Q: Dr. Crapo: About twenty-five years ago, I had teeth that needed whitening and repairing. I saw my dentist to see about what could be done. He talked to me about crowns, he talked to me about whitening and fillings.
He was quite thorough because he said after looking at my bite, that I should have crowns so my bite could be made right. It was reasonable and I would have gone that route but I was younger and had family with kids and their needs.
Long and short of it, I couldn’t find my way financially. So finally, I asked if he couldn’t do something else. He said he could do something that would fix the decay, make the teeth look better and may address my bite.
He called it bonding, showed me some pictures and I decided that would do the job. He did all the front teeth, top and bottom and it looked a lot better, even though my bottom teeth were thicker.
Basically, I’ve forgotten about my teeth until recently. They are breaking down and the hygienist can’t get them clean anymore. I saw a dentist and he said besides the crowning, I’m going to have to deal with some gum disease around some of my front teeth, maybe even surgery.
He said that over time some of the bonding had detached and made some rough edges under my gums uncleanable. The gums are red and bleed easily and about one-third of the bone in three of the lower teeth has eroded away. I also have gum pockets around most of the front teeth.
I’m not sure how this is going to play out but I very much want to keep my own teeth.
A: It sounds like there’s been a good start to mapping out the strengths and weaknesses of your dental health. In situations like yours, treating the gum disease is important but often can’t be done in the presence of non-cleanable areas around your teeth.
Planning how your teeth will relate to one another using crowns, is also very important. Procedurally, getting the gums as healthy as possible before crowning makes sense because making smooth cleanable temporary crowns are extremely important and that can’t be done in the presence of bleeding gums.
Once the temporary crowns are fitted, a period of two or three weeks of good homecare will allow for even better healing. If surgery is still needed, it is easier for the surgeon to remove the temporary crowns and fit them back on after the surgery.
Healing will proceed relatively quickly because the gums will have smooth temporaries to heal against. Healing before final crowns usually takes several months because gum maturity after surgery, takes time. Take your time and you should have the result you want in function and esthetics.