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.