The Blessings and Curse of Pharmaceuticals
Question:
Dr. Crapo: Through my youth and most of my adult life, I had very good teeth. They weren’t straight but they weren’t bad looking. I had a full smile that looked normal. Ten years ago, I had an accident that has completely changed my life. During the early part of my recovery I was placed on strong pain killers. Then there was physio therapy that was required, that went on for several years. During this time, there was depression and medications for that. Instead of the confident happy person there was a doubting, second guessing, hard on myself type that wasn’t me. During this time, many things fell by the wayside; one was care of my teeth. In these years, I’ve had bad decay, terrible grinding of my teeth and lots of extractions. Presently, I have no lower left back teeth. I’ve lost two important teeth on the upper right, with a lone molar at the back. I’ve lost my middle tooth on the upper left and I’m going to have the last molar on my lower right taken out because of decay. I’ve got a bit more decay on other teeth and may need a root canal as well. My front teeth are still good but the best news is that I’m almost 100% back. I want my teeth fixed so I can chew my food and feel normal again. The challenge I face is that I’m just getting back on my financial feet so I don’t have a lot of money. I know I need a lot of work and implants are expensive, so where to start, I don’t know.
Answer:
When I see or hear of trauma histories and their effects like yours, I’m alerted and reminded of the gap between acute medical treatment and supportive medical treatment. In other words, what isn’t hurting or debilitating is left to itself. Pharmaceuticals are so helpful for many things that come with a history like yours, but they have side effects that leave the mouth dry and the stomatognathic system (mouth, teeth, jaws, muscles, joints and ligaments, salivary glands etc.) restless and tense. Tremendous grinding and clenching forces increase the rate of tooth breakdown when antidepressant drugs are taken – so a person unknowingly is more susceptible to decay because of dryness produced by various medications and grinding produced by others. Start with the decay. If you can afford a bone graft when the molar comes out, do so. Take care of the decay, then work out a plan with your provider (dentist) that will best allow you to start eating on one side. A well worked treatment plan can be phased so you can get what you want and need over the next three to five years. The time will go faster than it sounds and each well planned addition will be a confidence building event.
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