This is My Worst Nightmare

Question: This is embarrassing and disastrous. I’ve never been good with my teeth. Even as a kid I was terrified. As an adult I always put the dental health of my kids and husband to the top of the list and me only when I couldn’t stand the pain. So, I had fillings only when I had a tooth that needed a root canal or pulling.

After the kids were long on their own, I still didn’t go to get my teeth checked or cleaned. For some reason I just couldn’t bring myself to do it.

But now I’ve got serious trouble. My front teeth broke away! I mean, they just all of a sudden started to wiggle, then move. When I talk, they move, no, fly forward like they’re going to ricochet out of my mouth. It’s such a helpless feeling. I don’t know what to do. What is happening? Can they be fixed? Will they just fall out on their own? I can’t be without my front teeth. I can’t go anywhere.

My husband said I’ll have to get dentures. I can’t imagine how that will happen. I know of a friend who had to have her teeth out and she was toothless for six months. Tell me that isn’t my future. Surely they can be saved or teeth screwed in or something. I can’t imagine myself without my teeth. Is this common? I’ve seen bad decay and broken teeth and rotting teeth but not teeth just getting so loose they’re going to fall out. Please, what do I do?

Answer: First off, yes, your situation can be remedied. But to answer your questions, you are suffering from severely advanced periodontal disease where inflammation left unchecked by inattention has “eaten” its way past your gums and into the bone around the roots of your teeth causing the bone to “dissolve” little by little until none was left. It is very likely that your bite has shifted as you have lost your teeth to extraction, so that extra force on fewer teeth also became a factor. Gum infection unchecked plus strong biting forces almost always leads to bone loss. When most of the bone is gone, the roots give way, the teeth become extremely loose, as in your case.

Today in almost 100% of the cases we see, there is a remedy. The procedure requires good CT scan x-rays (3-D x-rays) to determine where there is adequate bone in your dental arch (jawbone). Moulds are taken to know how to make the teeth that will replace your own. In a comfortable setting, your teeth will be carefully removed along with any disease, implants will be strategically placed, and custom bridgework custom made at the same appointment so you will leave with a beautiful smile and teeth that will work from day one.

This procedure is providing wonderful function for many folks that have problems where teeth cannot be saved or for whom dentures no longer serve.

I Think I Have TMJ

Question: I have prided myself on reaching my fifties with all my teeth except one wisdom tooth. I’ll explain in a minute. Up through my forties, I didn’t give my teeth much thought. I saw the hygienist kind of regularly but not religiously. My family has good teeth and every time I went, though I wasn’t diligent, I got a “good check-up, no cavities.” I thought, “Great,” then I’d let a year and a half go by, then two years, before going back.

A number of years after doing this, I did have a couple of cavities – big ones, so I got root canals. Then a year or so later, I began to have pain on the opposite side that ran over the side of my face, back of my head, and into my upper back. I saw a dentist and because my wisdom tooth seemed a bit tender, we put it down to that so I had that wisdom tooth pulled. I expected relief but it didn’t come and that has been several years. The pain is not debilitating but it really gets my attention and takes my focus from more important things. I’ve looked into it but can’t seem to find answers.

Recently, I saw a dentist who asked a bunch of questions and took a lot of x-rays and moulds of my teeth. After all the information gathering, I’m to go back and get a diagnosis but something interesting happened as I was about to leave. He said, “You have a deep overbite,” (something I knew). He said, “Because the pain is regional, over a large area, that is a good thing; proper treatment will relieve the pain.” That made me feel hopeful. What did he mean?

Answer: TMJ, or temporomandibular joint, is a shortened, almost acronym, of non-dental personnel to describe a painful aching or sharp pain that can affect the head, neck, back, and sometimes centres itself over the joint. This is a big topic so let’s keep it to your symptoms.

When pain is regional, it most often is a muscular response – lactic acid build-up and over exertion.

Though the root causes are multifaceted, clenching and retro pressure on the joint structure can set this off. It is exacerbated every time you swallow.

A deep overbite can often be found to be the mechanical cause. In other words, when you bring your teeth together, your lower jaw is forced backward because as the front teeth and bite come together, the final squeezing together of the teeth “levers” the jaw and joints rearward. This backward force stimulates muscle reactivity, meaning muscles that close the mouth and muscles that open the mouth are activated at the same time. Muscles that are supposed to be complementary become antagonistic as a result. This hyperactivity leads to muscle fatigue, lactic acid build-up, and pain.

Palliative and definitive treatment of muscular facial pain is available. It sounds like you are on the right track.