I Thought A Flipper Would Do
Q: During my life-time I’ve gone through stages of dental healthcare. From decay to sports, I’ve lost my share of teeth. At times, I used just the bare minimum fix-up for appearance reasons. At other times, I’ve gone all in getting my teeth fixed properly and so far, it’s been good money well-spent. The past ten years have been years of hard work paying off debts, getting kids through school, and mostly putting off my dental health care. Last week I broke a piece off a tooth that was providing most of my chewing force. I have teeth behind it but no teeth below it. On the other side, I have spaces and teeth but all in the wrong places – none of the teeth meet up. The bridge in the upper front is still good though twenty plus years old and I have all my lower front teeth but I can’t eat with just front teeth. I have a dentist that sent me to have the broken tooth out. I told him I could just get a flipper which I had in the front many years ago before my bridge. I thought maybe I could put a few more teeth on the flipper and get some chewing force on both sides. I’d like to get something more permanent but I’ve only got seven teeth on top, two of which are holding my bridge in. I’ve got some loose teeth, too, up top and I should also add I’m a smoker about a pack a day. Can I get by with a flipper or do I need to think long term?
A: With only one tooth making chewing contact, breakage is a certainty. Now, having no posterior teeth (teeth behind your eye teeth – bridged now), careful assessment should be made to ascertain the state of the remaining teeth. Saving teeth is important if the teeth are basically decay-free, have good bone support, and are in a position that bridging or implant placement works for your bite. A flipper, as you know, has retention by friction alone; either tooth friction or wire clasp friction, and possibly suction if made for the upper jaw. A flipper puts all biting force directly on the gums and bone. This results in bone loss at an accelerated rate. If there is mobility or looseness in your remaining teeth, it may be time for “going all in” as you did with your bridge. Removing teeth and placing implants immediately works well in some cases. If that is your case, keeping your bridge and placing implants that will receive crowns may be a good option. If five of the remaining teeth are in trouble, an excellent option is removing your upper teeth and placing implants and teeth the same day. The only caveat is your pack-a-day smoking. I really like to see three complete smoke-free weeks before surgery. You will be happy with “teeth in a day.”
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Based on actual patient cases
Calvin Ross Crapo