Q: I’m a thirty-nine-year-old frustrated denture wearer. Ten years ago I was having a lot of pain with my upper teeth. I got fed up and told my dentist I wanted the teeth out and a denture. He talked a bit about Implants but I said “no just pull’em and give me a denture”. He finally agreed and I thought—that solves that problem. Immediately, I couldn’t feel or taste my food like I used to but after a while I kind ‘a got used to it and put everything out of my mind. Then a year and a half later the denture got loose. I’d forgotten the bone shrinks so I went back and got a reline. That helped a lot but I’ve had to do that about every two years. A year ago I went and saw another dentist. He told me my bone was going away quicker that usual because I was putting a lot of pressure on my denture with my lower natural teeth. He showed me my bone and said “we need to get you into dental implants now before you lose more bone”.
It spooked me so I didn’t go back--until just two months ago. He said I’d lost more bone and he wondered if he could help me. He said he could graft some bone in one sinus to give that side enough bone but the other sinus looked like it had a hard growth in it so he wasn’t sure. I know I have to act soon but he doesn’t know if it’s possible. I feel like I gave up on my own teeth way too soon. Please advise.
A: I have seen your x-rays because I’m in your dentist’s study group that reviews challenging situations. My question is, do you clench your teeth? Extreme bone loss can have genetic, lifestyle (like smoking) and constant pressure as factors that increase the rate of bone loss. Bone grafting in your left sinus should be straight forward but grafting the right sinus will take more surgical skill and experience. Once completed, you’ll have adequate bone for three dental implants on each side in about 5 months. The very front of your boney ridge can be enlarged for a future implant. This is the bone that sits exactly behind the two upper front teeth when you had your own teeth. Most often, dental implants can be placed and a bridge fixed to those implants in at the same time. Sometimes (this has happened to me twice) a further four to five months is needed before the bone is set solid enough around the implants for this bridge.
Yours is a challenging situation and could take a year or longer to complete. As soon as this Pandemic is under control and dentists are back to their offices please start by deciding just how you want to proceed.