If It Ain’t Broke Don’t Fix It?
Q: I’m a thrifty guy. I’ve worked hard all my life and I’ve gone by the saying – “if it ain’t broke, don’t fix it.” I’ve done that with my teeth too but lately I haven’t had good luck.
I’ve lost most of my teeth on top - got a partial that doesn’t work because one tooth broke off right at the gums and the other, broke in half. On the bottom I’ve got nine or ten teeth and they’ve nearly worn out. When I had more teeth, they seemed to meet fine. I could bite anything clean off because the teeth came together on their edges.
Over time the upper teeth chipped and broke till I needed root canals, then I broke those, so they got pulled and a partial was put in their place.
Now the partial won’t fit and my lower teeth seem to be jutting out like I had an underbite. I can’t bite anything and I can’t chew anything. I’ve been thinking about implants, but I wonder if my bite is changing so much that I’ll never get a good bite again.
My upper lip looks caved in, my partial won’t go in so my lip sags, but is that because my bite or jaws are moving? I’d like to think that implants could give me a good bite and my face would be filled out again. Will I have to have an underbite? I don’t like the way it works or looks.
A: A good exam will help to answer most of your questions, but to give you a general answer from the outset – nearly anything can be done if you have enough bone or enough bone can be created for implants. Once implants are correctly positioned, teeth can be put in place, not only for a great bite and comfortable chewing, but for support of lips and facial muscles that would give you a full and youthful look.
When you lost your upper front teeth, the bone supporting those teeth lost nearly half its volume or width during the healing phase. You probably had a partial denture made at the same time to give you something to chew and smile with. That caused more pressure to be placed on your bone as it was healing, causing more bone loss. I’m sure you saw your upper lip collapse whenever the partial was taken out because there was no support.
Now that your upper partial can’t stay in, you will have a pouty look as you speak. That’s all correctible. You may only need upper implant supported teeth to do the job. If however, the lower teeth are worn severely, they may need work or implants placed to create the bite you need and want.
As I said, a good exam will tell.
Based on actual patient cases
Calvin Ross Crapo