 |
 | Home | Contact Us | FAQ | Search & Site Map | Link to Us |
 | Sign In | Join | Other 45 Sites in Network |
Medical Forum / General / Dentistry / March 2005Prolonged delay of treatment for periodontal diseases
Would appreciate an opinion about prognosis, concerning a letter just received from one periodontist: "It is necessary to start treatment for your periodotal infection. Periodontal deseases are progressive, usually painless, and are the major cause of tooth loss in adults. It would be regretful if prolonged delay led to the development of a condition that could not be treated." Question: What kind of regretful conditions could develop than can not be treated? Anything fatal or tragic? MORE INFORMATION: Removing the infected tooth (#12) is to leave two spaces since a cantalever is resting on the infected tooth and it is said to be best removed since it has no resting place. I asked about a new 4 or 5 tooth bridge and was told that it wouldn't last long since the dependent teeth are weak and for that reason, not recommended. Final diagnosis is: to remove ALL my upper teeth because they are weak. I am over 60. Had gingvitus twenty-five years ago which was reversed. I have all crowns and bridges and but for the infected tooth, I think they may still be of service for a number of years - but also (I am told) it is doubtful and that it makes sense to make the bridge because its expensive and painful (for me) and the DDS feels it would be unethical for him to recommend this. This opinion has been seconded by another periodontist. I am mortified by the thought of removing all uppers at this time (or anytime really) due an infection in one tooth - unless I want to go around with obvious spaces which for practical, business and vanity reasons I won't do. This is because 3 through 8 are one permanent bridge. 9,10,11,12 are independent crowns. 13 is a space covered with a cantelever solidly attached to 14. I can send full mouth exray jpg for better picture. The thing is: They are my teeth and I want to continue to enjoy food, looking and feeling good. I would not be satisfied with anything but a palatless perm denture or full implant which is a very large, time consuming and expensive project. involving bone augmentation at time of removal of any teeth. From what I've researched, bone augmentation is a good idea even for regular dentures because it help prevent gums from shrinkage - so that part I would do under any circumstances. I would like to put removing all my teeth off as long as possible. Why can't I just ignore the infection until it's too painful to live with in which case I may see about finding a DDS who will make a bridge in hope of hanging on to my teeth longer? What do DDS's mean when they say the teeth are weak. Some of my crowns have been in twenty-five years and still going - why cant those teeth be used as anchors? I don't understand. But mainly, My Question is, if I ignore this infection, exactly what regretful conditions am I risking? Anything fatal? I will happily send jpg of full mouth exray if anyone requests. Thanks for reading this. Jonesy, worried in CA >Would appreciate an opinion about prognosis, >concerning a letter just received from one periodontist: got it! >"It is necessary to start treatment for your periodotal infection. >Periodontal deseases are progressive, usually painless, and are the >major cause of tooth loss in adults. It would be regretful if >prolonged delay led to the development of a condition that could not be >treated." Diseases ...... >Question: What kind of regretful conditions could develop than can not >be treated? Anything fatal or tragic? Loss of teeth! LOOSENING and coming out. Does this really happen? YES. >MORE INFORMATION: >Removing the infected tooth (#12) is to leave two spaces since a [quoted text clipped - 3 lines] >last long since the dependent teeth are weak and for that reason, not >recommended. One should post x-rays so we can intelligently inform you what is what. If they were my teeth and I found this great group of dentists I sure would do it. PS- Almost no one takes us up on this! >Final diagnosis is: to remove ALL my upper teeth because they are weak. >I am over 60. You are too YOUNG for that. > Had gingvitus twenty-five years ago which was reversed. >I have all crowns and bridges and but for the infected tooth, I think [quoted text clipped - 3 lines] >unethical for him to recommend this. This opinion has been seconded by >another periodontist. X-rays ..... >I am mortified by the thought of removing all uppers at this time (or Me too! I mean I am mortified for you. >anytime really) due an infection in one tooth - unless I want to go >around with obvious spaces which for practical, business and vanity >reasons I won't do. RECOMMENDATION: Quick Monodont bridge, if it goes it goes. >This is because 3 through 8 are one permanent >bridge. 9,10,11,12 are independent crowns. 13 is a space covered with a >cantelever solidly attached to 14. I can send full mouth exray jpg for >better picture. YUP. Do it. Post at www.tinypic.com and then give us the URL right here. >The thing is: They are my teeth and I want to continue to enjoy food, >looking and feeling good. Who does not? > I would not be satisfied with anything but a >palatless perm denture or full implant which is a very large, time [quoted text clipped - 3 lines] >shrinkage - so that part I would do under any circumstances. I would >like to put removing all my teeth off as long as possible. YUP, let's see the radiographs before you go pulling al lthe teeth ..... >Why can't I just ignore the infection until it's too painful to live >with in which case I may see about finding a DDS who will make a bridge You can ,,,,,,, but sometimes this hastens mobility on other teeth .... >in hope of hanging on to my teeth longer? What do DDS's mean when they >say the teeth are weak. Means that you will not be able to pull a locomotive from a dead stiop using your teeth. I saw a picture of this once. > Some of my crowns have been in twenty-five >years and still going - why cant those teeth be used as anchors? I >don't