My Worst Nightmare
Q:I’m terrified going to the dentist because of a nightmare surgery. My eye teeth were sideways – fangs under my lips. My front teeth were in and out. One forward, one pushed back like someone knocked it there. My dentist sent me to the orthodontist who said, “take out her eye teeth and I’ll straighten the rest of them.” He sent me back to my dentist who took out my eye teeth… all four of them. O my goodness, ninety minutes of hell! It remains to this day my worst nightmare. The orthodontist got my teeth straight but I have receding gums on the teeth that were pushed into the eye tooth spots. The recession gets worse all the time. It started not long after my braces and is getting worse every year. I was told I need gum grafting to stop it. Also, why is it happening? If I get gum grafting, will it stop the recession? I need this to stop and I need to know I won’t go through another terrible surgery.
A: Your story is unfortunate on many levels but going forward excellent records of your bite, your bone support and gum support can show us the primary cause of your recession. There may be root size differences between your eye teeth and the teeth moved into those spots. If the moved teeth are wider than the eye teeth, your recession may be due to inadequate bone width i.e., root wider than the bone. As well, bone could have been taken away to get the eye teeth out and reformation of your bone was not complete. Another cause may be functional; that is chewing forces pushing outwardly on the teeth with every stroke. Bicuspids don’t do well with forces that eye teeth are made to take. Over time these forces stress the bone by pushing the replacement teeth (bicuspids) until bone resorbs (dissolves) away. Recession is about bone loss in one form or another. It is a maxim that eye teeth not be removed. No other tooth has the size or stability of the eye tooth. Its job is to deflect lateral (sideways), or shear forces for all your teeth. At the time your treatment was done, much discussion was circulating that taking out bicuspid teeth would produce midfacial esthetic problems. The thought that keeping both bicuspids produces a more pleasing appearance is not really evident. Losing the eye teeth has far reaching functional/working and appearance ramifications. Your situation can be addressed. Careful planning and execution can resolve your recession and bone loss.
Based on actual patient cases
Calvin Ross Crapo