Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

August 4, 2016

A couple of teeth just fell out!


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Dr. Hall,
My mother is 85 years old. Just last week she had two teeth filled. She recently lost a tooth and has a partial for that area. Then a few days ago, another tooth fell out. Both missing teeth are from the lower jaw. Fortunately they are in different areas of the mouth. She is very self-consious. At her age, her remaining teeth and gums are probably not in the best of health. We are considering a bridge(s) but are not sure as we don’t know how healthy the rest of her teeth are. Do you have any affordable recommendations on what we can do for the area that is missing teeth?
– Diane from Colorado

Diane,
If I am understanding you correctly, these two teeth just fell out. If that is the case, your mother has advanced periodontal disease (gum disease). It doesn’t get more advanced than that, for teeth to be so loose that they just fall out.

Continuing on with that assumption, it is likely that she has no really solid teeth left, so bridges would be out of the question. A bridge anchors replacement teeth to the remaining teeth, but in doing so it puts additional stress on those remaining teeth. In your mother’s case, that would hasten their demise.

The ideal replacement for missing teeth is dental implants. However, you asked for something affordable. Your mother would likely need full-mouth restoration, and the price for doing that with dental implants could easily get to be $20,000 to $40,000.

Given the condition of advanced periodontitis, all of her teeth are likely loose and would be candidates for extraction. I would seriously look at complete removable dentures. The main disadvantage of removable dentures is that it begins a long-term process of bone resorption. But at the age of 85, that would not be likely to be a significant problem for her.

Cu-Sil partial denture

A Cu-Sil partial
(image courtesy of Dental Arts Laboratory, Peoria, IL)

Another solution would be a type of partial denture called a Cu-Sil partial that is built like a complete denture, but has holes in it to allow the existing teeth to poke through, and there is a silicone ring in each hole that snugly holds each tooth. This is a little more stable than a complete denture, and as additional teeth are lost, it is a simple matter to then close each hole and put in a new artificial tooth.

A conventional removable partial denture also puts extra stress on the remaining teeth. It’s not as much stress as a bridge, but it’s still enough to weaken the teeth, so I wouldn’t recommend that either.

Dr. Hall

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About David A. Hall

Dr. David 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 complete Internet marketing for dentists.

September 25, 2012

This new tooth gap is really serious – her teeth may fall out

Filed under: Gum disease — Tags: , , , — mesasmiles @ 6:09 pm

What would you recommend for my smile? I had a huge overbite as a child from sucking my thumb, had braces and was very happy with the results. My problem is that I’ve been told I have periodontal disease and now have a HUGE gap between my lateral incisor and canine tooth and makes my smile look crooked.
– Karen from Washington

Karen,
Your periodontal disease sounds serious. Once your teeth start moving, they are already getting loose and may have lost half or more of their bone support. So your treatment plan is going to have to focus on that first. Exactly what options are available to you, that is going to depend on the severity of your periodontal disease. And your first step is going to be getting your periodontal disease under control, if that is even possible. Your dentist has hopefully made that clear to you.

And from there, you need to proceed cautiously. If saving your front teeth is a hopeless proposition, for example, you probably won’t want to invest thousands of dollars in porcelain veneers. Instead, you may want to be looking at getting dental implants, or a removable appliance to replace the hopeless teeth. On the other hand, if the periodontal disease can be brought under control and the destructive processes stabilized, the teeth may be able to be moved back into an esthetic position with braces and stabilized there with some type of splint that will prevent them from moving again.

You do want to be sure that your dentist is one of the small minority of dentists who is truly sensitive to appearance-related issues. 98% of dentists have a strong engineering mentality, focused on fixing things. While they are generally honest and skilled practitioners, they are not artistic and would not fully appreciate your concerns about your appearance or be able to give you back your beautiful smile. I would urge you to check our list of screened cosmetic dentists and choose one of those. That is why I operate this website.

Dr. Hall

We thank our advertisers who help fund this site.

About David A. Hall

Dr. David 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 complete Internet marketing for dentists.

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