I just turned 40 & have to have the rest of my teeth (16) pulled. I am a crying mess. I recently found I have a severe calcium deficiency which I am slowly but steadily turning around, but I need dentures & can’t afford a full set of implants. I have 1 implant already.
Would you say all-on-4 would keep my face from collapsing? Or do you have other ideas for me? I am a single mom of a 1- & 3-year-old and don’t want to look like their grandma. Please help.
– Stephanie from Minnesota
(See Dr. Hall’s answer below.)
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My first question for you is, Why do you have to have all your teeth extracted? You’re not giving me any details about this treatment plan, so my first response is to question it. Dentists vary in their desires to save existing teeth. Some view it as much simpler to extract teeth and do a denture. Saving teeth can be much more complicated. I would suggest getting a second opinion. Find a dentist who has strong views about trying to save teeth and see what he or she recommends for you.
Second, I’m not sure I understand this severe calcium deficiency you say you have. Is this something your dentist told you? A calcium deficiency doesn’t have anything to do with the health of your teeth, not at this point in your life. It can lead to cramps, nerve problems, or osteoporosis. But the teeth are all fully formed and will not be affected in adults by any calcium deficiency. I have heard this used as an excuse to explain problems with tooth decay, but there is no connection. The greatest contribution to decay problems is frequent snacking. There are other contributing factors, but that is the one that most often leads to rampant decay.
If you indeed do have to have all your teeth extracted, and you have no teeth or dental implants left in your jaw, you will, over a period of ten or twenty years, end up with facial collapse as your body gradually resorbs your jawbone, which it perceives you no longer need. You’re correct that this will leave your face looking sunken-in and old. But worse, it will leave you a dental cripple, unable to adequately retain any kind of removable lower denture and also impairing your having a satisfactory upper denture. The presence of any dental implants will prevent any bone resorption around those implants. Even two implants will be a great help, and a snap-on denture would be a tremendous improvement over a removable denture. Better would be four implants.
With freshly extracted teeth, you probably wouldn’t need the all-on-4 denture. What the all-on-4 denture does is eliminate the need for bone grafting when you have had a lot of bone resorption already. But if the teeth have just been extracted, there isn’t time for bone resorption. Though it would be best if the surgeon would place some bone graft material in the extraction socket—a relatively simple procedure.
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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.