Healthy Smile: I’m Afraid It Will Come Out

by Jeffrey Gross, DDS, FAGD of The Healthy Smile

I often hear that statement when a patient comes to me with something loose in his or her mouth. The loose object is usually a tooth, but more often than not, it could be a loose piece of dentistry. Those objects will typically be a crown or a permanent bridge. Both natural and dentist-made teeth loosen for a common underlying reason of deterioration of the supporting or anchoring mechanism.

When we refer to loose teeth, we usually see a breakdown in the bone or gum around the tooth. Fibers from these tissues attach to the teeth and create a firm base. These live tissues anchor the tooth into the jaw and allow it to withstand the forces of chewing and grinding. When talking about man-made teeth, the cement will have started to break down or disintegrate.

When I encounter these situations, my first task is stabilizing the loose object before things go from bad to worse. Stabilization could involve anchoring the teeth to their adjacent neighbors or reapplying cement, allowing the status quo to return to the mouth. Sometimes, though, I can not treat the tooth first on my list of repairs or fixes. I need to prepare the mouth for a more involved procedure.

When I do this, I need to duplicate the mouth so my lab or I can prepare something to place in the mouth down the line. Duplicating the mouth involves a dental impression or, as is commonly stated, “taking a mold of your teeth.” I take a large spoon-like object that fits in your mouth and covers your teeth. I fill this object with a putty that turns into an elastic, rubbery material in a few minutes or less. After it turns to putty, I remove it from the mouth and use that impression to create a model or duplicate of your mouth with all its unique details.

This process elicits the statement that I quoted in the title: everyone fears losing a tooth when I remove an impression. To be quite frank about this situation, that scenario is not impossible as I have to evaluate the looseness and, if necessary, take precautions to avoid that unwanted result.

I still make physical impressions as they are often needed, but I have another way to deal with the loose tooth issue and lay to rest any concerns of pulling out a tooth inadvertently. The days of tugging and stressing the tooth are gone through digital impressions. In addition to that fear, the often mentioned concern about gagging goes by the wayside also. Using a digital camera and very sophisticated software, I can make a model of your mouth without ever touching the teeth. As you can well imagine, the benefits are tremendous.

I saw a patient this week with a bridge in the front of his mouth that was attached to only one side. Using a traditional impression created a real danger of dislodging the bridge. Going digital allowed me to accomplish my goal without concern or thought of dislodging the bridge.

Every day, I look at and evaluate new technology. Some of the newer techniques solve problems, and others may be more cumbersome. I try to blend the new with the old and create the best level of dentistry that I can for you, my patient. If something is weighing on your mind in your mouth, please call us and see if I can allay your fears and concerns. Please call me at 440.892.1810 and set up a visit with me. I look forward to hearing from 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 •

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