Am I Falling Apart?
Q: I was born in the late fifties and as long as I can remember, dental health has been a priority. My parents made sure of that when I was young. I had cavities but they got filled before there was a problem so dental pain was not my experience. I even kept my wisdom teeth. I thought that was a good thing because they seemed to give me even more biting power. In my late twenties, I was convinced that my silver fillings were not doing for my teeth what they should, so under the care of a good dentist, I had all my back teeth filled or capped with gold. It was a good decision because, with the exception of a few teeth, little work needed doing for about fifteen years. Since then I’ve had several crowns done because I grind. About two months ago, several things came to a head. I was told that my bite had settled into a place where I was really grinding my teeth not only in my sleep but when I chewed my food. It was causing problems, especially in my wisdom teeth. They were breaking down and decay was getting under the crowns and I needed root canals. At the same visit, the dentist told me that my gum strength was not what it should be and needed reinforcing. He took records of my mouth and gave me an analysis. I feel like I’m falling apart. He’s assured me that all can be fixed but it seems pretty comprehensive. I’m in my mid-sixties, is this what everybody experiences?
A: Functional grinding (chewing your food) and parafunction grinding (nighttime grinding) are both hard on teeth. Together, they can defeat the best dentistry if mitigating helps and structure are not put in place to reduce this wear and tear. ‘Gum strength’ as you say, may be genetic but it too can be strengthened by predictable grafting. It is not uncommon for a good deal of wear to become problematic as we hit our senior years, especially if there are bite problems. What’s not expected is that instead of two or three teeth needing work, it can be ten or twelve or a complete reconstruction. (Tooth make-over and attendant gum and bone considerations and work.) While this is not an inexpensive endeavor, it may solve the issues that have contributed to the wear and breakdown. Heavy function on molars, including wisdom teeth, seem to induce more of the same. Not only can this lead to broken fillings and teeth but to the breakdown of the cement holding your crowns in place. These unseen breaks can lead to leakage and ultimately to decay. If good bite balance is established and the bite forces are distributed evenly, your function (chewing) will be excellent and your wear and tear reduced so breakage is not a problem going forward.
Based on actual patient cases
Calvin Ross Crapo