Healthy Smile: You Did Such A Good Job, So I Never Came Back

by Jeffrey Gross, DDS, FAGD of The Healthy Smile

I looked it up and found out that I saw that patient 22 years ago. At that time, I removed all of his upper teeth and most of his lower teeth. I fitted him for an upper denture and a lower partial denture. One of the keys to success involved what I did with the anchor teeth for the lower jaw. I protected those teeth with crowns. In addition, to the protective factor, the two crowns were lined up and made parallel. This parallelism created an ideal path for the lower partial insertion and removal. These factors translate into less wear and tear on the supporting teeth.

Most patients who take a hiatus from dental care walk into our office, requiring extensive rethinking and redesigning their dentistry. My old friend does not need extensive care to renew his upper and lower teeth. A new denture and a new partial will move him forward to the next decade or more because of the care and attention to detail that I placed over two decades ago.

I mentioned that I took out most of his lower teeth. I left the lower six front teeth to help support his partial denture when I did this. As I explained above, the two end teeth were crowns and are in great shape. The remaining four front teeth, however, are pretty beat up. Our dilemma in 2022 is what do we do with these teeth that show extensive breakdown and decay.

Fortunately for him, the choices are simple. Either I will try to save them or remove them. Let’s talk about both options. If our decision is the removal of the teeth and fill in the space with teeth on the new partial, then the only teeth left will be my two crowned teeth. There will be no anchorage in the back of the mouth or the front of the mouth. The new partial will rock back and forth, much like a teeter-totter. Suddenly, the two supporting teeth will be subject to a lot of movement. This movement will weaken and loosen the crowns that are protecting the teeth. The solution to this problem would involve either back or front implants to eliminate the rock and spare those teeth.

The other treatment option I gave him involved keeping and fixing the lower front teeth. Through the use of crowns and other treatments, I could conservatively treat those teeth and save them. Without losing those teeth, the future rock of the partial would not happen. This approach would not require dental implants. I could use his natural teeth to prevent the damaging rock from occurring.

After discussing both of these choices, he decided to keep his front teeth. This method would create a faster treatment as I would finish his treatment in less than six weeks. Another advantage for him is that there would never be a time when he was without his lower front teeth. As we come out of Covid appearances, neglected for so long, we are now resuming their important role in our lives.

Very few of us live our entire lives without ever repairing or replacing our teeth. This fact is even more true with dental work. Nothing lasts forever, and re-creation of the product is necessary. My philosophy is that replacing a denture or partial should happen every 5-7 years. The replacement is necessary because of wear and tear as well as hygiene reasons.

Call our office at 440-892-1810 to set up a “talking appointment” with me. We can discuss all of your smile options. 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