What’s Happened to Your Teeth

Q: This is a hard letter/confession to vocalize. During the Covid time with all its precautions and warnings, I was affected more that I knew. I consider myself a hardy person and am very conscientious. I am part of the dental health profession so this seems doubly hard.

About three or four months ago, I was having dinner with a dear friend-a confidante. This friend leaned over, after we’d sat and began our visit, and said, calling me by name, “What’s happened to your teeth?” “What do you mean,” I asked?” “they’re not visible like they used to be,” she said. “I haven’t noticed but I’ll check it out, thanks.” We returned to our discussion but my mind was in another place and it was very embarrassing

Next day I made an appointment for a thorough look-see. Records were made, x-rays taken, etc. Later I received a report of findings and I was astonished. I couldn’t believe that in three and a half years my teeth were so worn. The pictures they took were nothing like my once beautiful teeth. But the appearance was nothing compared to the wearing away that they said I had. The treatment was paralyzing.

I sought a second opinion and learned even more as I was shown every detail of the breakdown. This left me speechless as in that second report of findings I was shown a situation where underdiagnosis would lead to even more damage.

I don’t know where to start. Both dentists have assured me my teeth are restorable but there’s so much to do. Is one approach better that another? One talked about just my teeth but the second guy talked about my gums and reconstruction there, too. It’s confusing and I’m in the field of dentistry.

A: You are certainly not alone and its s on us as “dental specialists” in the field of medicine to communicate until you have clear direction and a critical path outlined to get you to the best state of dental health.

The order of care is this--address the greatest instability first and secure it. If teeth are badly broken down through decay, or wear, or looseness, start there, followed almost immediately by the gum reconstruction whatever that entails.

The greatest mechanical forces that produce the greatest instability are controlled by the front teeth. Often it is necessary to crown the upper six anterior teeth as well as the lower six anterior teeth. These teeth are meant to mediate the most damaging wear forces (shear forces). Adjustments can be made to your posterior teeth once these forces are properly coordinated. You may have to wait in your temporary crowns for a period until the gums are healthy and strong before going to completion but that’s fine. Going from a stability to stability; front teeth, gums, then back teeth will be a winner for you.

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

I Was Afraid To Deal With Teeth…Period. Then…

Q: Two years ago, I came to the realization that my teeth, my lower teeth wouldn’t make it through much more indecision.

They were starting to get loose, trap food and were painful to clean. Though I’m a medical professional myself, dentistry has never been easy. Finally, I screwed up enough courage and had my hopeless teeth out and teeth put in that same day. It went better than I thought and today my speech, my smile, my chewing ability is better than I can remember.

Having said that I only have eight teeth on top. They’ve been crowned but are in bad shape. The dentist told me there is decay creeping out from the edges and also the old porcelain on them is cracking.

They were repaired with bonding, but unsightly staining has appeared. They must be redone but my main question is what do I do for back teeth? Now I’ve got all these good lower back teeth I need uppers to chew with.

The problem is my sinuses. They are large which has thinned the bone where implants should go. I’ve been told that I can’t have implants because my bone is too thin. Do I go with a partial denture? I tried one on the bottom but it was a no go--I couldn’t wear it. I spent the money and the dentist couldn’t make it comfortable. I’m nervous about trying that again. Are there any other ideas?

A: Upper partials often function better than lower partials because they are out of the way. Cheeks, tongue and floor of the mouth muscles are affected by a lower partial. Sometimes one’s anatomy isn’t roomy enough to permit the comfort and stability needed for a partial to work in the lower jaw.

Having said that healthy sinuses offer an excellent opportunity to enlarge the needed bone for implants. The earliest pioneer of sinus grafting (Dr. Hilt Tatum) to enhance bone volume for implants started in 1974. I had the opportunity of seeing the master of sinus augmentation perform a number of sinus grafts in recent years (2018-2019). I was aware of his technique he finally settled on over thirty years ago. I have been using that technique for the last five years though I’ve been performing the procedure for over twenty.

It predictably allows bone to form in about five months. Then implants are placed into that newly formed bone and about four months later teeth can be made to fit the implants. In your case, grafting, then placing two implants on each side would give you posterior chewing power to greatly enhance your eating experience. If you start now your upper teeth will be as good as your lower in about nine months.

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

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