“What If We Didn’t Have Implants?”

Question:

Dear Dr. Crapo: I’m eighty years old and I just broke a tooth, at least that’s what I thought, so I went to the dentist. It was very painful when I bit down but it was two days before he could get me in. By that time it seemed that every time I swallowed it hurt. When he saw it he said I’d split the tooth and it’d have to be pulled. I asked if he couldn’t save it and put a crown on it but he said he couldn’t and would send me to a specialist because it had to be taken out surgically. I told him I couldn’t part with the tooth, so I left his office and went to see another dentist. He told me something similar but gave me more options. He said that I’d split the tooth down the root and the break was below the bone. He suggested I get it pulled and have an implant. I hadn’t even thought of that, so I asked him how the tooth could be saved if implants didn’t exist. He said I’d have to see a specialist to have the gum and bone cut back so that a crown could be made to fit at or just below the break. He said I’d probably have to have a root canal because the break was close to the nerve and by the time the tooth was trimmed up for the crown the nerve wouldn’t be happy, so I’d need to think root canal before the crown. He said that theoretically I could be going to three specialists to get the tooth fixed or two to get an implant crown. What’s best?

Answer:

In 1965, 1975 or 1985, saving the tooth would have been the best option. It would have been handled by three specialists – a periodontist – one who has been trained in gum and bone surgery around the teeth; an endodontist – one who has been trained to treat the inside of teeth; and a prosthodontist – who trims the tooth and prepares it to receive a crown.

This is still a valid way of treating teeth. Some dentists are trained to do all three procedures.

Are you trying to save the tooth because of cost, your age, or the thought of an implant puts you off?

If I was a family member I would suggest the implant for several reasons. First it’s stronger. It will not decay and it maintains the bone better. It is a less complex procedure and there is less pain because an immediate implant placement is relatively atraumatic - the gums and bone are not cut away.

The time from start to finish is about the same as if three specialists are involved and the cost may be similar.

Done well, either option will serve you well.

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

Back to the column

Getting A Grip On Things!

Q: Dr. Crapo:    Nine years ago, I decided I wanted a better set of teeth.

I had an upper denture and seven lower teeth with a partial. I had implants put in for new top teeth and crowns and a new partial made for my lower teeth. I had good care as far as I know and everything has worked well until three months ago when my implants on the upper denture wouldn’t hold my teeth in securely. I have two implants on each side of my upper jaw that hold the upper teeth in by a snap device that clicks when the teeth are in their proper place. The problem is that the snaps seem to have lost their grip. When I put the teeth in it seems to hold only to loosen and begin to fall as I speak or eat. It’s very frustrating. I went back to the fellow that put them in, but he says there’s nothing more he can do. He’s tried new snaps but that hasn’t worked. What am I to do? I’ve got implants – they seem fine but the part that makes them hold my teeth in place doesn’t work like it has for almost nine years. Will I have to go back to a denture where the palate is covered and just forget about the expense of the implants and the joy it’s been to have secure teeth and the ability to taste my food properly?

A:  You actually have many options that will work. As you proceed, do so carefully to find why the snap system isn’t working. The snaps you describe, that are most popular, resemble the snap button on a western style shirt; only they consist of a metal male part on the implant that fits into a plastic female part that’s housed in your denture. Sometimes it’s as easy as replacing the plastic female piece with one stronger in retention grip. Try that first. If after a few days or weeks that fails, the metal male component may be worn. Magnified examination will reveal wear if it’s present. Replacing the ones showing wear may well return the retention you need.

If those solutions prove unsatisfactory, consider that in the past decade surprising advances have been made in securing teeth permanently that are closer to your natural teeth than ever before and allow you to eat immediately.

If the four implants are in good shape and in the right location, a bridge may be constructed and fixed into position so that removing it is not necessary. An even more lifelike bridge could be created by adding an additional two implants (if the first four are in the right location) and no one will know they are not your own permanent teeth.

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

Based on actual patient cases

@ Calvin Ross Crapo

Victoria Implant Centre

778-410-2080

www.VictoriaImplantCentre.com