DENTAL CARE

Q: Will I Lose All of My Teeth as My Mother Did?

A: Last Friday, we received an emergency phone call from a patient that was not part of our practice. She was very distraught as she had a bad toothache and could not go to work. Her regular dentist could not see her until a week or so into the future, and she immediately needed help. I called her back, and we had an extensive conversation about the condition of her mouth. We also discussed her general medical situation and her short-term and future goals for her mouth. I presented a strategy for getting her comfortable immediately and promised to follow up with her over the weekend. My emergency intervention did take away the pain. We needed to fix the problem, though, for the long term.

What was her problem? What caused her pain? She was suffering from the Bermuda Triangle of dental disease. Let me explain what I mean. One of her complaints, when she was in pain, was the looseness of her upper front tooth. When I hear this complaint, it usually falls under one of two categories. Either she has fractured a tooth, and the two pieces are separate, or she has gum disease, and we are losing the bone that holds our teeth tightly in her mouth. In her case, it was the latter. When I saw her, she exhibited signs of gum disease in her mouth, which was the cause of her loose tooth. What causes the gum disease and subsequent loosening of teeth?

I began this column with a question regarding tooth loss and whether there is a hereditary component. If mom had gum disease and lost her teeth, is this where I am also going? The short answer is that if only we could pick our parents, then many health issues would be solved. We know that we cannot control the genetic traits that are handed down from our parents. We may very well be more susceptible to gum disease as a genetic problem. Our natural tendency toward this devastating disease is a fact that we can’t control. The inherited gene is one-third of our dental Bermuda Triangle that we cannot alter.

The second part of this triangle is modifiable. Smoking is a primary factor in gum disease. I see many patients who smoke, and most of them I treat for gum disease. Unlike our genetic component, this is a modifiable risk factor. In other words, smoking cessation or at least reduction as a first step will go a long way to decreasing the presence of gum disease.

The third component of gum disease in this patient is grinding or clenching teeth. The forces exerted on the teeth from a grinder or clencher can be 3-4 times the average amount that we apply to our teeth when we chew. Since gum disease involves keeping the tooth stable, these excessive forces will promote tooth loosening and loss of bone.

My new patient had two risk factors that we could address and one that we could not control. Her loose front tooth was beyond repair. I recommended that we remove the tooth and place a dental implant the same day. There are no delays in time or gaps in her mouth. We coupled this treatment with an approach to stop smoking and an anti-grinding device to protect her teeth from the destructive forces of grinding and clenching. The infamous triangle no longer posed a threat.

We know that the Bermuda Triangle spells disaster for those who venture into it. With our patient, we can break up the triangle and stop further destruction and tooth loss. If you feel a loose tooth, I encourage you to call us at 440.951.7856 and make an appointment to move you in the right direction. I look forward to hearing from 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