Q: Dr. Crapo: I’m getting on in age – past retirement and then some! My question is what should I do about my teeth? I have lost all my molars but one on the lower left, so I have twenty-one teeth - I counted them. The problem I have is that all the fillings have pulled out. I saw my dentist about 8 years ago and he put in white fillings on the tops of the teeth, but they’re all out. My teeth look pretty sawed off and short. Last week I broke one in the front. When I look at them, they look like little hollowed out coconuts, or like half egg shells. I know I’ve got to fix them, but if the fillings just fall out, what’s the point? My dentist did say I grind my teeth and that was what made them flat. Would it help to have crowns or would those just come out too? I’m in kind of a pickle because I don’t want to spend money if it’s all for not. I don’t know if I’m grinding my teeth but you guys are the experts. I just hope I can get a job that’s going to last. Do I need implants for my molars?
A: When teeth are flattened or show significant faceting (like diamond facets), grinding more than clenching, is occurring. Most of the grinding we as dentists see, takes place unconsciously, whether during the day or during sleep. Some of the most damaging grinding can happen when a person chews his food. In these cases, the person “chews through the bolus of food and grinds his teeth as a way of “smashing to smithereens” the food between his teeth. He does this over and over many times before swallowing. Good for the gut, not for the teeth - especially if the bite is out of sync to start with.
In your case, crowning will save your teeth if the whole bite is carefully analyzed and built so the forces directed at your teeth prevent the flattening from reoccurring. This takes careful engineering but if the roots, gums and bone are in good shape, a good job can be done. All twenty-one of your teeth will probably need crowning. Built properly, this solution can provide all the function you need. If you want molar teeth, I’d suggest just adding one implant crown on the lower right, upper right and upper left. Having one set of molars will give you all the biting and chewing force you need and will reduce your overall expense.
As I’ve said many times before, get a very thorough analysis, ask all the questions that come to mind and get answers you understand. If you don’t understand something, don’t proceed until you do.