Q: Dear Dr. Crapo: I’m seventy and going strong. As a teenager, I lost all my upper teeth, so I’ve had a denture since then. The last denture was done six years ago. I’ve got eight teeth left on the bottom and I wear a partial denture, though it’s a bad fit. I saw a dentist who said I needed a couple of fillings and then a new partial and I should be good to go. The idea of a few hundred dollars and I’d be right as rain seemed appealing but didn’t feel right, so I saw someone else and he said though I didn’t have decay, my teeth were falling apart. I told him, I didn’t show upper teeth when speaking and I’d like to. He examined my upper denture and showed me that I’d ground right through my teeth. Who knew?! He showed me on the x-rays that as a result of having lower natural teeth biting against the denture and putting so much pressure against the denture, that I had lost a lot of bone.
I asked what could be done up there and he said either make a new upper denture so I could show more teeth and hope it would serve me well or graft bone for dental implants and go with bridgework. “What about the bottom” I said? Because my teeth are in such bad shape and I’d been asking about dental implants, he said I could probably have my teeth out and new teeth fixed to implants. That sounded pretty good but was expensive. I’ve taken some time to think about it and I’m wondering if I could keep my teeth. Somehow, I just don’t want to let them go. This guy said the lower teeth had good bone, so I’m hoping something can be done. I have from left to right my eyetooth (which has a crown on it) over to two teeth behind my lower right eyetooth. He said the bone behind my own teeth was not enough to take dental implants.
A: If we start on your lower teeth and if it’s not decay but only large or numerous fillings, these teeth can be crowned. In fact, two or more teeth need to be crowned and fused together to support the forces, a new partial denture would exert on the teeth. Crowning all of your lower teeth will not only make for better repair of your teeth, it will allow excellent engineering so that your new partial will fit and feel secure. Partial dentures can exert too much force on gums and bone if the force is not channeled through your teeth. The crowns are engineered in such a way as to take that force.
Your upper denture can be made to fit the new crowns in a natural and esthetically pleasing manner.