DENTAL CARE

Q: I Lost a Tooth During

A: the Pandemic When I met this patient this week, she was concerned about the state of the rest of her teeth. During the past two years, numerous dentist offices have been closed. Some closures were temporary, while others became permanent as fear of the unknown overtook many of my colleagues.

For the patient, these closures meant delayed health care. As such, routine checkups which could make the difference between health and disease were canceled by both offices and patients. When patients started to return, we saw more infections than in the past.

My new patient suffered from an infection that got out of control. She saw more than one specialist after the problem became apparent, but it was too late. The only treatment for her infected tooth involved its removal. Fortunately, she was intelligent and educated and knew that replacement is the next step if one loses a tooth. When I saw her, she had a crown over an implant in that spot in her mouth.

The reason that she made an appointment with me stemmed from her concern about the loss of future teeth. Granted, her loss occurred when everyone’s lives were in upheaval, but the progression of disease that led to that loss happened quickly. She sought a second opinion from me as she was concerned that her dentist was not sufficiently aggressive in her assessment and treatment.

When she looked into her mouth, she saw areas where the gum started to pull away from the teeth. She did not want to miss the early signs of gum infection, leading to another tooth loss. After listening to her carefully, I proceeded to examine her mouth, emphasizing the areas of concern. The good news revolved around the fact that she took care of her teeth well. When I looked specifically at her areas of concern, visually, I did not see any signs of approaching disease or infection. In short, I agreed with her dentist and his assessment.

When she saw one of the specialists regarding the lost tooth, he informed her that she had a gum infection. That statement prompted her to become very proactive regarding her gums. Although I saw health throughout her mouth, the lower front teeth have issues.

Remember, I am looking at the gums, but I just said that the front teeth were of concern. Although there were no cavities present, she suffered from too many teeth in too little space. Her lower front teeth are jumbled together and crowded. When teeth are not aligned nicely, the chance of developing cavities and gum disease increases tremendously. It is important to remember that tooth position does not cause gum disease, but it sets up a situation where gum disease and infection can take hold more easily.

Crowded and crooked teeth are not self-cleansing and create spots where trying to clean the area is more challenging. Food debris and plaque are often left behind, and minor infections develop. These small infections grow and turn into serious problems.

The preventative solution for her is simple: straightening those teeth and aligning them. I have a patient who has struggled with his lower teeth’ gum and bone health for many years. He had surgery performed, but the problem never went away completely. I suggested that we straighten his teeth, and he agreed. Fast forward a few months, and all the disease is gone as cleanings and regular maintenance are so much easier than before.

If you look in the mirror and see crowding and twisted teeth, maybe it’s time for an assessment. The fix is quite simple, and the benefits are enormous. If this sounds like you or someone you know, please call Nikki at 440.951.7856 and ask her to set up a visit with me. It may be the most important phone call you make when saving your teeth.

Jeffrey Gross, DDS, FAGD, is an Ohio licensed general dentist and is a staff member at Case School of Dental Medicine in the Department of Comprehensive Care.