Q: I don’t know if you’ve come across a problem like mine but it’s getting serious. I’ve managed to keep some of my teeth. They are all very well capped and I have a partial denture that was machined to fit and it’s great. I’ve had a full upper denture for as long as I can remember and it has always fit snug as can be. When my bottom teeth were fixed and the partial was made the dentist examined my upper because it was a bit loose and I decided I wanted everything new so I had him make me a new upper denture as well. I’ve been a happy camper for three years. The last time I saw him I said the upper was getting a bit loose but it didn’t affect me much. He said if you start to notice it getting looser please let me know. Well it’s loose, really loose. He pointed out that I have essentially no bone left especially along the upper front. When I bite down it feels like my denture is pressing right under my nose and then the denture dislodges. He showed me that my front gums move like a reed in the wind. He said that’s because there is no bone for support. He said he can’t tighten that part of the mouth unless I get a graft put on that part of the jaw but then he said there may not be enough bone to even attach the graft too. I’m still in the public eye so, this scares me. He also said I don’t have any bone in back where my molars would go so what do I do? I’m afraid my teeth will fall out right in the middle of a speech.
A: Your situation, though not common, happens when one loses the upper front teeth while maintaining the lower front teeth and the molars are gone in both top and bottom arches. Because force from the lower anterior natural teeth is as great as ever, that force is too much for the upper anterior ridge. Over time resorption of that ridge is almost certain. When the boney ridge is gone, the remaining fleshy ridge becomes as flabby as a double chin.
The saving grace in your situation is that your sinuses provide a space were bone can be grafted and give you the bone needed for implants to act as roots for a bridge.
Once bone has been established, as many as four implants on each side can be placed and you can enjoy very secure teeth. It’s important to have at least three implants on each side to support the bridge because the shear forces on front teeth can put a lot of pressure on a bridge supported by posterior teeth. In your case the more the merrier.