Healthy Smile: “I Want to be Able to Eat….

by Jeffrey Gross, DDS, FAGD of The Healthy Smile

……and I want it to be cheap!”  Those were the opening words of my patient this week with the exclamation point. This visit from this patient was not the first. I saw him previously as we prepared him for open-heart surgery. Often, cardiac surgeons send a patient to a dentist for clearance before a procedure. Oral infections are very severe. These infections can and do get into the bloodstream. The results of this spread will be devastating on a patient after heart surgery. It could even result in a loss of life.

My patient was one of those people that I see under that circumstance. His mouth was a mix of infections and broken teeth. Due to the urgency of his surgery, we did not have time to do the entire treatment plan that we discussed. Our strategy involved removing all of his teeth and making him a denture. I had time to remove all of the teeth, but making a proper denture was not possible in the timeframe that he gave me. My other choice involved removing all of the teeth and leaving him with nothing until after rehab. That approach was less than ideal due to a lack of cosmetics and impaired eating function.

I decided to leave a couple of back teeth for chewing and some front teeth. The front teeth served a dual function. For the patient, they presented a level of dignity. For me, they gave me a guide to creating a denture with similar size and position of teeth. Leaving front teeth makes the possibility of “denture shock” less likely. What is “denture shock?” This phenomenon occurs when the look of the denture is drastically different than the patient’s original teeth. Leaving a few teeth until the very end precludes this problem from happening.

He and I agreed upon the plan a couple of months ago before the heart surgery. This week he came to me to finish the case. However, he changed his plan. He did not want to remove any more teeth. The teeth that I had left were not diseased. He no longer wanted to wear a full denture and wanted to use the remaining few teeth as anchors. I can make a partial denture with as little as two teeth. However, not all “two teeth” are created equally. The position of the teeth in the mouth will make or break a treatment.

He had more than two teeth, but the spacing was not ideal for a partial denture success.  An entire side of his mouth was devoid of teeth. The replacement teeth that I would make for him would not stay in place without some aid for stability. The only way for him to wear his new partial denture would involve the use of a dental adhesive. I never want to do a case with adhesive as a must from the beginning. Even with the adhesive as an aid, I could not tell him that he would be able to eat. He was willing to take the chance. I was not in favor of this plan as I felt it was doomed to failure.

I offered him a backup plan. I agreed to make an upper partial denture with the qualification that if we found problems, I could add an implant to make his treatment successful on all fronts. I do not have to start from scratch and throw away the partial denture. I can retrofit an implant into an existing partial or full denture. He and I came to a meeting of the minds and were both happy.

You don’t have to live with a sloppy fitting tooth replacement. There are many ways to turn disaster into success. Please call me at 440-892-1810 and set up a visit as a start to ending your problem. I look forward to meeting you.

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

The Healthy Smile • 27239 Wolf Road, Bay Village, OH 44140 • 440-892-1810 • www.jeffreygrossdds.com