Q: I have strong teeth, well the remaining ones seem strong. They’re only in the front so when I smile it’s a horsey grin because all you can see is front teeth with gaps up top and on the bottom. They kind of look like horse teeth too. When I bite, the edges fit right together or on top of each other. That’s been the way from the beginning. I’m nearing golden age so I’ve worn the teeth down quite a bit. My dentist has filled the edges many times but that wears down and then chips out. The long and short of it is that my teeth are failing. I was told the last time at my dentist’s that I’ve got another big abscess, though I can’t feel it other than the tooth in question feeling a bit loose, so I’m slowly losing my teeth. Can I keep the ones I’ve got and get crowns and implants? The doc said he didn’t know if I had enough bone, but I had a bone scan and there may be just enough for implants with some bone grafting. It’s not vanity, its function. Horses nip off the grass with their front teeth then send it way back into the jaw to munch it up on big hidden molars. My horsey grin is all there is – no back teeth to do the munching. I’m getting to the age where there’s still gas in the tank but I can’t go anywhere – at least not with my front grill. So, what do I do? I can still eat I just can’t smile.
A: With your self-deprecating sense of humour I don’t know if people notice your smile, but you do and that’s important. If your remaining teeth are failing badly (abscesses, breaking etc.) it might be time to replace them with implant supported teeth. This could be a one day affair – teeth in a day is a real option and is producing wonderful function and beauty for a great many people.
If you want to save and restore what you’ve got and add implants (if you have adequate bone) that may be alright but you have a bite that is not easy to reconstruct. If you have an end to end or edge to edge front tooth contact bite as your normal bite position extreme care in crowning your remaining teeth and crowning the implants for reconstruction is a must. End to end positioned front teeth tend to wear first, then back teeth wear. Over time different rates of wear cause greater damage in isolated areas. Often it is the back teeth that sadly enough are lost. If you go this route, excellent maintenance practices will ensure its success.