understand. They can ... maybe.... x-rays ??? >But mainly, My Question is, if I ignore this infection, exactly what >regretful conditions am I risking? Anything fatal? Nope. >I will happily send jpg of full mouth exray if anyone requests. Thanks >for reading this. YUP. Joely >Jonesy, worried in CA http://tinypic.com/view.html?pic=23p2d1 http://tinypic.com/view.html?pic=23p2d1 http://tinypic.com/view.html?pic=23p2d1 Monodont bridge - Yes, ok for one missing tooth, but what of two? Is it feasable for me to try to get the DSS removing that tooth to not remove the canterlever? The dentist who removes the tooth will be the same one to do bone augmantation - but he wants to drill away the canterlever because of too much stress on the rear tooth but why can't the canterlever just rest on the gum and a monobridge be inserted for cosmetic reasons or, if the canterlever must be removed, what about a two teeth duo-dont bridge - if it exists? (it it removable or what?) Or is it wiser to make a more permanent bridge even if the teeth are "weak". Many of the upper teeth are already loose - they have been loose for years since a car accident. Thanks for telling me about the monodent - BYW, I dont eat meat and foods that require alot of tearing strength. Jonesy >Monodont bridge - Yes, ok for one missing tooth, but what of two? Is >it feasable for me to try to get the DSS removing that tooth to not [quoted text clipped - 12 lines] >strength. >Jonesy Best bet is to post some x-rays .... .all cantivelers have different forces upon them. Joel >Monodont bridge - Yes, ok for one missing tooth, but what of two? Only for very short term use. A monodont replacing two or more teeth will only last 6-8 months. >Is >it feasable for me to try to get the DSS removing that tooth to not >remove the canterlever? No >The dentist who removes the tooth will be the same one to do bone >augmantation - but he wants to drill away the canterlever because of [quoted text clipped - 8 lines] >strength. >Jonesy there are many issues here. Your best bet is a second opinion in real life. If you want to ask questions to help understand what is said to you, this forum is ideal. .. Stephen Mancuso, D.D.S. Troy, Michigan, USA I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting. >But mainly, My Question is, if I ignore this infection, exactly what >regretful conditions am I risking? Anything fatal? >I will happily send jpg of full mouth exray if anyone requests. Thanks >for reading this. >Jonesy, worried in CA Ignore the problem and you will likely lose teeth, perhaps soon. When you lose the teeth, the bone will shirk faster due to the long standing infection. the longer you wait the worse the subsequent denture will fit. .. Stephen Mancuso, D.D.S. Troy, Michigan, USA I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting. I will send exrays to address given above www.tinypic.com and give url after this reply: Won't bone augmentation procedure following tooth removal take care of the shrinking gum problem? Jonesy >I will send exrays to address given above www.tinypic.com and give url >after this reply: > >Won't bone augmentation procedure following tooth removal take care of >the shrinking gum problem? >Jonesy OK bone augmentation ........ this is another pet peeve of mine. Many times its not required. In theory it is good but bone resorbs and remodels. It depends where in the mouth it is. Joel >>I will send exrays to address given above www.tinypic.com and give url >>after this reply: [quoted text clipped - 8 lines] > >Joel Too many factors involved to comment without an exam. .. Stephen Mancuso, D.D.S. Troy, Michigan, USA I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting. Jonesy teeth/panaramic: http://tinypic.com/view.html?pic=23p2d1 >Jonesy teeth/panaramic: http://tinypic.com/view.html?pic=23p2d1 Bad news! http://tinypic.com/view.html?pic=23p2d1 When you uploaded, it failed! Warning: mysql_connect(): Can't connect to MySQL server on '10.1.4.9' (99) in /apache/htdocs/Objects.php on line 272 cannot myConnect to database A tinypic URL looks like this: http://tinypic.com/t56hg7 sample (made this up, its no picture) Joel Panaramic of Jonesys teeth: http://tinypic.com/view.html?pic=23p2d1 >Panaramic of Jonesys teeth: http://tinypic.com/view.html?pic=23p2d1 Click it! It fails. >>Panaramic of Jonesys teeth: http://tinypic.com/view.html?pic=23p2d1 > >Click it! It fails. Works now Panoramic X-ray images are not good for evaluating periodontal health .. Stephen Mancuso, D.D.S. Troy, Michigan, USA I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting. >>>Panaramic of Jonesys teeth: http://tinypic.com/view.html?pic=23p2d1 >> >>Click it! It fails. > >Works now True, it works for me too. Joel >Panoramic X-ray images are not good for evaluating periodontal health >.. >Stephen Mancuso, D.D.S. >Troy, Michigan, USA > >I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting. >>>Panaramic of Jonesys teeth: http://tinypic.com/view.html?pic=23p2d1 >> >>Click it! It fails. > >Works now Here is another view: http://tinypic.com/23p2d1 >Panoramic X-ray images are not good for evaluating periodontal health >.. >Stephen Mancuso, D.D.S. >Troy, Michigan, USA > >I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting. Clarification needed. Tooth #12 is the one with the infection, correct? Tooth #13 is the missing tooth being replaced by the bridge. (You call this cantalever (sic). Tooth #14 has a crown. You claim that 12-13-14 are all connected making that a "fixed" non-removable bridge. In that case it is not a cantilever. A cantilever is a free ended support mechanism. DEF Projecting horizontal beam fixed at one end only Construct such that only one end is fixed; as of girders and beams This is similar to the verb, canted. DEF Departing or being caused to depart from the true vertical or horizontal Or the noun, decanter A bottle with a stopper; for serving wine or water This is because one "cants" the mouth of the decanter so that you can pour off the wine without pouring out sediment into your glass. RECOMMENDATIONS WILL FOLLOW ..... Joel >>>Panaramic of Jonesys teeth: