Dr. Hall,
My 22 y/o son is a recovering drug addict whose teeth have been destroyed. His dentist recommends extracting 27 teeth at one time and replacing with dentures. Is this a lot to do in one visit? Aren’t dentures custom fitted? I know this is probably the best route to take for him and he is ok with this. Right now he only has his front teeth to chew with. Thank you.
– Rebecca in California
Dear Rebecca,
I am not in favor of this treatment plan. It’s easy for the dentist and a lifetime of difficulty for your son. Twenty-two is way too young to be getting all his teeth extracted.
Once the teeth are extracted, your son’s jawbone will start to shrink, and will continue to do so for the rest of his life. By the time he is 40 he will be a dental cripple, unable to comfortably retain any kind of a removable denture. His face will shrivel up and he will look much older than his years. He will be wanting expensive and complicated bone grafts to his jaw to try to get to some level of function where he can eat normal foods. By the time he is 60 it will be much worse.
Surely, out of those 27 teeth, there are some that can be saved. Any that are saved will help preserve that jawbone. Yes, it is more bother for the dentist and it will be more work for your son to maintain those teeth. But it is well worth it.
And, if there are none that can be saved, placing some dental implants will do the same thing as far as helping prevent the shrinkage of the jawbone. Even two implants per arch will help preserve his bone, though more would be better.
It’s easy to look down on your son and say, “Drug addict – not worth the trouble.” And he may well have similar feelings about himself. But I would hope for better things for him.
As far as the number of extractions, that is a little much for one sitting, in my opinion. The amount of novocain required to extract all the upper teeth in one sitting is pretty large, and that can be a significant risk factor, in addition to the amount of trauma from all those extractions. The lower jaw can be completely numbed with two main injections, but the upper jaw requires multiple injections.
If I were in your shoes, I’d go dentist shopping. Dentists have to pass minimum competency examinations, but there is no examination for caring. Find a dentist who gives you a feeling that he or she truly cares about your son and his long-term future, and that will greatly improve your chances of getting good care for him.
– Dr. Hall
Reply from Rebecca:
Dear Dr. Hall,
Thank you so much for your reply – I really appreciate it.
My son is the most important person in the world to me and if I was financially able I would have his teeth replaced with implants. I will accept your advice and get some other opinions. I am not an expert but I too thought this was an extreme treatment plan.
Again, thank you and have a great day!
Related links:
Immediate dentures are placed the same day as teeth are extracted. They require relining a few months after being placed.
Dentures that are made with special attention to their appearance are sometimes called cosmetic dentures.
Soft dentures are made with soft linings for a more comfortable fit and sometimes a more snug fit.
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.