Am I Missing Something?
Question:
Dr. Crapo: My teeth have always been important to me but I haven’t had good luck with them. I’ve lost all my upper molars. In the past several years, I’ve resolved I’m going to have a good set of teeth. I’m going to keep everything I’ve got and get implants for the rest. My problem is that I don’t know if it’s as straight forward as that. Last month I saw a dentist and he said the teeth in front of where my molars were, are starting to get loose. That’s what happened to my molars. They’d start to ache, then I’d get root canals and crowns, then all of a sudden it seemed like they’d get loose and they’d have to come out. So now my worry is that I’ll get implants and then they’ll get loose. Am I missing something? I want a great smile. I’m prepared to pay for it but I’m really worried that I’ll be throwing good money after bad. How can I be certain, I mean, I know it’s hard to give guarantees but how can I move forward with a reasonable expectation that my teeth, once they’re fixed, are going to last? My dentists over the years, have said that I have normal bone. They have all said I grind my teeth but they didn’t think it was that bad. I really want to go forward but I do have concerns.
Answer:
When bone is lost around teeth – the adult dentition – the four major causative factors are – genetics – one is predisposed to bone loss, plaque and calculus producing inflammation that is not removed, smoking and finally clenching/grinding due to stress, bad bite, or extraordinary chewing of one’s food. Grinding one’s teeth happens at one or more of the following times – nighttime (nocturnal bruxing), daytime or when eating. Functional grinding means that one chews through his/her food to his/her teeth and then grinds tooth to tooth. Most people don’t do this but those who do can cause tremendous damage to their teeth.
In light of this, before you start, it will be necessary to find out which of these factors are causing your problems. This can happen in the same time frame that the dentist is evaluating your functional bite. Humans have two sets of teeth – the front six from eyetooth to eyetooth, on top and on the bottom. It is vital that the front teeth take on the cutting forces of your chewing and grinding strokes. They will have to be restored to do this. The posterior (rear) teeth can then be made to take care of your chewing requirements.
After that is done, it will still be necessary to wear a protective bite splint or orthotic system that will prevent excessive force on your new teeth during the times you inadvertently grind your teeth.
If we can help, we’d like to. Call 778-410-2080 for a consultation.
Based on actual patient cases.