It’s Another Whopper!

Q: I’m a sixty-something guy who’s had a lot of dentistry. Just about the time I get my teeth problems taken care of, something else rears its ugly head. I’ve had a couple of implant crowns done just recently, but then as the dentist was finishing them, he decided to take an x-ray and found a problem that’s a whopper. He found a molar with a crown that has a split root. Go figure, just my luck! I ask all kinds of questions only to find out that my best option is probably an extraction, a bone graft, then an implant. Another big bill! I hate the fact that dental plans don’t participate in implants. I’m not in any pain but the dentist said that the tooth is weak and the forces in my mouth that caused the break will just do more damage. What’s happening under the gum, can you tell? Will I for sure need a bone graft? Are there any other solutions? I’ve got teeth on each side of the broken tooth. The dentist said it was my six-year molar that was badly cracked. I’d like your take.

A: Roots of teeth don’t crack that often, especially if the tooth has been crowned. However, it does happen, so there are several facts that one needs to account for before attempting a fix. First, roots that are cracked leave a definite mark on the bone that is housing it. Usually there’s a significant loss of bone all around the crack. If you extract the whole tooth, a graft to restore bone is highly likely and you’ll want a lot of bone so that a big implant is supporting the new crown. A solution from the sixties/seventies is still possible. In this treatment, the offending root is sectioned from the tooth and extracted. Your molar at that point, becomes a bicuspid (small tooth in front of molars). If you make a bridge using the tooth behind the “new bicuspid” as an anchor and attaching it to the new bicuspid and the natural bicuspid in front of it (so three teeth in a row), you will make a good strong bridge and your plan will participate. The other good thing about this solution is the analysis of your bite that is necessary before you start. The treating dentist should find forces that can be redistributed more evenly in that part of your mouth. Though the implant idea is a stronger, more elegant solution, it takes time, costs more, and may not exact the same analysis of your bite which should be done no matter which route you take. Ask for the analysis to be done, whatever you decide.

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 Keep Losing My Teeth

Q: Just three years ago, I felt a problem in a molar that had been treated with a root canal and a crown several years before. When I saw the dentist, he said I had a gum abscess that was destroying the bone around the roots. It had to come out, so it was extracted, and a bone graft put in. Eighteen months later I had a similar problem, this time on the lower and upper right side. I lost four molars to gum abscesses. When the dentist did an x-ray, he was surprised to see lots of bone destruction around these four teeth. What surprised us both is that the x-rays just eighteen months earlier had not shown this destruction going on. It is distressing because now I have no molars to chew with on the right side. I thought of getting implants, so I went back and had a very thorough work-up. The result was that two lower right front teeth have lost a lot of bone which I’ve been feeling lately; I’m getting pockets and puffiness around these teeth. In the work-up, the dentist showed me that I’m grinding my teeth. I have always had a bad bite and I seem to fiddle with my teeth unconsciously. The dentist saw it and commented on it. My husband, who was with me at the consult, confirmed that during the day I do it all the time. Can that be the cause of my problem? This makes me very nervous to lose my teeth so quickly. I need teeth to chew with; what do I do? I’m in my early fifties, I need this to be taken care of.

A: Adults who have rapid tooth loss usually have a genetic trait that is seen in other family members but tooth loss usually starts earlier if genetics is the major cause. A genetic problem is manifested in parents or grandparents or both. Usually, some or all siblings will also manifest this problem. In some individuals, aggressive gum infection compounded with a bad bite and/or clenching and grinding can result in isolated teeth (that are taking most of the force) rapidly losing bone. Smoking is the fourth bad guy in the scenario. Before implants, in a case like this, perfecting and balancing the bite was orchestrated by a prosthodontist (crown and bridge and denture specialist) who would ensure harmonized function. He would temporize this new bite and ask a periodontist (a gum and bone surgeon) to do any surgery so that “pockets” were eliminated and gum support strengthened. Once healing took place and both specialists were satisfied, final crowns and bridges were installed. Today, that treatment is still available and can produce excellent results. Another solution is teeth in a day where one decides to remove the existing teeth (especially if a majority are not saveable). An excellent bite can be established and healing is predictable. Get as much information as possible then decide what’s best 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