Q: Dear Dr. Crapo: A:I'm 70 years old and I need some dental advice and help.
In the last ten years I've had more trouble with my teeth then the first sixty combined. I'm breaking and losing teeth like never before. In my working life I had all my teeth.
My dentist of thirty years kept me patched up and I don't remember having many problems other than a broken tooth or two – which he fixed with large fillings. At retirement before my dental plan ended, I asked him to fix anything that needed fixing. He said to me, “I'm going to do better than that; I'm going to send you to a specialist”.
I went but when I got the $60,000 bill I almost choked. When I told my dentist friend he said “I didn't know it would be that much”.
“I don't want to spend that kind of money”, I said. Several days later my dentist was on the phone to me. “I found out why the cost was so high” he said, “you've got all your teeth but the wear on them and your bite alignment requires a complete reconstruction. The specialist said that unless you take care of the alignment you'll continue to break and lose teeth – your costs will also go up over time and your alignment problems will be more complex”.
I wish I'd listened to him but that was so much money. I don't know that I could justify spending that much money on myself. I travel a lot and have thought of getting my work done in places where the dentistry is a fifth the cost. What do you suggest?
A: Today I saw a full mouth reconstruction (all twenty eight teeth crowned) done for a young man by a specialist in India. I was happy to see an acceptable fitting of each crown but felt sorry for the patient because his alignment hadn't been corrected and as a result he was breaking the new porcelain crowns in every quarter of his mouth.
Yesterday I saw a gentleman who had spent substantially less for his dentistry in Mexico. I fear for its longevity due to the quality of workmanship and materials used. What you're describing is a dilemma many face. The specialist you saw ten years ago was right – alignment trumps all – especially if you're hard on your teeth.
It requires extensive training and careful attention to hundreds of details to treat malalignments. Few can or want to tackle them. Be careful, if you're forced to lay out money a second time for a job inadequately done once, you may find that money is not the worst of your concerns. Your condition can be phased and should be, to ensure that it works every step of the way.