http://tinypic.com/view.html?pic=23p2d1 >> [quoted text clipped - 8 lines] > >I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting. Quick diagnosis: Is it time for upper denture (no teeth left)? No. Absolutely not. Joel >>>Panaramic of Jonesys teeth: http://tinypic.com/view.html?pic=23p2d1 >> [quoted text clipped - 8 lines] > >I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting. I have been to two periodontists and a prosthodondont who all agree to remove all the uppers - which to me seems hasty. I don't know if one influenced the other; or of if they are basing their opinion on my financial state, or what? All I know is, if I remove that tooth I will have to do something if I want to be left with an acceptable smile - either pull them all out, or make a four tooth bridge which they say is a very bad idea - and that's what I don't get. One also suggested something might be "going one" on #8 but another one disagreed. >>>You claim that 12-13-14 are all connected making that a "fixed" non-removable bridge.<<<<<<<<<<<<<< No, there no fixed bridge on 12,13,and 14. #13 is a space. #14 is a cantilever bridge - a fixed bridge made up of two crowns - on the side of 13 adjacent to 12 is a tiny wire resting in a tiny whole drilled into the side of crown #12. #12 is an independent tooth with crown. If infected tooth12 is pulled the periodontists say #13 should also be removed by drilling, because it will then have nothing to support it on the 12 side and therefore, will put extra stress on #14, an achor tooth. I think that's the only thing that makes any sense to me that I can agree with - But, when #12 is removed there will be remaining on that side of the mouth: 9, 10, 11, and 14. And both periodontists, and a prosthodontist are in agreement hat it would be "wrong" to make a bridge on weak teeth. It wouldn't last long, they say and I don't understand why not? The infected tooth #12 received some oral surgury (osseous) about three years ago but it did not improve. It is now loose and sensitive. I don't know if one influenced the other; or of if they are basing their opinion on my financial state, or what? All I know is if I remove that tooth I will have to do something - either pull them all out, or make a four tooth bridge (or five is someone recommends) which they say is a very bad idea! (Why is it very bad?????) They say: it won't last long and it's only a matter of time before another area of the upper mouth will act up. It will be a waster of pain, money and time. When any tooth under the six tooth bridge on the other side "goes" it will be curtains for that bridge. It has two spaces now. The reason for bone augmentation is because it is supposed to be best (so I'm told) at time of tooth removal. My head is just swimming with conflicting opinions about what to do. I'm sure I can find a dentist to make me a four or five tooth bridge if I look hard enough - but I keep hearing those periodontists and that prosthdontist saying things like: no good DDS would do that. They don't think my teeth can be saved - period. I'm left with getting that infected tooth out if it doesn't get better (it's getting harder to live with) and having a perm bridge made anyway... or having them all out and proceeding with a transplanted denture about six months after the upper gum heals - using a regular bridge in the mean times. UGH! I don't want any of these things. >I have been to two periodontists and a prosthodondont who all agree to >remove all the uppers - which to me seems hasty. I don't know if one [quoted text clipped - 12 lines] >two crowns - on the side of 13 adjacent to 12 is a tiny wire resting in >a tiny whole drilled into the side of crown #12. OK that is a cantilever, with an occlusal (biting surface) rest on tooth #12. I might recommend an endodontist and inquire if #12 can be treated by drilling through the top of the crown and not disturbing the bridge. SECOND IDEA: Extract #12 if necessary, and then create a cantilever for #11 and attaching #12 to that. THIRD IDEA. Pull the entire brisdge off, extract #12, and make a bridge for #11 to #14. None of these is ideal, but in my book, they are STILL more ideal than the best of full upper dentures! I have made thousands of upper dentures, by the way. If you have a friendly dentist who will do all of this at less than top-dollar fees, due to the fact that it will not last forever, then you got something. I used to do these jobs at COST-PLUS. Patients paid me by the hour, plus they paid the lab bill. Why? Who knows how long it would last? Its still a good dental service, although not ideal. Joel >#12 is an independent tooth with crown. > [quoted text clipped - 36 lines] >denture about six months after the upper gum heals - using a regular >bridge in the mean times. UGH! I don't want any of these things. <<<< I might recommend an endodontist and inquire if #12 can be treated by drilling through the top of the crown and not disturbing the bridge.>>>> You are the first to recommend that - if It is a vialbe option, It would be marvelous. Sure couldn't hurt to ask a good endodontist his opinion here. For some reason my primary DDS felt it was a problem for the endodontist. I think she was thinking long term and frowns on short term. >>>SECOND IDEA: Extract #12 if necessary, and then create a cantilever for #11 and attaching #12 to that.<<<< There already is a cantilever on 14 extending over 13 that periodontist recommends also come out due to stress on anchor in which case it will leave two spaces. If 13 is left in place, can two cantilevers be side by side?? Will there possibly be extra stress on the anchor if #14 cantalever is left in place? It doesnt seem to be soundly wired in to 12 now cause I can manage to get the floss easily around it. THIRD IDEA. Pull the entire brisdge off, extract #12, and make a bridge for #11 to #14. Sound idea. >>If you have a friendly dentist who will do all of this at less than top-dollar fees, due to the fact that it will not last forever, then you got something.