A Hole in One
Q: Dear Dr. Crapo: Two years ago I was on the golf course enjoying myself. On the back nine the food wagon came by and I bought a sandwich. At the fourteenth we were backed up so I got out the sandwich. On my second bite I knocked out a crowned tooth. It so concerned me that I blew the last five holes. I got in to see a dentist that very afternoon and thank goodness he was able to save the situation. Because my whole mouth is crowns and bridges, I decided to get x-rays and a thorough exam to make sure this didn’t happen again. I got a very thorough exam and was going to proceed with the care but then I got the treatment plans. One plan called for redoing essentially all the crowns and bridges and the other option called for replacing my teeth with implants. The price was about the same but for some reason I couldn’t make up my mind. Fast forward a year – another crown came out – again I had it put back in but with the counsel that it might not last and I should redo it. Today at seventy-seven I still seem to be at a crossroads wondering what’s best. At a recent visit with my dentist, he said that despite my dry mouth (I’m constantly drinking water) my decay isn’t fast moving and I have great bone support for my roots. I thought I was ready for the implant option because I’m so nervous about a tooth coming out in an important social event, that I didn’t want to deal with crowns any more. My dentist said I should thoughtfully consider my decision but in the meantime, make sure my dental cleanings occurred every three to four months and my flossing and brushing at home was very consistent. I’m in good health, what would you advise?
A: I think you’ve received good counsel. If your decay isn’t spreading quickly, decide what you want. Ask your dentist if you could speak with people that have decided on the crown reconstruction and those who have done the reconstruction with implants. An experienced dentist who does both kinds of mouth rebuilding, will have patients who will gladly share their experience. During the 70’s and 80’s, and even the 90’s, crown reconstruction was the conventional method. It often entailed gum and bone surgery to ensure a healthy foundation for each crown. These rebuilds can serve for life. In the last decade implants have taken center stage and are providing an incomparable service of strength and impermeability to decay. With your dry mouth, it’s only a matter of time and the teeth will succumb. That’s my recommendation, teeth placed in a day on implants that will support your teeth for the rest of your life.
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