Will I Ever Stop Losing my Teeth

Question: I’m hoping that there is hope for my mouth. I’m near retirement age and I have lost all but seven teeth in my lower jaw. There’s also an implant where the crown is broken off and a tooth that is broken off at the gum line, so seven teeth that are chipped and battered plus a broken one and the post sticking out of the implant with no crown. I have no posterior teeth to chew with. No one wants to touch me because they say nothing stays that they put in my mouth.

In my upper jaw I have several crowns in the front with part of the crown broken off, one is an implant with a crown, so I need teeth for the bottom. I can’t have a lower denture because I have large boney growths on the inside part of my lower jaw, so they can’t make a denture fit on top of these large projections. They are also annoying because if I eat crusty bread or anything hard, the gums over these bones gets pinched and scraped terribly, causing a lot of pain. I can tell you I’m pretty discouraged because I’ve just been getting the looks like you’re too hard a case, you’ll have to go elsewhere.

Am I that odd? Aren’t there ways to treat what I’ve got? I can’t stand the idea of getting something put in that just falls out a few days or weeks later. What do you think?

Answer: Certainly, your situation is not average; it is complex and care must be taken to diagnose and treat comprehensively. When I see loss of teeth, there are generally two major processes:

1.     Biological disease caused by bacteria, decay, gums, bone disease, etc.

2.     Mechanical factors that overstress the system – the teeth, bone support, gingiva (gums), joints, muscles, etc.

Of course, personal systemic immunity in all its variations play a roll as do psychological factors and sociologic factors (habits, smoking, drinking, and drugs), but breakage happens because of excessive force on the tooth/teeth. Crowns, fillings, prosthetic teeth don’t just fall out on their own, they must be stressed beyond their fixed limits.

Preventing these damaging forces is a matter of coordinating the bite in such a way as to permit smooth function in any and all chewing and non-chewing grinding of the teeth. In your case, when this is done, it will give you great function but even then, as a hard grinder/bruxer/gnasher, you will have to wear a protective splint orthotic to ensure your strong grinding/clenching cannot be tooth to tooth. You will need to see your reconstructing dentist regularly and he will check your function and make judicious adjustments as need occurs. The reason for this is that your lower jaw has, as its anatomy, the ball portion of the ball and socket joint known as the temporomandibular joint. Over time, this joint undergoes slight changes. When this ball/socket complex changes even 50 microns, it affects the position and thus the pressure on your teeth.

It will be important to have an excellent diagnosis followed by an excellent reconstruction to put everything in a seamless balance and important that you work with your reconstructive dentist to discover when these forces are in play – at night, during the day, when you chew your food, or a combination. Knowing this will help put in play the therapies needed to ensure your reconstruction lasts and lasts.