The “Big Deal” With Implants
Q: Dr.Crapo: When I was twenty-five, I was told that my back teeth were soft. I was told they would never hold a filling, so my best bet would be to have them all out.
So they took all my lower molars and the teeth in front of the molars (bicuspids) out, nearly fifty years ago. I’ve had good and bad partials for all that time but right now I’ve got nothing, which makes it hard to eat.
It’s been quite a few years in fact, since the last set broke. When I didn’t get them replaced I was warned that the upper teeth, which have crowns, might descend down because they had nothing to chew against and because teeth are always growing they would just come down.
Well after not seeing a dentist in six years, it’s happened – my upper teeth have grown down and the dentist is wondering what to do. He said that my lower spaces show a lot of bone and implants could be put in. I checked with a denturist and even he said I should think about implants, but what about the overgrown upper teeth? How does that work? And why is everybody talking about implants? That’s all I hear anymore. Can’t somebody make a partial that fits? Now I don’t know if one could even be put in - so could you explain it all to me.
A: Without seeing the relationship of your upper teeth to the lower spaces where your teeth used to be, it is hard to give you an absolute diagnosis. Sometimes the descent or over eruption brings the upper teeth within a few millimeters of the edentulous space (your ridges). In these cases, placing posterior teeth with a partial denture or implants would require extraction of the upper teeth to make the proper space.
If the descent of your upper teeth is only partially infringing into the space that your lower molars once occupied, re-crowning the upper teeth may be done to “hike-up” the upper teeth so lower teeth can be put in at the proper height and alignment.
The “big deal” about implants is that they work so well – 95% of the time they work as well or better than a person’s natural teeth, they are stronger than natural teeth and experience no decay. In the other 5%, undiagnosed health concerns, operator error, patient habits (smoking, alcohol, dangerous life styles) and manufacturing defects contribute to implant failure.
In an environment as harsh as the mouth dental implants have passed the test of practical and scientific scrutiny. As time passes, the one thing that bothers me is that because they work so well other viable and less expensive services that maintain natural teeth may be rendered obsolete.