Q: I’ve had a good life. I’ve had health, a good career and supportive family. On reflection, I’ve put a lot of good miles on this body of mine but perhaps neglected doing the small things to keep my dental health where it should be. I have had strong teeth all of my life or so it seemed until a couple of years ago when I was chewing some stringy beef and my upper left molar gave me a stab of pain. I got my bite of food down and then felt to see if I could feel anything wrong. It was the first big tooth or molar I guess that felt tender and a bit loose. That surprised me so I began checking all around and found a couple of others moving as well. Not good, I thought, so I made an appointment with the family dentist and to my surprise he said I had four teeth that had to go. He showed me why and I was blown away that so much damage had been done to the bone around my molars top and bottom. So, I had them out—they couldn’t be saved—no bone! Who knew?! He said once things healed I could get bridges. It was miserable because I couldn’t really get hold of my food and grind it properly. He told me that I’d had some general bone loss throughout my mouth probably due to my smoking for about twenty- five years but that the bridges would do the job. I’ve let this go now for almost two years but I still can’t chew like I used to. I’ve also done some research on dental implants and thought I might get implants. Then I thought why not just get all my teeth out and start over with new teeth because my own teeth, though strong, look terrible. Funny, I never thought about it before—what do you think?
A: When I hear that molar teeth are lost to gum and bone disease and the rest are still relatively strong my mind wants to know why. Often, I find lifestyle (smoking), sporadic hygiene cleaning and home maintenance are factors but grinding one’s food and perhaps night or day time grinding are factors. Not only that, your bite may also be a factor.
Don’t replace “good teeth” with implants, especially if most of your teeth are still strongly anchored in healthy gum and bone. Excellent analysis may well point the way to bite improvement which will balance the forces evenly on all your teeth. If implants to replace the missing molars can be placed they will also be more successful because they won’t have to shoulder the forces that “knocked out” your own teeth. Dental implants are very strong but lateral forces (side to side grinding) can cause bone loss around them as well.