Healthy Smile: I Want To Eat

by Jeffrey Gross, DDS, FAGD of The Healthy Smile

Don’t we all want to eat? This simple statement made by my patient sums it up for most dental procedures. For many of us, the focus of our days is food. We all need to eat, and many of us love to eat.. My patient is 75 years old, and the missing teeth on his upper right side have been the focus of his concern since he called my office last August. When he first called, he told my receptionist that he lost a bridge in that area of his mouth. He wanted a replacement.

I focus on removing and correcting any types of disease in their mouth with any new patient. This gentleman was no exception. When I met him, I observed mild gum disease and an area where food was collected regularly. Before I did anything else, eliminating both of these findings is imperative. I want to credit him for not pushing for tooth replacement earlier. He trusted me as a doctor and followed my protocol. In our case, it took a few months, but I am proud to say that his mouth is now disease-free.

We can finally get to the purpose of his original phone call, which focused on getting a new bridge. He only had two teeth from the back of his mouth to the front. The supports for his old bridge were gone, and we had to decide what approach to take to replace it. The loss of these supporting teeth left a large gap on that side. Essentially, there was no chewing function on his entire right side. He could chew on the left side and the front teeth, but that was all he could do. All my readers know that a setup like this is a recipe for disaster. While it may work for a while, the stress and overload of the left side will result in breakage and damage on that side. Additionally, the front teeth are not designed as grinding teeth. If we use them that way, they will start to loosen or fracture.

Losing an entire cemented bridge means that replacing it involves making the new bridge bigger and longer. When I started in practice, very long bridges were commonplace as we had no other choice. However, this is not an ideal approach to the problem. As the name implies, a bridge spans an area of missing teeth. This concept is analogous to a bridge over water. Although a short gap between the two shorelines would work with only two supports, longer spans need more support.

This thought process carries through to the mouth and shows up in our patient. The load transferred to the supporting teeth on a long bridge will result in a short life span of that bridge. The chewing load will cause the support teeth and the bone around them to weaken. Alternatively, the supporting teeth will fracture or come loose over time resulting in cavities on these teeth. The long and the short of it is that this bridge is too long (no pun intended).

I suggested adding some supports, just like engineers do on long bridges, to reduce the load on the end teeth. With the addition of a single implant, I can improve the odds of long-term success. Ideally, placing two implants would be better, but he did not have enough bone support for that, so I suggested a great alternative.

My goal is to ensure that you can eat to the best of your ability in your given situation. If you are struggling with eating and are looking for a permanent solution, please call us. I will try my best to help you. Please call 440-892-1810 for an evaluation, and 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