<<< There are plenty of DDS's with dental plans or discounted plans - if that's what you mean. I'll see if I can get it cheaper. It's not in the front so I won't be fussy. My theory is I might die from a nasty fall from a horse or in another accident of some time - any time... so why no drag out having my own teeth as long as possible. Thanks for understanding. I will really followin messages now. ><<<< I might recommend an endodontist and inquire if #12 can be treated >by [quoted text clipped - 6 lines] >the endodontist. I think she was thinking long term and frowns on >short term. Plus, when its YOUR teeth not someone else's the ideas seem more tenable. Joel >There already is a cantilever on 14 extending over 13 that periodontist >recommends also come out due to stress on anchor in which case it will >leave two spaces. If 13 is left in place, can two cantilevers be side >by side?? Will there possibly be extra stress on the anchor if #14 >cantalever is left in place? It doesnt seem to be soundly wired in to >12 now cause I can manage to get the floss easily around it. Even one cantilever is not good at best unless its a tiny, tiny space. For example, a guy came to see me with a huge chicklet type tooth covering his lower first molar. It had zero anatomy. I popped it off and had the lab create a beautiful normal size, beautifully detailed first molar (normal size) plus a very small extra tooth CANTILEVERED onto the crown. He was pleased. Joel > If 13 is left in place, can two cantilevers be side >by side?? Will there possibly be extra stress on the anchor if #14 >cantalever is left in place? Yes, this can be done. The two free end cantilevers will resist the tipping force to some extent. They are butting up against EACH OTHER. If I were doing this I would mill in (using a high speed turbine) a channel so the second cantilever could be cast in, or fitted into the first. It will resist some force but AGAIN, this is not ideal. It is stop-gap to delay dentures. PS- I have DELAYED dentures for patients for 20-30 years. That's my job, in general. Joel > Yes, this can be done. The two free end cantilevers will resist the > tipping force to some extent. They are butting up against EACH OTHER. > If I were doing this I would mill in (using a high speed turbine) a > channel so the second cantilever could be cast in, or fitted into the > f What if one or both teeth walk and it opens up? SP  SignatureFinally: take out the TRASHH >> Yes, this can be done. The two free end cantilevers will resist the >> tipping force to some extent. They are butting up against EACH OTHER. [quoted text clipped - 4 lines] >What if one or both teeth walk and it opens up? >SP You mean like an earthquake fissure and the teeth get swallowed up? > >What if one or both teeth walk and it opens up? > >SP > > You mean like an earthquake fissure and the teeth get swallowed up? Non, No und Nein, silly JME: I mean that the attachment between the two cantilevers is not a precision attachment, therefore, the parts could come apart if one or the other tooth starts to walk. Then, there would not be mutual support of the two cantilevers touching each other, as they wouldn't be touching any more. Then, I would guesstimate that lateral movement to one or the other tooth could cause more damage than if the teeth had been joined in a fixed bridge. Skoal SP SignatureFinally: take out the TRASHH >> >What if one or both teeth walk and it opens up? >> >SP [quoted text clipped - 4 lines] >cantilevers is not a precision attachment, therefore, the parts could >come apart if one or the other tooth starts to walk. Yes, that's why its a stopgap measure, not as good as say several implants. Joel > Then, there would >not be mutual support of the two cantilevers touching each other, as [quoted text clipped - 3 lines] >Skoal >SP >>>If you have a friendly dentist who will do all of this at less than >top-dollar fees, due to the fact that it will not last forever, then [quoted text clipped - 5 lines] >possible. Thanks for understanding. I will really followin messages >now. That's my thinking too. Often I see some bridge that looks a little crappy, but it is not decaying or otherwise causing harm. I leave it! I tell people to leave well enough alone! Sometimes the gum shrinks leaving the bridge high and dry. Do I replace it? NO WAY. Joel Joel, I just removed a message I sent due to mistake so here it is again. <<<< I might recommend an endodontist and inquire if #12 can be treated by drilling through the top of the crown and not disturbing the bridge.>>>> I askied the periodontists and prosthodontist this same question and they say no. But, I haven't been to an endodontist on my own to ask and pershaps I should despite other's not recommending it. It would sure solve the problem im a simple manner. >>SECOND IDEA: Extract #12 if necessary, and then create a cantilever for #11 and attaching #12 to that.<<<< There already is a cantilever on 14 extending over 13 that periodontist recommends also come out due to stress on anchor in which case it will leave two spaces. If 13 is left in place, can two cantilevers be side by side?? Will there possibly be extra stress on the anchor if #14 cantalever is left in place? It doesnt seem to be soundly wired in to 12 now cause I can manage to get the floss easily around it. THIRD IDEA. Pull the entire bridge off, extract #12, and make a bridge for #11 to #14. Sound idea. I understand about it not lasting. >>If you have a friendly dentist who will do all of this at less than top-dollar fees, due to the fact that it will not last forever, then you got something.