Managing by Emergency
Q: As a kid I had pretty good teeth. As a young adult, things changed as school, job and finances were totally on me. I managed by emergency, so some things got neglected till they couldn’t wait any longer. Because I had good health and teeth, I just took it for granted. As stresses built up and demand too, I burned the candle from both ends so to speak and got into stuff to “help” me that didn’t serve well. All said, I found I was getting holes in my teeth, but I never got toothaches, so I’d let it go. Long story short, I’ve got five teeth broken/rotted to the gums but no toothache. The problem is I haven’t got any back teeth to chew with. My front teeth seem fine, maybe a little crooked on the bottom but no lower back teeth on both sides. During this time, I had a lifestyle that wasn’t the best and I got sick for over a year. During that time, I had a very queasy stomach and threw up almost every day. I think it did something to my teeth, like melted the backs of my upper teeth because they seem thinner and are chipping. During that time, I was grinding my teeth so could that have done it? I’m afraid my front teeth will start to have problems and if I don’t feel pain I could be in a worse situation. I need back teeth to eat so will that save my front teeth? I do hit them hard.
A: In your situation your front teeth will have to be addressed so that the forces of chewing and grinding your food is guided for efficiency and balance. Front teeth are designed for cutting and tearing food but also protecting the posterior teeth from horizontal shear forces. As your bite became compromised it is possible that your decayed back teeth weakened and were more susceptible to breakage. A thorough work up will demonstrate what that really looks like. The silver lining in your state is that the teeth though decayed off at the gum still have a root that has maintained the bone volume needed for implants. If there are no abscesses removing roots and placing implants can happen at the same visit. Usually, teeth would not be placed on the implants at that appointment but if multiple implants are placed in good strong bone, temporary crowns could be placed. In reconstruction of a dentition (restoring one’s teeth and bite) as you will need, it is almost always the case that your front teeth would be treated first to make sure they guide and distribute your chewing forces so that your new implant supported teeth work efficiently and are protected.
Based on actual patient cases
Calvin Ross Crapo
Victoria Implant Centre 778-410-2080