Healthy Smile: “There is Nothing New Under the Sun.” Ecclesiastes 1:9

by Jeffrey Gross, DDS, FAGD of The Healthy Smile

If you are wondering, I did not give up my dental practice to become a religious leader. Although the title of this week’s column could lead you to believe I did move in that direction. That being said, I want to share some thoughts with you on how important it is to keep an open mind regarding dental care. An open mind is important for the doctor and the patient. Openness starts with the professional but needs to trickle down to the patient. This can only happen when there is communication and trust between those two individuals.

I saw a patient this week who lost her upper right molar. Although many patients did not give enough importance to this tooth, she understood that it is one of the keys to effective and efficient chewing. In practice, the first molars, the first big teeth we encounter as we move from the front to the back of the mouth, account for 80% of our chewing strength. These teeth take the stress off the rest of the teeth, resulting in all the teeth lasting longer with less wear and tear.

My regular readers know that implant dentistry is a normal part of my practice and has been for almost 30 years. For a long time, I was the only general dentist placing implants back in the day. With that as a background, my patient’s choice for replacing her upper right molar should be an implant with a crown. As with any medical procedure, there are certain requirements and prerequisites for that technique to create the desired result.

When it comes to implant dentistry, there is a unique set of needs to allow the procedure to take place. First and foremost is adequate bone. What does that term mean? Adequate bone is defined as enough width and height around the proposed implant to anchor the implant. If the bone is lacking in either of those dimensions, the implant procedure will not work, and we need to look for alternative treatment.

That is the case with my patient, and she did not want to try creating more bone. She wanted to replace her tooth as soon as possible, and bone creation procedures took time. The next treatment option is a permanent bridge. When I do this procedure, the teeth on either side of the missing tooth will receive crowns to anchor the bridge. Those teeth are in great condition in her case, and she did not want me to shape those teeth for the bridge.

At this point, many people would run out of options, but I reached into years of practice and recommended a very popular technique before implants became commonplace. I suggested that we utilize a bonded bridge for replacing the missing tooth. With this procedure, lack of sufficient bone is not a factor. The concept of no or minimal preparation of the adjacent teeth solved her problem. I could even do the procedure without any numbing solution because it is so gentle and not invasive.

The bonded bridge technique is not new, but neither is her problem. As the title of the column says, there is nothing new under the sun. At the same time, there may be exceptions to that statement but in life, that message is true quite often. My patient was very pleased with the approach as it solved all her problems and saved her money. I would call that a win-win for all concerned. If you are missing teeth and want to explore various techniques to replace the tooth, please call me at 440.892.1810.

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