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After Forty Years – What?


Dr. Crapo

Question:

Dear Dr. Crapo: I retired about ten years ago after a long career as a registered nurse. The work was fulfilling and demanding, but sacrifices at home and work took its toll. I have a number of conditions incident to stress and hard work. I have taken care of myself as best I can and that includes my dental health. Over forty years ago I lost my lower front four incisors. A replacement bridge was made that has performed very well. Over time I have lost bone and gum around all my teeth, as well as around my lower eyeteeth which have acted as anchors to this bridge. I noticed the teeth and thus the bridge become loose about two years ago but it was still functional and my dentist thought it could continue to serve. The gums and bone under the bridge have reduced in size as well, so a gap under the bridge and teeth has developed. In the past several months, the bridge doesn’t feel stable and the gap is unpleasantly catching and trapping food. My dentist said it’s time. He suggested that a partial denture might be just fine but I don’t want something I have to take out, remember and fuss with. I have developed diabetes and take medication but my blood sugars, while a bit high, are stable. I’d like to get this taken care of but I don’t think managing a partial is possible. A new bridge might work but I didn’t know if my remaining teeth are strong enough, so I wonder if a bridge would last. I’ve thought of implants if I could have them but I don’t know if I can have teeth on implants right a way, so that I’m not missing my teeth when the bridge is taken out. I don’t want the huge gap just left till something can be made.

Answer:

Your health will dictate what you may have to accept. If your health conditions are stable and there is adequate bone, you have at least three options. The first option, though not to your liking, is a partial denture that could be made in advance. Once the teeth are removed it goes in. The second option is in fact a bridge. This could also be made the same day, so you go home with teeth. It would require crowning the two bicuspids on each side. It would be a larger bridge but if the bone is sufficiently strong, it would work just fine. The final option is very good if you have adequate bone. Implants placed in each socket of your existing eyeteeth with one beside them, will provide excellent anchorage for a bridge made to fit the implants. Firm implant to bone attachment is the key. The best bone in the mouth is usually found right there in the lower front jaw.


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