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DENTAL
FAQ's
Be
true to your teeth...
O.K., so you
tried, but you just couldn't prevent the loss of a few teeth. Fixed
bridges, partial dentures, full dentures, implants...
what now?
What's right for you?
Q: I lost a
front tooth and the gap is equal to nearly 1½ teeth. (My teeth started
spacing after I gave birth to my son 31 years ago. Doctors informed me
that I probably had juvenille onset peridontitis which was not detected.)
I do have peridontitis which has been treated but there has been damage.
I've been advised that one other front tooth needs to be removed, although
it's not very loose. One dentist advised a bridge and crowns from canine
to canine, while another advised against it and suggested that I need lots
of surgical work done before anything can be done to restore my smile. A
flipper (small removable denture) would not work for me because of the
very large gap. I was wondering if there is a method whereby a removable
denture could be constructed that works much like a bridge capping my
other teeth from canine to canine. My bottom front teeth are also splayed
and need correction. What I need to know is what would be the best and
least expensive corrective procedure to restore my smile? I've been
practically a hermit since it happened and in a severe depression which is
worsening. Anyway, any advice would be appreciated.
A: There is
almost always a removable denture prosthesis that can be made in lieu of a
fixed bridge (the converse is not nearly as certain).
The logistics
and sequence of the treatment must be determined. If (as most patients)
you are not fond of walking around with the missing tooth in front, you
will want to consider making a provisional denture prior to other
treatment. There is nothing inherently different in the construction of a
provisional denture from a "permanent" denture, but its intent
is different: it is intended to serve its function until the other
preparatory work (extractions, periodontal, and restorative) is completed,
and a "permanent" prosthesis is constructed.
Given your
periodontal status, attention to this gum problem is indicated. However,
there are those who, due to failure of a previous periodontal course of
therapy or poor periodontal prognosis, will refuse further periodontal
treatment. In any case, if the prognosis of the remaining teeth is
guarded, provision should be made for future tooth loss. This will usually
mean construction of an acrylic base partial denture, which is well suited
to the possible future addition of denture teeth as their natural
counterparts are lost. We would advise extraction of those teeth that are
most in danger of near-term loss prior to denture construction, in order
to minimize the inconvenience of frequently parting company with your
denture as it travels back and forth between your mouth and the dental
laboratory as new denture teeth need to be added.
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