What’s Happened to Your Teeth
Q: This is a hard letter/confession to vocalize. During the Covid time with all its precautions and warnings, I was affected more that I knew. I consider myself a hardy person and am very conscientious. I am part of the dental health profession so this seems doubly hard.
About three or four months ago, I was having dinner with a dear friend-a confidante. This friend leaned over, after we’d sat and began our visit, and said, calling me by name, “What’s happened to your teeth?” “What do you mean,” I asked?” “they’re not visible like they used to be,” she said. “I haven’t noticed but I’ll check it out, thanks.” We returned to our discussion but my mind was in another place and it was very embarrassing
Next day I made an appointment for a thorough look-see. Records were made, x-rays taken, etc. Later I received a report of findings and I was astonished. I couldn’t believe that in three and a half years my teeth were so worn. The pictures they took were nothing like my once beautiful teeth. But the appearance was nothing compared to the wearing away that they said I had. The treatment was paralyzing.
I sought a second opinion and learned even more as I was shown every detail of the breakdown. This left me speechless as in that second report of findings I was shown a situation where underdiagnosis would lead to even more damage.
I don’t know where to start. Both dentists have assured me my teeth are restorable but there’s so much to do. Is one approach better that another? One talked about just my teeth but the second guy talked about my gums and reconstruction there, too. It’s confusing and I’m in the field of dentistry.
A: You are certainly not alone and its s on us as “dental specialists” in the field of medicine to communicate until you have clear direction and a critical path outlined to get you to the best state of dental health.
The order of care is this--address the greatest instability first and secure it. If teeth are badly broken down through decay, or wear, or looseness, start there, followed almost immediately by the gum reconstruction whatever that entails.
The greatest mechanical forces that produce the greatest instability are controlled by the front teeth. Often it is necessary to crown the upper six anterior teeth as well as the lower six anterior teeth. These teeth are meant to mediate the most damaging wear forces (shear forces). Adjustments can be made to your posterior teeth once these forces are properly coordinated. You may have to wait in your temporary crowns for a period until the gums are healthy and strong before going to completion but that’s fine. Going from a stability to stability; front teeth, gums, then back teeth will be a winner for you.
Based on actual patient cases
Calvin Ross Crapo