of that experience, I’ve tried to save my lower teeth – what few I have left. I count nine and only three are in a good state of repair. Because I’m prone to decay and some of the bad ones are far gone, I must do something. I hate my denture but the shock of losing the rest of my teeth brings back bad memories. I’ve lived with the inevitability of making this decision for the past five years. I’ve gotten opinions about my options. A lower denture is out – I want something that really works, and I know a lot of people with lower dentures who say to avoid it at all costs. I’m leaning towards implants, but the recovery time seems long, and I don’t think I can adjust to seeing my lower teeth gone, left with a loose denture and stitches in my mouth. I’d like a quick transition. I’d like teeth on implants soon if not immediately, after my own teeth are gone and I’d like to be able to clean my teeth like my own. I know that’s a tall order but that’s what I’d like.

Answer: You have several options if you make a few allowances, but only one if you insist on cleaning the implant teeth exactly as your own.

Because your situation pertains to lower implant teeth and you have lower teeth in place now, albeit in compromised condition, teeth replacement on the day of your appointment can readily be accomplished. This option is the fastest of all options and there is no down time, no time for you to look at yourself without teeth and barely will you see any stitches. The only drawback is that you have to clean under the teeth like a bridge. This takes a bit of practice but is quite manageable.

The second situation would have you replace each tooth with an implant – wear a denture for several days to a couple weeks, while temporary crowns are made to fit the implants. Then in two to three months, porcelain teeth are made and fitted to the implants. This option is more expensive, but you will be able to clean them just like normal teeth – flossing and brushing as if you’ve been given a new set of adult teeth.