Recession Proof Your Mouth

Question: Two years ago I became very aware that I was having recession around my teeth – especially the lower front teeth. It’s not that I hadn’t seen it before, but no one made it a priority. I became aware because I started to see looseness in my lower front teeth. It startled me so I immediately made an appointment with my dentist.

He said I’d lost over half of the bone around my roots. I asked him how that could have happened and he said I could have inherited weak gums and bone. If I was a smoker, which I’m not, that could have played a role. I know he said years ago I could go see a specialist about my receding gums but because it didn’t hurt then, it seemed to me unnecessary. I wish he would have said more. I asked him what I could do now, or would I have to get dentures or implants. He said he could fix the teeth together with bonding and that might get them through a few more years.

Desperate, I agreed, so he put this bonding all over my teeth. It looks like a mess, I can’t see the teeth for the bonding – it just looks like a blob! How does that help? It’s rough and hard to clean. Isn’t there a better solution? Can I keep my teeth or will I need to get them out and have a denture or implants?

Answer:  Gum recession can be a serious problem and should always be taken seriously. Genetics do play a role, as does smoking, plaque and calculus, and a misaligned and unbalanced bite. It should be noted that any loss of gum is proof that the underlying bone has been lost as well. If you lose an eighth of an inch of gums (3mm approximately), you’ve lost the same amount of bone. If you smoke, the recession and bone loss occurs more quickly, generally speaking. If you have a bad bite (which you personally may not be able to discern), that may also speed up the process.

Splinting or bonding the teeth together does at least two things. First, it immobilizes the teeth. Teeth that move or are loose, speed bone loss. Loose teeth gain strength when fixed to fellow teeth.

Splinting may also be made by crowning teeth. This produces better function, better esthetics and easier management. It is also much more permanent.

Without seeing your x-rays and moulds of your teeth, I can’t make a clear diagnosis or outline treatment, but I have several patients with extensive crown splinting where their bite was aligned properly and teeth strengthened. Two of the gentlemen that come to mind, have been that way for fifteen years and counting.

Implants will always work, but you may not have to go there.

My Teeth Don’t Like My Cooking

Question: Many years ago as I decided my vocation, I fell in love with cooking. Almost forty years later, I still love to cook. I make very good and tasty dishes. Each dish is sampled in its preparation to ensure taste and quality control. I’ve retired from commercial work but still cook at home for my wife and friends. I say this because when you’re cooking and tasting six days a week for long hours then fall into bed late after clean up only to sleep and start the day again, there is not a lot of time for self.

My teeth have been neglected over the years to the degree that I have lost all my lower molars and six or seven teeth on top so that I have really no biting power. I’ve got a partial denture but it is of little help. The only reason I really have it is because I have a missing front tooth and the partial fills that tooth space. I am supposed to chew better with it – but it’s mostly for looks…

I need to know what to do because one of the teeth that the partial clings to is loose and I know is going to fail soon. I don’t want a denture. I will lose all the fine tastes and textures that make eating and drinking such a pleasure but I don’t have a lot of options, I’ve been told. I’ve also been told I have an end to end bite so I’m naturally hard on my back teeth, I guess between decay and root canals, I really broke down my teeth. What can I do to get the best result? I know I’m going to lose more teeth so can I get help that will correct my bite and give me teeth to chew with?

Answer: I have seen a number of chefs over my career and this problem of tooth decay is not unique. Your lives are intense, and self-care is often secondary. Tooth loss unfortunately seems common to lifetime chefs. Most should be seeing a dentist and hygienist every three months so that cleaning and coaching on tooth and gum care becomes an important part of personal hygiene and self-care.

When many teeth are missing and jaw considerations are a threat to the existing teeth (your edge to edge bite) good dental records and analysis will inevitably lead to a full mouth reconstruction plan so teeth can be fabricated to the right position, the right angulation, and the right length for even wear, bite comfort, proper speech, and good aesthetics.

Today, existing teeth in the upper jaw can be gently removed and implants placed and a bridge put in place that will satisfy the above requirements. This treatment has an excellent track record.

Your lower molars can be replaced with implants that will support crowns. If your existing lower teeth need crowning to fill the requirements of reconstruction, that can be accomplished in a timely manner.