Dr. Hall,
I am considering getting full dentures. I was told I had little enamel left on my teeth about 13-14 yrs ago and since have had two pregnancies in which I vomited every day (sometimes multiple times a day) during my entire pregnancy. Since the birth of my last child 8 yrs ago my teeth have literally started crumbling like powder, cracking and I have a lot of visible cavities.

I had a tooth removed last week because it had already started falling apart and I cracked it in two blowing up a float for my child and I flat out had enough. Five of my teeth are literally down to the gum line now and one crown and post have fallen out. My dental insurance only covers $1000 a yr and it doesn’t take much to use that up so if you are wondering why I have not had all this fixed as it happened when you run out of insurance in March it is hard to get anymore done with insane cost of cosmetic dentistry. It will only cost me $1400 out of my pocket to get upper dentures (I am still debating on lowers as they are not as bad as the uppers) but I was quoted about $4000-$5000 out of pocket to get root canals and crowns or bridges. I do not qualify for any loans or assistance to get this done so dentures appear to be the only option.

I have read just about everything you have on this site and am really irritated at your comments about people’s care or lack of care for their teeth as you do not know what some have gone through. I also had meningitis as a baby and was put on a lot of meds (I have other health issues due to this but my teeth are the worst). I would love to have an awesome cosmetic dentist fix my teeth right but unless you or they intend to do it for free I think you need to stop being so condescending about what people should do and/or what caused their teeth to become bad in the first place. In case you are wondering I have brushed after every meal and snack since I was a kid and flossed at least once a day as well as rinsed with a mouthwash but it has done me no good except to ensure fresh breath.
– Wendi from Alabama

Wendi,
It sounds to me like you’ve almost completely decided what you want to do, so I don’t know that you need much help here, but I’ll offer some. I was also intrigued by your comments and wanted to respond to them.

I think you’re trying read things into my website that aren’t there if you come away from reading it thinking that I would condemn someone like you in your situation. I don’t know where you would get that. Yes, I’m going to tell people to take care of their teeth when they can. To do otherwise would be negligent. But I rarely criticize patients who write to me with their problems. And then there are always things that can happen that are difficult or even impossible to deal with, which sounds like what you have experienced.

About the cost of dental care—yes, it can be expensive. I think it will help you to understand that the overhead to run a dental practice is very high. It can run into hundreds of dollars an hour. And some insurance plans, including government programs, discount their coverage so much that a dentist will lose money on every case. In my practice, I would see some patients with these programs that caused me to lose money, but I had to limit my participation or I would end up turning my entire practice over to that and wouldn’t be able to deliver the quality care I wanted to.

If your finances are really limited, it may be that dentures are your only option. I saw a number of patients in your situation and did my best to help them as much as I could. But don’t expect me to sugar-coat your situation. There are troubles ahead when you get full dentures. They will reduce your chewing efficiency, and there is a great deal of dissatisfaction out there with people who have dentures. In addition, your jawbone will begin to shrink and within about twenty years or so, you will have to deal with facial collapse. But let me try to be helpful, and share some ideas that may be helpful for your situation, because you are in a difficult situation.

Losing your lower teeth is much more serious than losing your upper teeth, and an upper denture is much easier to adjust to and to use than a lower. An upper denture is held in place with suction, so it is considerably more stable than the lower denture, which rests and kind of floats on your lower jaw and is held in place by your tongue and cheeks. Additionally, if you have lower teeth chewing against an upper denture, it may help the lower teeth to last longer. So if you are looking for the most economical solution and you can keep your lower teeth, any amount of time you can keep them will delay facial collapse. And there is much more satisfaction with upper dentures than with lower ones.

Also, any teeth that can be saved for any amount of time will delay the bone resorption. Sometimes the crowns of the teeth can be cut down and the roots of teeth can be retained and this will also delay the bone resorption.

I hope that you can find a sensitive and caring dentist who will take care of your needs and take the time to discuss your options.

Dr. Hall

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