But What if I Want to Keep My Teeth?

Q: I’ve kept most of my teeth to this point of my life even though I was told by my parents when I get old, I’d lose my teeth and have to have dentures. True to form, I’ve had siblings both younger and older lose their teeth and now have dentures.

Even my wife has lost most of her teeth but now, because of implants, has nice teeth that are comfortable, and she can eat anything. With her having a good experience, I thought I’d go and get an assessment of my own teeth and where things stood.

I got a thorough exam with all the x-rays and moulds and went back to see the results. Now I have to admit that I’ve lost about four teeth, one in the front, two on one side, and one on the other; all on the top.

The results were, in my mind, slightly confusing. When I pressed the doctor, he had told me that I’d lost about one third to, in some places, one-half of the bone around the roots and in three spots about 80 percent on the sides of three teeth that he called key teeth (my eye teeth).

He said his general impression was that I would fair best with implants and bridges placed all in one sitting – similar to my wife.

Inwardly, I suspected this might be the case but I wanted to be the exception so I said you told me none of my teeth were moving so why can’t you do something to strengthen them so that I can keep them? I’m going back to see a new plan. Am I looking for something that is just a lost cause or is there a shot at keeping my teeth long term?

A: I see many folks as they get into their senior years that have similar questions. Here’s my general response: if the teeth can be balanced so that the functional forces can be evenly distributed, they are easy to clean and maintain, and if your daily care and cleaning is up to your hygienist’s instructions, then yes, keep them.

In your case, bone grafting may have to occur on those three teeth where you’ve lost a great deal of bone. Bridging, coupling of teeth by crowns and implants in the open spaces where you’ve lost teeth will also help to meet and balance the forces that have influenced bone loss.

The great proviso in any treatment like this or treatment your wife has received is to make sure you’re not a smoker. Smoking of any kind is one of the four pillars that cause tooth loss in adults. Also, be prepared for this treatment to take some time as healing and proof of surgical success is necessary on teeth that have excessive bone loss. From start to finish, it could easily take a year.

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

Fussy... May Be Good

Q: Dr. Crapo: I’ve got a bit of a dilemma and I don’t know if I’m being too fussy, (aka) anal, or if my doctors dentists) are not explaining things. Several years ago, I had a root canal on my last upper left molar. The tooth as then crowned and everything has been okay.

Six months ago, I felt a little tenderness on the gum beside the tooth, but it only lasted a day or two. I had an appointment with my dentist for a cleaning, so I thought I’ll just have him check it out then. At the appointment, he took an x-ray.

When he saw it he was very surprised and said, after looking in my mouth, that the tooth was lost. I’m very logged about why things have to be done, so I asked him a bunch of questions to which he just kept saying, there’s a lot of disease around the roots of the tooth and the tooth was probably cracked, so it couldn’t be saved. I asked if he could send me for a second opinion which he did, because he doesn’t extract teeth. When I saw the surgeon, he said it needed to come out because the root canal had failed and that was the best thing to do.

Here’s my dilemma. I don’t understand what’s happened, other than they said the root is cracked. Is that all that can be done? What happens to the tooth (its biting opposite) on the bottom? I don’t want to lose the tooth, but

mostly I want understanding and options.

A: When a bridge comes loose there is always a reason. Sometimes it is operator (the dentist) fault; other times it’s an anatomic problem that is not discovered before the procedure (i.e. a bad bite).

Most of the time it is the latter, but careful analysis before the bridge is made, prevents your kind of problem most of the time.

When you’re told that too much bone was removed from the side, it means that one of the four sides of the socket was broken away as the tooth was removed. Most of the time, it is the cheek side portion. This inevitably makes the ridge of bone narrower than is ideal or too narrow for implant placement. On upper teeth, the ridge may have also shrunk to the point that it is too close to the sinus. Your problem is a narrow ridge and not enough room between the ridge and the sinus.

A bone graft of the ridge and the sinus will give you enough bone to place the implant. This grafting can be done together so that six to eight months later an implant can be placed. The root canal should be reassessed. Decay means leakage and leakage may compromise your root canal. Have that done and then place the crown while the bone graft is maturing. Lastly, be sure that your bite is not going to place excessive force on the new dentistry.

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