Headaches, Headaches, & More Headaches

Question: About eight years ago I had problems with my front teeth and they had to come out. I had to wait till my gums healed to get a partial flipper so I could at least smile. After a year I’d had enough because I couldn’t eat with it in my mouth so I went back and they said, “We can give you a new set of teeth that will stay in better.” This time I got a real partial with clips and such so it would stay in my mouth as I ate. It was a whole lot better for about two years when I started getting toothaches.

When I went back, I was told I was getting decay on my back teeth where the partial was hanging on. Some of the teeth he filled, and others had to get root canals. They told me to take them out at night, but I didn’t want to because I was afraid someone would see me without my teeth, so I kept them in.

Well the inevitable did happen and I lost a back tooth to decay. They even had to cut part of the partial off that was hanging onto that tooth. As the dentist was doing the adjusting, he said, “You should have a bridge and get rid of this partial. Why don’t we get some records and do a proper diagnosis. The thought of getting rid of the partial was welcome and exciting.

At the consultation appointment when the dentist was explaining the process of getting rid of the partial, he asked, “do you get headaches very often?” “Yes,” I said, “about three or four times a week.” “Where do your headaches register,” he said. I pointed to the sides of my head and back of my skull. “I thought that might be the case,” he said. “How did you know,” I asked? “When I was analyzing your models on the bite simulator, I could see your lower front teeth hitting the framework of the partial and they had a tendency to push your jaw backward. The pressing of your teeth meeting the partial pushes your jaw backward, then your muscles and joint react to that force and constantly feel ‘forced.’ This leads to headaches.” Will the bridge really get rid of my headaches?

Answer: You’ve experienced some serious setbacks. Losing teeth not once but at least twice, rampant decay, and then experiencing orthopaedic jaw problems.

Dental treatment and then good oral hygiene care is a team effort with you playing a significant part. Replacing teeth with either removable teeth (a partial) or fixed (cemented) bridgework requires careful attention and good communication so that the fit is excellent and the instructions for care are communicated over and over. We all learn better with repetition.

The bridgework is easier to clean and maintain, and if done well will reduce or eliminate headaches. It will make you less self-conscious about being seen without your front teeth because they will be a part of you.

Get it done, you’ll be very happy you did.

Too Many Cooks Spoil the Soup?

Question:

My mom is not a complainer but recently she told me of her challenge with her upper denture not staying in. She’s hard on her teeth and is constantly fussing to keep her upper denture in. She uses some kind of denture adhesive so they don’t fall out of her mouth. Even so, she moves her mouth around and if you’re close enough, you can hear her clicking her teeth. She claims to have a disorder of sorts where she’s constantly moving her jaw, so her teeth click. Her problem, though, is that she doesn’t have enough suction for her upper denture.

Two and a half years ago she saw a specialist who took her teeth out. She then went to a denturist for her dentures. She said there were complications with the surgery, and she had to go back a number of times because, the surgeon explained, she had tooth bits or bone sticking out of her gum so the denturist couldn’t make her dentures.

That happened on several occasions and finally she was able to have dentures. Then she was referred to another specialist to put in implants for her lower denture could be secured. That made it possible for the lower to stay in but the upper still was/is a problem. It was then she found out that a lot of bone in the upper had been ground away so that now there’s no bone up there for implants.

The poor woman is having all kinds of problems trying to keep her upper in to eat with and most of the time she has to go without her teeth. How does this kind of thing happen? She had most of her teeth, albeit in poor shape, but that means she had bone, right? Can nothing be done?

Answer:

It’s hard to come into a situation without all the details. When a person gets to the point of full mouth tooth extractions, it’s extremely important to start with a very comprehensive exam and diagnosis. If your mom had teeth top and bottom, there is usually bone enough for implants at that stage. Implants should be put in at the tooth extraction appointment or very soon thereafter or bone grafting done so there’s bone enough for implants. The other reason for thorough diagnosis is that some palates are not deep enough or shaped properly to allow suction of the upper denture to stay in.

A loose lower is a problem. A loose upper is a disaster and CAN BE DIAGNOSED before any teeth are removed – the poor suction potential can be seen before any treatment.

The Solution

In cases like these, sinus grafting has been a solution for over thirty years. Creating bone in the sinus will allow implants to be placed so a fixed bridge can be made. The grafts take six months to mature. Implants at that time can be placed for the future bridge. In some cases, newer implant techniques can not only provide teeth in a day but shorten the timeframe and lower costs of treatment.