Q: Dear Dr. Crapo: I’m about to retire so I’m making a list of what needs to be done while I’ve got insurance and extra money coming in. One of the things that need addressing is my teeth. I can’t eat properly and it’s socially embarrassing. I sit there focusing on how to chew my food and I’m out of the conversation. I have lost all the bottom molars but have the rest of the teeth forward. I’ve lost a molar on my upper right so it leaves a gap.
I saw a dentist and he said I had a bridge in front of the gap and the back tooth it’s attached to (the one in front of the gap) is in very bad shape, so I’m going to lose the bridge. I went in thinking I could get a dental implant or two and I’d have something to eat with. He said my bone was good for implants but I have a lot of fillings and some crowns that need to be done. I left sort of overwhelmed and not knowing what to do, so I can eat again. That’s why I went in. Even if I could just get one side done for now. I’ve got a dental plan so that will pay for the fillings but not crowns. The more the dentist talked, the more confusing it seemed. I need some help here. Oh by the way, I smoke a pack of cigarettes a day.
A: If you have disease that’s affecting your upper right side, that needs to be taken care of soon and that would dictate the side to begin with. If I read this right, you have a bridge that attaches your upper right eyetooth to your second bicuspid. If the second bicuspid must go, you can at least save the crown on the eyetooth by sectioning (cutting) the bridge between the eyetooth and the pontic (that’s the fake tooth in the bridge). The bad tooth should then be removed and a bone graft placed in its socket to preserve the bone volume.
At that same appointment, dental implants could be placed in the molar area that you call the gap and in the space created by removing the “fake” tooth as well as two dental implants in the lower jaw. In two to three months, measurements can be made with impressions to create your new teeth. This will give you great function and eating ability.
Now the caveat – you must quit smoking for three to five weeks before the surgery and no smoking while things are healing. I know some people cheat and some get away with it but when they don’t; it’s very expensive and very discouraging.