Dr.Crapo: I’m in my late fifties. I have had my share of decay and fillings, as most in that generation. I’ve lost several teeth which were filled in with a removable partial denture. That seemed to work for a good period of time and then I was told I should have my silver fillings out because of the mercury. After that, my partial didn’t fit very well and I’ve had several teeth with white fillings break. I don’t wear my partial anymore because it doesn’t go in and stay in. When I eat, it gets so much more food under it than before. My spaces on my top teeth show, so I don’t smile anymore. I’m thinking I should get implants so I can get crowns put in so that I can smile again and get rid of this terrible partial. I saw a dentist and he said I’ve got decay under the fillings that were put in. The ones that broke are very rough and hard to clean, so I’m sure they’ve got decay. I’ve still got my back molars but it’s the ones in front of them that are gone. The dentist also said my teeth are strong, at least the bone around them is strong and I know that’s true. Are implants the way to go?
Implants may well be the treatment of choice but there are other concerns as well. Teeth with large white fillings that are decaying, need to be addressed. As a side note, history has shown that very large silver fillings in posterior teeth should not be replaced with very large white fillings – especially if the person has a destructive (hard) bite. The life of a well placed large silver filling, is at least three times that of a similar sized white filling.
In the optimal situation, implants with crowns, as well as crowns on your natural teeth that are breaking down, would be the best choice. However, well done fixed bridges represent conventional treatment that is excellent.
Bridges (not removable partial dentures), have advantages and disadvantages. The advantages are substantial because teeth that need crowning on each side (back and front) of the gaps are crowned. The space is made up with a tooth that is fused to the crowns on each side. In other words, the bridge gets its anchorage through crowns fixed on the very teeth that need crowns. It’s a two for one situation – space filled, teeth crowned. It’s also less expensive.
The disadvantage is threading floss under the replacement tooth to ensure food and plaque are removed. If you have normal coordination, this feat is quite easily managed. Implants are easier to clean and not susceptible to decay, so it becomes a choice based on maintenance and what seems to have the most value to you.
If we can help, we’d like to. Call 778-410-2080 for a consultation.
Based on actual patient cases.