<<< There are plenty of DDS's with dental plans or discounted plans - if that's what you mean. I'll see if I can get it cheaper still. It's not in the front so I won't be fussy. My theory is I might die from a nasty fall from a horse or in another accident of some time - any time. So why not drag out having my own teeth as long as possible. Thanks for your valuable input. I will read following messages now. Reply >I askied the periodontists and prosthodontist this same question and >they say no. But, I haven't been to an endodontist on my own to ask and >pershaps I should despite other's not recommending it. It would sure >solve the problem im a simple manner. YUP, you may be asking the wrong people. I asked my stock broker what he thinks about investing in real estate and frankly he does not like the idea at all. Joel > I have been to two periodontists and a prosthodondont who all agree to > remove all the uppers - which to me seems hasty. I don't know if one [quoted text clipped - 44 lines] > > My head is just swimming with conflicting opinions about what to do. I'm missing what the conflicting opinions are, except that the dentists agree you need to have all your upper teeth extracted, and you don't want to do it. You have a sub-optimal situation, but not an uncommon one. I've had patients twist my arm to save teeth in a situation such as yours. I even sometimes will agree to it IF they fully understand that saving the teeth is likely to be a stopgap measure, and it is very likely despite any treatment the remaining upper teeth will be lost, probably in the not-too distant future. Of course, you are extremely likely to find a dentist to do what you wish, take your money, and you may luck out. Greater chance though that if you are not fully informed of the risk, that dentist will have your money, and you will be unhappy. If you think the dentists are making a clinical decision on other than clinical grounds, by all means get another opinion. But I'd avoid a dentist who tries to make you happy by telling you what you want to hear. Steve > I'm sure I can find a dentist to make me a four or five tooth bridge if > I look hard enough - but I keep hearing those periodontists and that [quoted text clipped - 6 lines] > denture about six months after the upper gum heals - using a regular > bridge in the mean times. UGH! I don't want any of these things. SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 I would have no problem keeping the teeth and restoring them if the patient signed a form saying there would be ZERO guarantee after walking out the door and that the patient understood that the procedure was the patient's preferred treatment not mine. Fees would either be full fees or slightly higher as it is harder to restore mobile teeth with poor periodontal health. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >> I have been to two periodontists and a prosthodondont who all agree to [quoted text clipped - 75 lines] >> denture about six months after the upper gum heals - using a regular >> bridge in the mean times. UGH! I don't want any of these things. Yes, I understand about signing a form saying there would be ZERO guarantee....another thought is to maybe skip pocelain for resin or some other cheaper material. I'm sorry - I gave you the wrong url it's http://tinypic.com/29zgxj The exrays were taken with the bridge 8 through 3 removed fora better look (since it was loose and needed recementing) There are four remaining teeth - 3,3,6 and 8. It looks like it must be number 8 since it's beside a crown that must be nine.. What do the dds's mean when they say it (tooth with white arrow) is cause for the bridge to not last long - that that tooth is not supportive? Why is it unsupportive? >I'm sorry - I gave you the wrong url it's http://tinypic.com/29zgxj I couldn't find the CANINES. Joel >The exrays were taken with the bridge 8 through 3 removed fora better >look (since it was loose and needed recementing) There are four >remaining teeth - 3,3,6 and 8. It looks like it must be number 8 since >it's beside a crown that must be nine.. What do the dds's mean when >they say it (tooth with white arrow) is cause for the bridge to not >last long - that that tooth is not supportive? Why is it unsupportive? >I'm sorry - I gave you the wrong url it's http://tinypic.com/29zgxj > [quoted text clipped - 4 lines] >they say it (tooth with white arrow) is cause for the bridge to not >last long - that that tooth is not supportive? Why is it unsupportive? #8 not much tooth left and not much bone support. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >>#8 not much tooth left and not much bone support. <<<<< Thanks W_B - guess I needed to hear that reiterated (dern!) >>>#8 not much tooth left and not much bone support. <<<<< > >Thanks W_B - guess I needed to hear that reiterated (dern!) Welcomed. I suppose you could extend the bridge (new construction) to #9 with at least one maybe two stress breaker attatchments. This would buy some time, yet is not cheap. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com I had asked about 3 to 9 instead of 3 to 11 but was told that with ten gone it would need the others for strength.... What are stress breakers? >I'm missing what the conflicting opinions are, except that the dentists >agree you need to have all your upper teeth extracted, and you don't >want to do it. ummmm. YES! On Mon, 14 Mar 2005 23:23:17 GMT, Mark & Steven Bornfeld <bornfeldm...@dentaltwins.com> wrote: >I'm missing what the conflicting opinions are, except that the dentists >agree you need to have all your upper teeth extracted, and you don't >want to do it. Joes M. Eichem reply: ummmm. YES! My reply: Yes, there's that, too. It's a hard decision to make - one I can't face. It's a decision I will never be ready to make unless in great pain or to avoid open spaces, or a fatal condition. By consulting an endodontist and have him work through the tooth, or by extracting #12 and having a four tooth bridge made (signing contract about no guarantees) I am avoiding the peroidontist warnings here that I'm just postponing the inevidable. So talking about it here is helpful. Here my pet peeves or fears about having my upper teeth extracted: #1 - I don't want my palate covered. #2 Transplants can be annoying and painful. #3 my gums are not straight from bridges being removed and remade over the years...one side of my gums is much higher than the other. Will dentures be adjusted in the fake gum area or the crown length (I don't care which one) so that I wind up with a straight level line on the bottom edge of my teeth when I oven my mouth? So often I see dentures that are slanty and I hate their look. I always wonder why