Tooth Talk: A young smile, Part II

Q: My dentist won’t stop bugging me. I had a tooth that broke and needed to be pulled, so my dentist pulled it. Now he keeps bugging me to have it replaced. I’m in my 60s and at my age it’s just not worth it. Why won’t he leave it alone?

A: I’ve answered this question in last week’s column but I wanted to extend it by sharing a story about a personal experience I’ve had with one of my own patients.

“Betty” as I’ll call her, had been a patient of mine for a long time. For years we had discussions about replacing her missing teeth but she always put it off. She was a very vibrant woman busy with friends and many hobbies and social engagements.

As time passed her situation worsened but she still kept putting of the treatment she needed in order to help save her teeth. Eventually, she had a problem and there was no other alternative but to proceed with the treatment I had been trying to get her to do for years.

During our discussion about her treatment she said she knew she shouldn’t have waited. But she had that “at my age…” barrier up which she couldn’t get past in order to do what was best for her overall long-term health.

She was right, she shouldn’t have waited and if she hadn’t there would have been more options. As I stated before, missing teeth create bone loss, and a marked decrease in the quality of remaining bone, shifting of the teeth and a change in the bite.

As these things progress the choice of treatment options becomes narrower and narrower until finally there is only one or two viable options available.

“Betty’s” only option was to remove her remaining upper teeth, place grafts to augment and improve the quality of the bone and make her a full upper denture to wear while everything was healing.

Once healing was complete we would begin her permanent treatment. She hated the denture. It became difficult for her to eat and her social life suffered because she was embarrassed by the denture.

For some people dentures just aren’t a possibility. It may be a strong gag reflex, the inability to taste food, a lack of support for the bone or a variety of other problems that make dentures at best uncomfortable and at worst unwearable.

As I said before she wasn’t happy but she was getting by. Later that season she became ill and had to be hospitalized. Since she couldn’t wear her denture her nutrition suffered.

When I saw her again she had lost weight but was excited to proceed so she could resume her old life. Her treatment continued but her ability to cope with the denture was becoming increasingly difficult. At this point “Betty” had lost 75 percent of her chewing power because she was dependant on a denture until we could complete her treatment.

The ability to chew food and thereby digest it is highest amongst natural teeth and implant prosthetics. This makes an extreme difference when it comes to nutrition as you can see with “Betty’s” case.

In every case it is always better to treat a problem once it arises as opposed to waiting. This makes treatment less costly, more predicable and easier for all involved. People are living longer, fuller lives than ever before. Dining and socializing with friends are becoming increasingly important especially for today’s seniors. Your dentist is keenly aware of that as we see you out and hear your stories regularly. So, when you dentist makes a recommendation consider your lifestyle, think of “Betty” and listen but don’t wait.

© 2008 All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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