My teeth are terrible!! Help!

The Life-cycle of a Tooth

When we are young, our personal hygiene isn’t so great and our diet is often terrible!  We don’t like the foods we should eat and love the foods we shouldn’t!  Candy and chips are a stable for kids.  Somehow, after brushing their teeth, a kids toothbrush is often still dry!  Not surprisingly, kids get cavities.  These are simply places where sugar-fed bacteria excrete an acidic waste that eats holes in the tooth.  Then, a dentist puts a filling in it.  A few years later, that filling breaks down and the tooth needs a bigger filling.  When that fails, the tooth needs a bigger filling or a crown.  Then the crown finally fails and the decay irritates the nerve of the tooth and the tooth gets a root canal.  After having to be re-fixed several times, that tooth finally breaks.  Often we get the first filling on the tooth when we are 9 or 10.  Today, we live to 80 and beyond, so it’s not at all a surprise that we have the tooth or several teeth fail.

Another common path for a tooth failure when we are adults is to have crowding and alignment issues as a kid.  Often, the orthodontist would even take out permanent teeth and then pull the teeth straight.  While this is ok in some cases, it is almost always better to grow the arches larger to accommodate all your teeth.  It is easier to assume there are too many teeth for the size of the mouth and take some out.  This makes the process easy, but it is usually not correct.  This sets up stress and strain on the airway and puts people on a path to grinding.  Over the years the bumps are ground off and the teeth become flat.  We can generate so much force on our teeth that in a poor bite with chronic grinding, we can even fracture the teeth!  Sometimes it is from how the braces finished the bite, and sometimes it is because we didn’t get braces to correct the bite.  In either case, chronic grinding causes a lot of teeth to fracture!

It’s just a back tooth so you can’t see it…

No doubt at all that missing front teeth cause huge issues with the smile!  The smile is such an important part of who and what we are that a missing front tooth has a huge impact on people. Self-esteem, confidence, happiness, and even success have all been shown to be directly related to how we feel about our smiles.  For the back teeth, life-span, health, medications, and nutrition are all impacted by how well they work.  when back teeth are missing, it doesn’t always show, but it does always make a difference.  Missing one tooth makes you 50% more likely to lose another tooth.  Missing teeth causes a loss of bone.  Wearing removable teeth accelerates bone loss.   The simple reality is we would be healthier and happier and live longer and better lives if we have aesthetic and functional teeth that don’t come in and out from the front all the way back to the molars.

What if teeth are already missing?

In almost every situation, the best solution to missing teeth would be either a dental implant or a bridge.  A dental implant will replace the root of the missing tooth and allow you to put a crown on that will work almost exactly like a natural tooth.  The dental implant settles into the bone and over a few months, becomes solid and heals into your jaw so that it will work like a tooth and you can chew, smile, and support your bite and airway correctly.

Although any dentistry is a little (or a lot!) intimidating, the process of placing the implant is almost always much easier than the extraction was in the first place.  When the tooth is fractured or broken down beyond the ability to repair it, there is a large space left in the bone and gum tissue that has to heal.  When the tooth is removed, the pressure causes the area to stay sore.  After the extraction, all the tissue that has to grow into place makes the area sore.  Even the large space takes a long time to fill in and the tissue remains tender as it does.

However, once the area is healed, the implant site is carefully prepared and implant is placed into a precise area that leaves minimal tissue trauma and minimal healing.  In most cases, the implant is also very stable, and only needs time for the bone to mature to be able to handle the stress and load from chewing.  In almost every case, the implant surgery is easier than any treatment leading up to it on the tooth!

Sometimes it’s not just one tooth – sometimes it all of them!

Dental implants are actually very flexible in terms of options.  While the outside of the implant is directly in contact with bone, the inside of the implant is simply a precision threaded area that we can screw a number of things into.  Sometimes it is a single crown.  Other times a pair of implants can be used to support a bridge.  People who wear a denture can be fitted with implant snaps and actually snap the dentures in place!  One of the most amazing advances is to use the implants as the support for the whole arch of teeth.  Often called “All on 4” or “Teeth in a Day” using a series of implants to support the whole arch is a game changer!

If the teeth themselves have had significant bone-loss over the years, the options become more limited.  In fact, sometimes the least expensive and most predictable solution to get a mouth restored and healthy is to use 4-5 implants to support the whole arch of teeth.  The implants are spread out in the arch to maximize support and distribute the forces of biting into the bone.  Implants keep the jaw bone protected and healthy.  Assuming the normal hygiene visits and home care happens, the implant supported teeth will likely last decades!

The beautiful thing is implant allow people to once again eat what they want to and chew like they should.  They are able to be healthier and often need less medication and live longer!