Tooth or Consequence
Q: I’m a guy who can put off tooth pain with the best of them. I’m so good in fact that I’ve lost most of any back teeth- I get pain, take some pain pills and for the most part get through it. I then get holes in said teeth. I’ve had root canals, but never would spring for the crowns—what happened—just what they told me would happen, I broke my teeth down to the gums. Presently I can just feel some shards of teeth in my gums on the upper right side. The last molar on the lower right is a “goner” too. The only molars that I’ve got are on the upper left side but they’ve got nothing to bite against on the bottom.
I’m now in a position where I’ve got to get some back teeth for chewing. I was told I’ve got good enough bone for implants on the lower left side but I’ve got to get the right side going as well. I need those tooth remains out and a bone graft put in them as well. I was told that the “good” upper left molars are growing down so they have to be ground shorter for crowns so they will be hoisted back to the length they were when I had lower teeth on that side. I’ve got some decay, though not bad on the teeth just a head of where the molars are or were.
I am serious about this but there’s so much that I don’t know where to start.
A: In your situation, there seems to be many moving parts but if you prioritize treatment into two categories it will help. You have disease and function that must be addressed. Disease must be arrested. That means tooth repair for the salvageable teeth, removal for the unsalvageable teeth, and bone grafting for future bone preservation. This will give you a clear path to start the next phase.
Next, you need function. If implants can be placed on your lower left side do that as soon as possible. The teeth above which are “growing down” as you say will continue doing so until they find teeth to hit against. In three months, little growing down will occur so at that time the upper natural teeth can be prepared for new crowns to meet the crowns for your implants. When crowns for your upper natural teeth are placed at the same time the implant crowns are placed a nice even bite can be established. This will give you posterior function (chewing ability) on the left side. When the bone has healed on the right side, implants, then crowns three months later can be placed to restore your right side, giving you full chewing power.