the patient didn't complain? The periodontists, along with a consulting prosthodontist want to pull out all the teeth at once and perform bone augmentation and have me get a regular bridge while it's healing and see how it feels. If I can't live with it, then I would go for a palatless denture which I understand can only be make if attached to transplants - 6 or 8, depending ( there are only 12 teeth). I do however have a neighbor who is a singer and who had a palatless denture made up about 20 years ago. (no transplants) She swears by it and speaks normally, but I don't know where I could find a dentist who would make up that kind of denture today. I would need bone augmentation for implants and/or to help keep shrinkage down for regular denture. You said many bone augmentations are unnecessary.. I seem to have some bone loss that the DDS feels might not support a transplant and that augmentation in necessary areas should solve the problem. If it works it is also helpful for regular dentures. But here's another fact: I have an over bite in my front 6 teeth. If that part of the gum shrinks toward the rear, wouldn't that help lose the over bite? But, would I be trading and over bite for those awful wrinkles in the upper lip that some people get? Are those wrinkles from shrinking gums? I don't know why else they would appear since they don't seem to be in my family genes. My parents used to say I inherited my mother's "soft" teeth - whatever that means. I was in a series of sporting accidents when younger that caused me to lose teeth or develop loose teeth. I am over 60 and still do risky sports. Do you know of any famous attractive people with dentures? It might help me if I knew about them.. Thanks. Jonesy >My reply: >Yes, there's that, too. It's a hard decision to make - one I can't [quoted text clipped - 4 lines] >guarantees) I am avoiding the peroidontist warnings here that I'm just >postponing the inevidable. So talking about it here is helpful. Exactly. There is a difference between accepting an inevitable conclusion where you have explored every alternative, and accepting a CHOICE position. The CHOOSERS become disgruntled denture patients. I hear about it all the time, but fortunately, not from my patients! >Here my pet peeves or fears about having my upper teeth extracted: >#1 - I don't want my palate covered. This part is not as annoying as one might think. The alternative requires implants. I have made thousands of upper dentures and there would be fewer than one percent who have this problem. >#2 Transplants can be annoying and painful. >#3 my gums are not straight from bridges being removed and remade over >the years...one side of my gums is much higher than the other. Will >dentures be adjusted in the fake gum area or the crown length (I don't >care which one) so that I wind up with a straight level line on the >bottom edge of my teeth when I oven my mouth? YUP, the occlusal plane (plane of the teeth) will be level. >So often I see dentures >that are slanty and I hate their look. I always wonder why the patient >didn't complain? Inebriated dentists ....... ??? No, kidding. >The periodontists, along with a consulting prosthodontist want to pull >out all the teeth at once and perform bone augmentation and have me get >a regular bridge while it's healing and see how it feels. Surprisingly an immediate denture is better accepted than the denture made after the gums heal. This is surprising but true. > If I can't >live with it, then I would go for a palatless denture which I >understand can only be make if attached to transplants - 6 or 8, >depending ( there are only 12 teeth). $$$ Quanto Costa ????? >I do however have a neighbor who is a singer and who had a palatless >denture made up about 20 years ago. (no transplants) She swears by it >and speaks normally, but I don't know where I could find a dentist who >would make up that kind of denture today. Every mouth is different so do not count on this at all. > I would need bone >augmentation for implants and/or to help keep shrinkage down for >regular denture. Bah humbug. > You said many bone augmentations are unnecessary.. >I seem to have some bone loss that the DDS feels might not support a >transplant and that augmentation in necessary areas should solve the >problem. If it works it is also helpful for regular dentures. OKAY wait a minute, if we are talking implants some sites require bone augmentation or sinus lift if the implant is to be be placed too close to a low-hanging sinus area. >But here's another fact: I have an over bite in my front 6 teeth. If >that part of the gum shrinks toward the rear, wouldn't that help lose >the over bite? But, would I be trading and over bite for those awful >wrinkles in the upper lip that some people get? Are those wrinkles >from shrinking gums? YES, and the fact that without teeth, the support for the face changes. I can spot dentures from 20-30 feet away, generally, by looking at the canine region or corners of the mouth. >I don't know why else they would appear since they >don't seem to be in my family genes. My parents used to say I >inherited my mother's "soft" teeth - whatever that means. It was before fluoride and the sugar got inside the teeth. Other people may have more "sealed-up" teeth or more resistant teeth. If you come from Texas and your teeth are slightly brown, then natural fluoridation, fluoride from the mountains seeping into the drinking water may put the local dentists out of business. This is how the effect of fluoride was discovered. > I was in a >series of sporting accidents when younger that caused me to lose teeth >or develop loose teeth. I am over 60 and still do risky sports. Good for you. I do Extreme Channel Surfing ....... that's risky with what's on TV today! >Do you know of any famous attractive people with dentures? It might >help me if I knew about them.. Thanks. Yes, many many. Joel >Jonesy >>Do you know of any famous attractive people with dentures? It might >>help me if I knew about them.. Thanks. > >Yes, many many. > >Joel Clark Gable comes to mind. