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.

Not Enough Bone?! Really?

Question:

As a kid up till I was out of university I saw the dentist and hygienist faithfully. Mom insisted we all go regularly. Even in university, Mom made sure, when we got home from school, we saw the dentist. I had great teeth. Once I was off the plan and on my own it wasn’t a priority. I was just too busy for my teeth.

One day as I was home visiting, Mom asked, “how long has it been since you’ve seen the dentist?” It had been five years. I had started smoking on the job and even got into a marijuana habit. The money was good and I was having a good time. I promised I’d go… but didn’t. Then one day, for the first time, I had a toothache. I couldn’t believe it! It surprised me so I found a dentist. He said, “You’ve got a couple of molars that need root canals.” “Can’t you feel holes in your teeth when that happens,” I asked? “Your decay went straight through the top of your teeth into the nerve,” he explained. Well, I had to have the root canals so I did. “Those teeth should be crowned,” he said, “Next month, ok?” Next month turned into next year when one day I bit down and heard a great crack. “What was that,” I thought! I sifted through what I was eating and pulled out most of one of the root canaled teeth.

“Can’t fix it,” said the dentist when I went back, “and the other one is gone too. They’ll have to come out.” That was a shock! Out they came. “How will I chew on that side,” I asked? “Implants, except you don’t have much bone.”

That was ten years ago but I’ve been told implants can’t be put there. Is that right? I’ve cleaned up my act and go regularly to the dentist and hygienist but it’s the pits that I lost my teeth!. Anyway – no to implants? Really?

Answer:

You’ve experienced what some other patients have when upper teeth are extracted. That is – very little bone between the ridge where your teeth were to your sinus. Historically, bone thickness there needs to be at least five millimeters thick for the shortest of implants to be placed to avoid the sinus.

In the last five years, however, great breakthroughs have advanced in sinus bone grafting. New technologies let us place implants into the sinus cavity the same day as bone goes in. In effect, a pathway to the sinus is made, the delicate sinus membrane freed so that bone can be inserted then the implant placed. This bone becomes your own and holds your implant fast.

Final word, yes to implants and the crowns that follow.