This week’s column is a little different. Usually, I discuss a statement or question from a patient. Our subject today comes from another doctor. I met a patient a couple of weeks ago who lives in two places, our area and the West Coast of Florida. He travels back and forth between both locations regularly. His dentist in Florida worked very hard to salvage his smile. He has a severe grinding habit which destroyed his lower teeth. I saw his original facial photographs, and no tooth structure was present on his lower teeth. There are no back teeth, and all of the chewing occurs on the front teeth only. The dentist in Florida worked very hard to recreate his smile. She did a magnificent job.
Just yesterday, she called me to discuss this patient. Front teeth chewing is a subject that we discuss a lot in this column. The solution to the destruction of front teeth chewing is the introduction of back teeth. Adding teeth to the back of his mouth is crucial to not losing his new smile. Chewing on the front of his mouth can break or fracture his new teeth in the same manner that it destroyed his natural teeth.
My colleague in Florida asked me to place dental implants in the back of his mouth to take the stress off the front teeth. Although she knew that the correct solution to the excessive wear problem was dental implants, his grinding presented an issue.
When I teach courses to other doctors on dental implants, I spend a lot of time discussing grinding. Dental implants are the most substantial tooth replacement ever used in the history of dental treatment. These artificial teeth can not decay or break down. Their design is such that they can withstand tremendous forces during normal function.
However, teeth grinding is not a normal function. Grinding natural teeth will wear them down or even knock them loose. These extreme forces, when applied to dental implants, will also stress the implant. Screws can break, the connections can fracture, and even the implant could get loose. The looseness is due to bone destruction around the implant as grinding forces travel through the implant to the
surrounding bone. Is there any way to create back teeth that will not succumb to his grinding habit?
Remember when you were a kid and played tug of war. The side that could dig their feet in the best and hold their ground won the battle. That team withstood the forces of pull by the opposing team. The same analogy can apply to our case. I will create a strong anchor with our dental implants. I plan on placing two implants followed by two crowns on them to have adequate anchorage. The dentist in Florida will join the crowns together so the grinding forces will dissipate over both implants.
This patient is a challenge, but working closely with his doctor in Florida will yield an excellent result. Often the team approach is the appropriate solution to solving a problem. I can work with your doctor, or if you are seeking a new dentist, I can make it a solo operation. Either way, the goal is excellent and long-lasting dental care.
If this sounds like something you would like, then please call our office at 440-892-1810 and set up a visit for you. 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