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >>>Do you know of any famous attractive people with dentures? It might >>>help me if I knew about them.. Thanks. [quoted text clipped - 4 lines] > >Clark Gable comes to mind. REALLY? >>>>Do you know of any famous attractive people with dentures? It might >>>>help me if I knew about them.. Thanks. [quoted text clipped - 6 lines] > >REALLY? It's what I've heard. The odor is supposedly legendary. Actresses didn't want to kiss him. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com I could tell he was wearing dentures. >Do you know of any famous attractive people with dentures? It might >help me if I knew about them.. Thanks. >Yes, many many. >Joel Really, Joel? Who are they? It would help to have "role models" ----- Jonesy >>Do you know of any famous attractive people with dentures? It might >>help me if I knew about them.. Thanks. [quoted text clipped - 4 lines] >Really, Joel? Who are they? It would help to have "role models" ----- > Jonesy Merlina Mercury The Italian Actress ...... Funny you should say that, she was my Mom's favorite actress. >>>Do you know of any famous attractive people with dentures? It might >>>help me if I knew about them.. Thanks. [quoted text clipped - 8 lines] > > The Italian Actress ...... Well, I believe her son, Freddy Mercury, was actually of Turkish background. Melina Mercouri however, was Greek. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 Oh, I was thinking of Melina Mercouri - the Greek actress. >Oh, I was thinking of Melina Mercouri - the Greek actress. YUP that's who I was trying to say .......... Mercury in sci.med.dentistry parlance. > Oh, I was thinking of Melina Mercouri - the Greek actress. So was I. ;-) Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >> Oh, I was thinking of Melina Mercouri - the Greek actress. > >So was I. ;-) We spell it Mercury here though. >Steve Speaking of Mercury, they just announced on the news ........ 48 million pounds of mercury from coal burning power generation plants! 48 million ......... that's bigger than 17 micrograms right? Joel >> Oh, I was thinking of Melina Mercouri - the Greek actress. > >So was I. ;-) > >Steve > Well, I believe her son, Freddy Mercury, was actually of Turkish > background. Melina Mercouri however, was Greek. > > Steve D'you remember those GLASSES?????? Not even I, who looks like Frankenstein's Monster on a bad hair day, would dream of wearin' those in public places without a bullet proof vest... If YOU have unexplained eye problems and the organized opthalmologists are giviny you the snow jop.... . . .. . .. .. .. . . . . . ... . . OK, I'll not drag you through that again... SP SignatureFinally: take out the TRASHH >> Well, I believe her son, Freddy Mercury, was actually of Turkish >>background. Melina Mercouri however, was Greek. >> >>Steve > > D'you remember those GLASSES?????? Melina Mercouri's? No. I remember her walk in the opening scene of "Never On Sunday" though. Steve > Not even I, who looks like Frankenstein's Monster on a bad hair day, > would dream of wearin' those in public places without a bullet proof [quoted text clipped - 7 lines] > OK, I'll not drag you through that again... > SP SignatureCut the nonsense to reply > Melina Mercouri's? No. I remember her walk in the opening scene of >"Never On Sunday" though. > >Steve I am humming a few bars as we speak! > Merlina Mercury > > The Italian Actress ......à <clown> .... If you have unexplained teeth problems,,,, and your acting career is not going places.... CHECK THE LAST NAME!!!! Don't go to a regular, organized movie producer, go to an alt. movie producer,,, one that knows how to fix your LAST NAME in a real shyster environment with lots of smoke and magic, while removing copious amounts of greenbacks from your back pocket.... Here, only SWNMNBM is a gentleman... all the others are organized LAST NAME changers... I went to an alt movie producer: one who knew how to treat me and sweet talk me into things with cloudy science behind them... IT CHANGED MY LAST NAME!!!!! Beware the lying movie producers on this NG; they'd just as soon change your fillings as look at ya... </clown> Note to Jonsey: this is a bit of an inside joke, albeit a lousy one... guess I'm gonna catch hell for it... Re: dentures or keeping your teeth: If you're near a University with a Dental Program, especially a graduate progream, you might get some good alternatives w/o paying top dollar for them. This is one reason that those programs exist: to push back the envelope of the accepted by trying treatments that are not yet mainstream. If/when you do decide to get dentures: DON'T get a piano key board installed, or a set of perfectly straight teeth. IIRC, you're in your sixties, and if you look around you, you'll probably see (as I do) that most of those in your generation have teeth that are imperfect (read: natural). Those who have teeth that are perfectly aligned are quite often denture wearers. I can bet dollars to LAST NAMES that the denture wearing actors (both male and female) have had those front teeth moved around and characterized so that they are imperfect (read: natural looking). Re: covering the palate: you can get a palate made of metal, which is a lot thinner that full plastic, and so is kinder to the tissues and the tongue. HTH Cheers! SP SignatureFinally: take out the TRASHH >> Merlina Mercury >> [quoted text clipped - 6 lines] > >CHECK THE LAST NAME!!!! Changed to M E R C U R Y in honor of Jan Drew ....... >Don't go to a regular, organized movie producer, go to an alt. movie >producer,,, one that knows how to fix your LAST NAME in a real shyster >environment with lots of smoke and magic, while removing copious amounts >of greenbacks from your back pocket.... Good one! >Here, only SWNMNBM is a gentleman... all the others are organized LAST >NAME changers... [quoted text clipped - 32 lines] >Cheers! >SP Yes, I know whatca mean. I will want as natural looking as possible - >>>>>Exactly. There is a difference between accepting an inevitable conclusion where you have explored every alternative, and accepting a CHOICE position. The CHOOSERS become