Disease and Function – Do I Have A Choice?

Q: I am deathly afraid of dentists. I have always had trouble with cavities since I was a child. As an adult I’ve had tons and tons of work. So much so that a few years ago I decided I just couldn’t go back and have the dentist say you’ve got three more cavities, or four, or five. It was a bad decision because I was forced back by a toothache that ended up as a root canal and a crown. If only I’d gone sooner, it would have been a filling – ten times cheaper and far less painful.

Well, I decided I needed to go and get a very thorough exam and have every nook and cranny looked at. I want to have healthy teeth that look nice, too. I’ve got old white fillings in the front that look like there’s rust all around the edges. Brush as I might, it won’t come off.

So, off I went and had a session of x-rays, exams, moulds of my teeth, and all kind of measurements. The dentist took a long time on each tooth and that made me nervous because I know he was finding stuff I had no idea of. Well, I went back later for the consultation and was blown away. When decay and old fillings get just so big, the tooth needs a crown. When your teeth don’t fit just right, those crowns have to be made so that your bite works better. No one has ever talked about my bite fitting better with crowns. I thought at best crowns just held everything together and made the tooth stronger than having a big filling.

I can’t do it all, how do I fix my teeth? It’s too much money. If this is an all or nothing deal, I’m going to have to have dentures and that I don’t want. Give me some perspective, please!

A: You’ve landed in a good place and your concerns are justified. When a dentition is analyzed, there are two general areas of concern: disease and function.

Disease has many manifestations, but decay and gum disease are the most prominent, as you’ve experienced. It is important that all disease is eliminated and that might include abscessing of teeth when decay has overwhelmed both the teeth and nerves (and sometimes the gums and bone).

Function requires the teeth be in the right position, at the right angle, and the right length and all teeth be in harmony with the joints and muscles of your jaws.

Functional reconstruction includes all disease removal and exact placement of crowns, implants, and bridges. If finances do not permit a reconstruction of your whole oral system, you may have to treat the disease at this time and put off the additional expense of functionally perfecting your bite until your finances can handle these changes.

Freeing your mouth of disease is very important, take care of it now.

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

A Chip Off The Old Block

Q: Dr. Crapo: Many years ago (thirty-five plus), I had extensive bridgework. I lost my right eye teeth and the one beside it towards the front. Over the years it has held up well but I’m hard on my teeth. I’ve broken off porcelain from my eyetooth, which I guess is a fake tooth. The bridge is still hanging in there but I had to have the piece of porcelain bonded back on. I know it’s just a matter of time till something bad happens – so I went to a dentist to ask him about dental implants for those two lost teeth. He said I didn’t have enough bone for that, so I’d have to get a new bridge. He said the bridge might have to be a bit longer or larger, I can’t remember which, because the teeth the bridge is fixed to won’t give me the same life as this one did. He said I was losing some bone support around the anchor teeth, so more teeth had to be included so the bridge would last.

About fifteen years ago I had lower implants on both sides and they’ve been great. I’d sure like to have implants if there’s any way – it seems like they’re so strong. The bottom crowns that were made for my lower implants make eating such a breeze and I never have any sensitivity – way better than my own teeth. I’d sure like it if dental implants were possible.

A: Imaging technology allows us to see and determine the possibilities of a situation like yours. As you may know, implants must have good bone in all three dimensions – length for adequate strength to support a crown – (in natural teeth the root makes up approximately two-thirds to three-quarters of the entire length of the tooth and is anchored in jaw bone) - width of bone to approximate the titanium root (implant) to a similar position of the missing teeth and in proper relationship to your existing natural teeth beside them - finally thickness of bone for bulk and dimension to accept, house and surround the root-like cylinder screw which is what the implant is.

If you have enough length and width but not enough thickness, which can be remedied with a piece of bone that is taken from your jaw and relocated into the spot where the thickness is needed. This type of bone graft takes about four months to heal and fuse to your existing bone that once housed those lost teeth, then at four months dental implants can be placed and three months later, crowns can be made. During the surgeries a temporary bridge is fabricated so that the space is not unsightly. Though this is more involved it is a common practice and produces excellent functional results.

You can always count on Dr. C Ross Crapo & Associates in protecting your oral health. We specialize in family dentistry, cosmetic dentistry, implant dentistry and restorative 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

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