Q: Dr. Crapo: I don't have a lot of money but I've got to get something done because my teeth are getting loose and beyond fixing.
I have three teeth on my upper with a partial that fits, but it is breaking down. It still works but I've been told that it will need replacing in the future.
My great concern is my lower teeth. I've seen someone who said I could get a denture supported by two implants. I would see one person to extract all my loose teeth, then get the implants and then I would see someone else for the denture and the hook up on the implants.
I'm a clencher and a grinder. I used to smoke but I don't anymore – actually I'm on a vapor smoking program. I'm afraid that I might put a lot of pressure on the new teeth and break them as I've broken my own teeth.
I've been told that I've got good bone around the upper three teeth (two molars and an eye tooth) and good bone where the teeth are missing. The upper partial isn't as strong on the side missing my eyetooth, but it's working.
In the morning I can feel that I've been grinding my teeth, so I know I could break a tooth any time. I need to get the bottom fixed and then maybe a new denture with implants on the top. I need to know if that would work or if I need new teeth top and bottom at the same time.
A: Two implants supporting a lower denture can work, however in the past year, I've seen people with two implants supporting lower teeth, who have come in because the two implants were placed too close together and that produces a less than stable situation.
The complaint has been that chewing anything hard or sticky actually causes the back of the denture to lift. This then allows food under the denture and a painful bite as food particles are crushed between the gum and the denture.
The two implants must be as far apart as possible, so that this phenomenon doesn't occur. A better situation is to place three implants and this will eliminate the problem entirely. If this is not possible start with two, then in the future additional implants can be placed to make a more secure situation.
As for the top, you might be able to add an implant in the missing eyetooth spot and make your existing partial very secure. Hang on to teeth that are solid, in good shape and have good bone. We have a number of very satisfied patients, where their existing partial was retained and made very stable.
Good luck with your anti-smoking program. As you know, implants heal poorly, if at all, in most smokers.