Many of the patients I hear from online believe that the solution to their dental problems is to have dental implants.
This may be true, but dental implants are expensive, they are not pleasant to have (I mean, no dental treatment is, really, is it?) and they take time.
So it makes sense to ensure that whatever is done, the chances of a long-lasting and healthy treatment result are increased as much as possible.
In my experience, there are two main reasons that dental implants fail:
1: They get gum disease, lose bone, and have to be removed
2: They have uneven bite forces, they either lose bone or break and need to be removed.
The first scenario is more common, but the second cannot be ignored.
By looking at the mouth as a whole, and not focusing on the missing teeth, or the loose denture, we are able to assess the mouth from different viewpoints, so we look at it from 4 categories.
Health relates to both gum health and tooth health. Gum disease and tooth decay are the two biggest sources of all dental problems and ultimately lead to tooth loss.
So it makes sense that we always take the time to get the mouth to perfect health before we start the rebuild process.
The bite and support are related. As we lose teeth, our bites change and some teeth can become overloaded, leading to tooth fracture. Often missing back teeth can cause front teeth to break.
In this case, tooth 1 was causing pain, and the patient’s own dentist could not figure out what the issue was. The patient thought it was another tooth, but if you look at tooth 2, it is taller than the rest.
This has happened because there is no tooth above it.
As this tooth has overgrown, it now hits awkwardly against the back of tooth 1 – causing pain and sensitivity in this tooth.
This lady was ready to have this tooth removed and have an implant, but all we needed to do was a little bite adjustment, and the problem was solved.
In other cases, bite problems cause the lower jaw to change position, and when this happens, the front teeth contact more heavily, and typically old crowns that have been fine for years, start coming off again and again.
The support relates to the number of teeth in contact, and we need to have enough so that the bite is stable, and when the teeth contact, there is a well-definied contact.
Lastly, we look at the aesthetics.
The funny thing is that if we address the bite, the health and the support, then the aesthetics seem to take care of themselves to a degree!
Personally, I am very focused on aesthetics, and this is a key reason that many people reach out to me to help them with their smiles, but as you can tell from this post, often, a lot of stuff needs to happen before we look at the aesthetics…BUT… The aesthetics need to be planned for at the beginning.
This is why I am reluctant to carry on work that has been carried out abroad – it is almost impossible to get a perfect looking result if something early on in the treatment has not been carried out properly.
But I will give you an example of this next week.
