Q: I’m sixty-five years old. I have a full upper denture and a lower partial denture. Ten days ago, I saw a dentist because it had been three and a half years since my last visit. I have no pain but I thought I had better get things checked out.
I have two teeth left on the lower right side and two on the lower left side – four teeth in all, holding my partial denture that fits o.k. He took x-rays and showed me that decay had taken off in one of my teeth. The tooth, he said, had died, even though I never had a toothache. He said that the teeth were still fairly tight, but I needed to crown them because they are crumbling. Crowning all the teeth will probably mean a new partial if I go that way.
No one has ever said how implants might help my situation, so I wonder. Should I get the root canal, four crowns and a new partial, or should I think about adding some implants? How would that work? Should I give up on my teeth?
A: There are many things you could do to have a good result. Let’s look at the pros and cons of keeping your teeth. Doing a root canal and then using crowns (preferably splinted or tied together for strength) is a good conventional way of going. If you have good bone support in the areas where the teeth are missing, then the pressure on the anchor teeth will be offset substantially. However, the bone will go away over time so relining your partial will be important – on average about every two to three years. Another concern is the decay that “took off” as you say. If you are decay prone this may even increase in severity because salivary output will decrease with age. A drier mouth always produces more decay.
The best, the fastest, the most functional way of employing implants is to do a “teeth-in-a-day” procedure. Your teeth would be removed, four or five implants placed and a bridge fabricated on them. Immediately you have a solid bridge that doesn’t come out and you clean it like people clean a bridge that is secured to their own teeth.
Other solutions using implants are many. If you want to hold costs down, think about two or three implants that would allow you to snap a denture into place. This will keep your denture teeth in and give you good security. Moving up in cost, you could use four to five implants, have a bar supported denture so relining the denture would never be an issue. These last two solutions require four to six months before you have full function.