Q: Dr. Crapo: I was a post-war baby and now just into my retirement, I say that to let you know I was here before fluoride use in toothpaste. I was around before regular dental care was part of one’s personal health maintenance. Going through childhood I always had toothache from my baby teeth. Then when my adult teeth came in, I had decay and fillings. I remember the grinder drills – it took forever to get a filling. Then I remember when the whiner drills came along – much faster and better but there was always some grinding too. I’ve had fillings, crowns, root canals and some implants. I get fixed up, it lasts for several years and then decay or breakage happens and I end up needing more work. Years ago, I had a partial denture made and it works pretty good though I seem to chew it up every three or four years. Recently I saw a very thorough chap and he said I could use some implants and that would get rid of my partial. It’d be nice not to take that thing out after every meal and clean it. He also said I need some gum grafts, a bone graft in my sinus to hold the implants, some crowns and then he said my front teeth need to be crowned for alignment purposes. He said it would help my over-bite too. It sounds like a lot of work. I’ve never been one to go for the full meal deal on dentistry and this sounds like a big refit – sort of like the Spirit Ferries. What do you think? Worth it?
A: There are text book reasons for doing things. Most of the time those reasons are valid and appropriate. Only you determine worth. If you need those things – which I’m sure you do, you will benefit in many ways.
First, in replacing the partial denture you will have no more pressure on your gums. Your bite will be stronger and chewing much better. The bone you have and that will be created, will be preserved.
Gum grafting is necessary to preserve the bone around your existing teeth and implants. If you have gum recession it means that you’ve lost bone around the roots of your teeth. Gum grafting is the process of replacing weak recessed spongy gums with hardy, tough gums that grows into the bone around your teeth, thus stabilizing the bone.
Crowning your front teeth to stabilize your bite is good practice when the front teeth are not doing their job. Their job is to police all the movements in your mouth. They tell or cause the back teeth to function in such a way as to grind your food efficiently but not grind the teeth themselves. Ultimately this reduces wear and tear and may well give more life to the dentistry you need.