Up Close & Unnatural

Question:

Dear Dr. Crapo: I’m a professional woman in an “up-close” job – meaning I’m in front of company executives, training company employees and making speeches on a regular basis. In the past fifteen years, I’ve been under the care of a specialist and his staff for my gums. Two years ago I suffered a debilitating condition that took me out of circulation. I’ve returned to work and despite a slight handicap, I’m back doing the things I used to do. I must tell you I have diabetes, but it’s under control. I faithfully monitor my blood sugar levels each morning and have been given a stable bill of health. Dentally speaking, I have ever-widening gaps between my front teeth that started about three years ago. It’s been discouraging and I’ve wondered if my four trips a year for cleaning were worth it. They haven’t had any answers other than I needed to do a better job of my home care (brushing and flossing). I’ve seen these gaps develop in my father, his siblings and my brothers and sisters. I don’t like to look at my smile in the mirror and I’m upset that it’s getting worse. Is there help for me or am I going to lose my teeth?

Answer:

You’re describing a discouraging situation. I’m sure your hygienist and periodontist are not happy about the way things are going either. Last week I encountered a similar situation to yours again. I say again because your problem is not isolated. Dental cleanings four times a year under the care of a specialist tell me you’ve got build-up and gum inflammation challenges and your diabetes makes you prone to lose bone and gum support around your teeth at an accelerated rate. When you tell me that spaces are developing, I know you have a self-destructive bite, grinding and clenching, or all three. In the presence of inflamed gums, bite forces that are excessive will cause bone and gum loss.

In the gentleman I saw this past week, he was not aware of loose teeth or gum and bone loss. He was not aware he was placing undue force on his teeth, which was causing the problem.

His bite is self-destructive and his unconscious (grinding and clenching) habits are rapidly destroying the support of his teeth. He will need to have his bite reconstructed. It will be a big expense and it can’t be done piecemeal. Very few dental professionals want to take on the challenge his bite presents and dental plans may deny coverage when his dental needs are outlined. Find someone with experience with these problems who has treated them before. There are good solutions to your dilemma – don’t lose hope.

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