Not A Good Subject for Dentures
Question:
Dr. Crapo, My wife has been in Canada for over twenty-five years. In her home country, dentistry was a luxury. When she came here, she was missing several teeth. When she had her first dental problem we went and got it sorted out. Shortly thereafter she decided to visit the dentist every six months. She did her best to follow the instructions of the dental hygienist and dentist. Even with her best efforts, she'd get a loose tooth and it would have to come out. She has been able to eat well enough, until six months ago when she said her remaining upper teeth were starting to feel pain when she bit down on her food. Our dentist took a look and said he couldn't see anything that was a problem. The pain didn't go away and finally we went back and he said she had an infection so he gave her antibiotics. This seemed to help for a while but then she started to get a gap between her two front teeth. She had gone to this same dental office for over twenty years so it was a hard decision to get a second opinion. When we went, we found out things we'd never heard before. She had very bad gum pockets, her bite was very hard on her teeth - one was broken down to the root. Different kinds of X-rays were taken, that hadn't been taken before. They showed she'd lost 80 - 90% of the bone around her upper front and side teeth. A three-dimensional x-ray showed barely enough bone to put implants in. We are unable to understand how this could happen and what to do. The second dentist said the teeth can't be saved and my wife is not a good candidate for dentures.
Answer:
Your wife has suffered from periodontal disease coupled with a destructive bite. When bone loss occurs because of a predisposition that is inherited, it is bad enough even without major bite forces; imbalances and misalignments in tooth to tooth contact can be enough to exacerbate bone loss.
When there is clenching or grinding that is strong enough to break teeth, bone surrounding the roots receives pressure that sets up a response that ultimately eats away the bone more quickly. Even with good homecare, the disease, if not checked through a number of distinct therapies, advances much more quickly than sometimes is appreciated and one sees disastrous loss of bone and teeth.
Bacterial sampling and treating, along with surgery and placing a good number of implants, can save your wife's function and appearance. If the teeth are simply removed and a denture placed, it will not be long (a few months) before implants will not be able to be placed, because after extraction, bone loss will occur much more rapidly.
If we can help, we’d like to. Call 778-410-2080 for a consultation.
Based on actual patient cases.