DENTAL CARE

Q: Don’t Touch That Tooth!

A: I met her yesterday, and she was listed on my schedule as wanting a partial denture. She smiled at me and showed me an obvious gap in the front of her mouth. I observed that her teeth were in disarray as she had several missing teeth. The teeth that are opposite the missing ones had moved out of place. The lower teeth moved upwards, and the upper teeth drifted downwards. When I looked at her bite, only two teeth touched when she closed her mouth.

Movement of teeth occurs when there is nothing for the tooth to chew against. Teeth move until they hit something and then stop moving. Teeth that have a solid foundation in the gum and bone move slowly. Patients who have teeth that have a failing support system move even faster. Missing teeth cause an overload to the ones still present as they take on the brunt of the chewing. The extra chewing causes a further deterioration of the bone and gum holding the teeth in your mouth, resulting in a loose tooth.

Looking further at her teeth still in her mouth, I noticed deposits of tartar present. The build-up of debris on teeth, teeth out of place, and loose teeth all spell one thing. My new patient has periodontal or gum disease. The tooth I was not allowed to touch was loose, and she was worried that the tooth would fall out of her mouth. We discussed her dental history, and she told me she saw a dentist regularly. She also told me she knew she had gum disease and followed that declaration with my charge. I was supposed to fill in her gaps but not touch her teeth. She wanted a removable partial denture for her mouth to improve the cosmetics and her smile in general.

We went on to discuss the angulation of some teeth and my concerns about a partial denture fitting properly. I suggested that I manicure and recontour a minute amount of tooth to help in this area and again was told not to touch any teeth. At this point, I’m sure that you are as curious as I was. Why did she come to see me? Furthermore, why didn’t she seek help from her existing dentist?

The story finally unfolded and was centered around our technology. She knew that I could make crowns, partial dentures, or full dentures without taking an impression. I use a digital scanner to make a copy of what I see and use that copy to make some dental device for a patient. This new person in my life was afraid that she might lose a tooth if she used a traditional impression technique with her. She knew how loose some of her teeth were and was concerned that the impression material may grab a loose tooth and speed up its loss. The fear actually centered around pulling out a tooth when taking a traditional impression.

My patient needed to address the severe gum disease in her mouth but was not ready to face it head-on. She wants to delay the inevitable for as long as possible. I hoped to make her smile and feel comfortable so that when the time came, she would seek help from some dentist to move her to the next stage. I performed my digital impression without touching a tooth as I was directed. I know dentists who would have sent her away, but I saw no point in doing that. I wanted to help her and make a friend so I could be there when she was ready for the next step. If you have a situation in your mouth and are afraid of what a dentist may say to you, please call Nikki, and let’s meet. You might be surprised by what you find out. Our phone number is 440.951.7856, and as always, I look forward to meeting you.

Jeffrey Gross, DDS, FAGD, is an Ohio-licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine. The Healthy Smile 34586 Lakeshore Boulevard (¼ mile west of Route 91 on Lakeshore Blvd) Eastlake, Ohio 44095 440-951-7856 Severance Medical Arts, Suite 603 5 Severance Center Cleveland Heights, OH 44118 216-371-2333 www.jeffreygrossdds.com