Q: Dr. Crapo: I’m in my seventies and in good health. Over
the past fifteen years, I’ve been wearing a partial denture that is attached to two of my upper molars. These teeth were root canaled and crowned many years
ago. In the last six months, I began to have a foul taste to some acidic foods
and fruits. I saw my dentist to tell him about this development. After taking
x-rays and examining my teeth, he said that new decay had occurred under the
crowns. He said they’d have to be redone. He also said that the decay might be
too advanced to save the teeth. When I asked him what options I had, he said I
might have to get a denture. When I asked him about implants, he said that
could be done, but the expense was much greater than the upper denture alone.
For some reason the thought of a denture is distasteful to me (no pun intended).
I don’t know my options, but I wonder if I do implants and keep my teeth, if I
could at least have another partial denture and not have to have a full
A: You may have many options that are
satisfactory, especially if your bone structure is adequate. Keeping your upper
molars may be a good idea but if there is decay under your crowns, it will be
imperative to assess the root canals. Very often decay means leaking. Bacteria-laden
saliva gets under the crowns, which often leads to leaking of bacteria past the
root canal filling material and into the bone at the end of your roots. If this
is the case, a retreatment of your root canals will be necessary. This will add
substantially to your costs. Adding implants to the treatment and making a new
partial denture will approach the cost of a palateless “teeth-in-a-day” bridge.
The disadvantage of keeping your own teeth at this stage of your life to anchor a
partial denture is that they may decay again. (Teeth that anchor partials have
a higher decay rate). Redoing root canals in those upper molars and then re-crowning them can become quite expensive because of disassembly charges (taking out posts and filling materials after removing the crowns). It would be a shame to lose your investment.
Look carefully at your options and their costs before keeping your own teeth. (The
taste by the way, is the leaking of decay out from under your crowns). An
implant fixed bridge may avoid future decay and completely frees your palate to
taste and enjoy your food.