Q: Over the years, I’ve tried to keep my teeth. Still, I’ve lost the back two teeth on the lower right side and a molar on the lower left side. I still have my very first molar on the upper left but the wisdom tooth and the one in front of it are gone. They were lost to decay.
My funds are limited but I have a broken front side tooth just by my upper left front tooth that I need to get fixed so I went to see a dentist and he did a very thorough work up. He checked my gums, my bite, the way I chew and then told me all the things that should be done. I was happy to get the information and I would like to do everything from correcting my bite (which I know has been bad from day one) to fixing teeth that are breaking apart in the back. I now understand I should get all my front teeth put right to help my bite. I know I need implants for the missing teeth. I know all my teeth have big fillings and need crowns. The problem is cost. I just can’t afford it. Is there some way to get all this work done one or two teeth at a time? The dentist said no but I’d really like to get it done and I think I could, if, it was broken up so I could pay for it little by little. I hate debt so is it possible?
A: When we do a full mouth reconstruction in dentistry- meaning all the teeth must be crowned or bridges placed or implants placed for crowns- there must be a starting and a finishing point. Normally front teeth- that means eye teeth, lateral incisors and central incisors must receive crown work, for both the top arch and the bottom arch. The fit and function must be precise and any fit problems in the posterior teeth corrected at least provisionally while the front teeth are being perfected functionally (sometimes back teeth have to be modified before they are crowned).
You have a full mouth reconstruction situation and it is best to proceed as stated. You can do it two teeth at a time but the overall cost would be much greater because they must be balanced and aligned as the procedure goes along. Changing only two teeth can throw off the whole bite and that would necessitate wearing an appliance 24-7- not practical or cost efficient. In your case try to have the bite you’ve got balanced as well as possible and fit the new crowns into that new balance.