I Need a Quarterback?

Question:

Dear Dr. Crapo: I’m in my late seventies. During our working life I taught school and my husband had a successful law practice. We had a good life. In retirement our health has given way to a number of issues. Last week I had a terrible toothache around my upper left eyetooth. I saw my dentist and he said I needed a root canal and put me on antibiotics. He sent me to a specialist who gave me a quote but also said that tooth was part of a bridge and the whole bridge was loose. He said it was the two teeth that were holding the bridge that were loose in their sockets. He thought things might tighten up after the root canal. I knew the bridge was loose – I’ve known that for a long time. The fact is, I find myself biting it into place regularly throughout the day. The two front teeth to the right of the bridge are a bit loose too. On the upper left side I’m missing the tooth behind the abscessed eyetooth, it was extracted but a bone graft was put in so I could have an implant. I was told that under my front bridge I have good bone and two implants could be put in there to give me new teeth and they also might give strength to the loose teeth on each side. I’m getting this in bits and pieces from my dentist and two other specialists but nobody has given me an appointment to take care of the problems. The root canal guy doesn’t make new teeth, the gum specialist can put in implants but the bridge has to be taken off carefully and then replaced and he doesn’t do that. My own dentist thinks it’s very complicated, so he doesn’t want to be responsible for all of it. Where do I start?

Answer:

Loose, diseased teeth are a real challenge. Managing efforts for their treatment and providing the vision for a good end result requires a person with skills and understanding in all the disciplines needed to correct the problems. He/she becomes the central figure or quarterback through which all plans, timing and execution are coordinated. The “quarterback” would evaluate the entire situation. He/she then decides what comes first. He may have skills that allow him to do any root canals you need and if the “loose” teeth are not too loose, he might remove the bridge you have and prepare adjacent teeth so that a larger more stable bridge could be put in place for a period of a few months to see if the teeth will heal (from the root canals) and tighten up. He might also place implants where there is missing teeth and over a four to six month period, get your mouth ready for a strong beautiful functional result.

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