Black Holes – On Earth!

Question: Dear Dr. Crapo: I’m a 72-year-old man in good health…except my teeth. Three weeks ago a bridge on my upper right side that extended to my front tooth broke off, leaving me with two stumps in the back. I’ve seen my regular dentist but he said my mouth had problems beyond his ability to fix. I saw another dentist and he said basically the same thing, so I asked him who could help me. He sent me to a periodontist who said I should have the two stumps removed and implants placed – possibly at the time of the extraction and then another implant to anchor my front tooth to replace the broken bridge. When I asked him if he would be doing the bridge he said no, he just puts the implants in. When I asked him who could do this, he said he had a specialist friend who could do the bridgework. When I asked him if he knew someone who did all of the treatment, he said he didn’t know who to recommend. I was frustrated, to say the least. When I asked these fellows why my bridge teeth had broken so badly, no one had an answer. I’ve only got 5 teeth on my upper left side, and now I have nothing but a black hole on my right side. Though I’m not into appearance at my age, I do look a little frightful when I smile. I need help – what do you suggest?

Answer: I see folks with problems like yours on a regular basis, and it is troubling to have something major like this go wrong. When I see a mouth that has already lost several teeth, and then more break, I know I’m dealing with tooth decay, excessive grinding forces and a bad bite. With only 5 upper teeth left, I’m more than certain this is the case with you. If you place three implants on the upper right side and make a bridge, you’ll have new teeth there, but you’ll still have a bad bite because the left side remains unchanged. If you’re going to see the periodontist’s specialist friend, have him examine you so that he approves every step of the reconstruction. A good prothodontist will do a critical path analysis before any surgery is done, so you’ll have no bite problems after the work is finished. Three weeks ago I saw a fellow who had complex problems like yours, in both the upper and lower jaw. He had seen 6 dentists trying to find the right solution. Yesterday, his teeth were removed, implants placed and bridges fixed to the implants, which totally restored his mouth. He looks great, his bite problems are solved, and there’ll be no more breakdowns.

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