Good Intentions Gone Wrong!

Question:

Dr. Crapo:  I was born about the time fluoride toothpaste hit Canada – late fifties, early sixties. When the T.V. ads hit the air, we couldn’t believe you’d go to the dentist and only have one cavity. Finally, it was the in thing by the time I was ten to make the switch to a fluoride toothpaste. By that time, I’d had teeth pulled because of decay and abscessing. Fortunately, they were only baby teeth, so when my permanents came in, I resolved to take better care. Well, like all good intentions, I’d get caught up in this or that and there would go my resolutions. I did make it to my adult years with all my teeth, albeit I have my share of root canals and huge fillings and crowns.

About two years ago I had a crown break off a root canaled tooth because of decay. I was just not careful and by the time I saw the dentist, the decay had completely spread under the crown. When the hygienist was cleaning my teeth, the crown was loose. She let me and the dentist know and before long he gave me the prognosis that the crown was lost. He had me come back but said he couldn’t promise that the tooth was strong enough to put a new crown on it. I went back hoping against hope but to my fears, the decay had travelled down the root too far to be strong enough for a new crown. He said the tooth would have to come out. Right there on the spot I couldn’t go through with it, so I said I can’t have it out – I’m just not prepared.

He said he could get rid of the decay and put a cap filling down the roots and just up to the gum line. I said ok because I wasn’t prepared to do anything at the time. It’s my lower left back tooth and chewing isn’t the same. He said I might be able to get an implant but wasn’t sure. I’d really like that tooth back, can an implant be put in?

Answer:

There are many things to be considered in answering your request. Why did the tooth start to decay when good procedures were put in place to save it i.e. crowning, root canaling? Is your bite causing stress that’s excessive, thus loosening the crown making it susceptible to bacterial invasion? Your diet, your cleaning – these are questions to be answered before you spend your money.

The answer is yes – the root can be removed and an implant placed immediately. In three months, you can start the process to have a new crown on that implant. This is a very predictable and successful procedure but answering the above questions will ensure that the procedure is not only successful but long lasting as well.

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.