disgruntled denture patients. I hear about it all the time, but fortunately, not from my patients! <<<<<<<<<<<, Well, I certainly don't wnat to be a disgruntled anything! -- but I don't understand. By CHOICE position do you mean patients who elect to have their teeth removed rather than spend time researching ways to keep them, whether or not they were given a poor prognosis? >>>>>>Exactly. There is a difference between accepting an inevitable >conclusion where you have explored every alternative, and accepting a [quoted text clipped - 7 lines] >have their teeth removed rather than spend time researching ways to >keep them, whether or not they were given a poor prognosis? I believe the main reason is cost. Then again, removing teeth is quick and painless compared to preparing teeth for crowns etc. I made some dentures that were fairly decent and one patient told his buddies to stop fixing their teeth as the dentures are better than the reaol teeth. After I heard that through the grapevine, I called the guy and set him straight. He was unfortunately or fortunately ..... lucky! Joel >Do you know of any famous attractive people with dentures? It might >help me if I knew about them.. Thanks. >Jonesy Florence Henderson does denture commercials but I don't know if she wears one. If so it looks pretty good, if not that leads to many questions about why she does these commercial$. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com I recall there being some truth in advertising law passed a while back where actors advertising denture adhesives had to be actural wearers of dentures -- I think it was Betty White who more recently advertised "Depends" and that really made me wonder...why advertise such a thing? I removed a message I left earlier since learning Flo Henderson does not wear dentures - according to these reports. http://www.flohome.com/floanswers01.html flo henderson denies she wears dentures... a few questions down on page. http://www.ftppro.com/librarycgi/library_cf.php?sName=Florence_Henderson >I removed a message I left earlier since learning Flo Henderson does >not wear dentures - according to these reports. Some actresses and actors do not wear Fixodent but use it in their slippers to prevent slippage. >http://www.flohome.com/floanswers01.html flo henderson denies she >wears dentures... a few questions down on page. > >http://www.ftppro.com/librarycgi/library_cf.php?sName=Florence_Henderson Sit down and watch TV with a dentist one day. We can point to the screen and tell you which ones (in most cases) are real or not. The mould 22E gets used too much in Hollywood. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... >I removed a message I left earlier since learning Flo Henderson does > not wear dentures - according to these reports. [quoted text clipped - 3 lines] > > http://www.ftppro.com/librarycgi/library_cf.php?sName=Florence_Henderson >Sit down and watch TV with a dentist one day. We can point to the screen >and tell you which ones (in most cases) are real or not. The mould 22E gets >used too much in Hollywood. I really prefer 32 E -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >>Sit down and watch TV with a dentist one day. We can point to the screen >>and tell you which ones (in most cases) are real or not. The mould 22E gets >>used too much in Hollywood. > >I really prefer 32 E 350 mV? >>>Sit down and watch TV with a dentist one day. We can point to the screen >>>and tell you which ones (in most cases) are real or not. The mould 22E gets [quoted text clipped - 3 lines] > >350 mV? 342.82 mV -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com Have you an examples of 32E or 350V? Can one choose the shape of their teeth the way one chooses a hair style from a photo? >Have you an examples of 32E or 350V? Can one choose the shape of >their teeth the way one chooses a hair style from a photo? the 350 is 350 mV and its the one Keith loves ....... >Have you an examples of 32E or 350V? Can one choose the shape of >their teeth the way one chooses a hair style from a photo? Yes but tooth shape generally follows the inverse of facial shape. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >>Have you an examples of 32E or 350V? Can one choose the shape of >>their teeth the way one chooses a hair style from a photo? > >Yes but tooth shape generally follows the inverse of facial shape. True, many patients get the thin teeth ........ Can you please tell me the number of the tooth (from the exray) which is also said to be in trouble...I can not tell which one it is. Thanks http://tinypic.com/view.html?pic=29zgxj >Can you please tell me the number of the tooth (from the exray) which >is also said to be in trouble...I can not tell which one it is. Thanks > >http://tinypic.com/view.html?pic=29zgxj It is definitely not the CANINE tooth! OH, I'm sorry - I gave you the wrong url it's http://tinypic.com/29zgxj The one in question with the "trouble" is from bridge 3 through 8 - the bridge came loose and the exrays were taken with the bridge removed to get a better look. There are four posts... 3,4,6(canine) and 8. It looks like it could be 8.. since next to an actual crown which I assume to be 9. What kind of "trouble" can I suppose the dentist meant? That was never made clear to me except that it was irreversible.... No, I am aftraid it must be number 8 - from bridge 3 - 8 ....so say W_B, and at least two other DDS's. :( The bridge is off for the full mouth exrays on top of the page > http://tinypic.com/29zgxj which explains why you see just the four posts... 3,4,6 and 8 - 6 would be the bicuspard... :( Someone actually proposed removing 8 and making a NINE-TOOTH-BRIDGE from 3 - 9 (Doesn't seem like a wise idea to me regarding longevity and a some what extravagant, time consuming, painful way to hold off dentures a little while longer - Other than that, the alternative is to to the dentures, impanted or otherwise - but at least do bone augmentation at time of tooth removal where implants would be needed, if I decide to go that way which I probably will. I can get a temp bridge while gums heal the six months or so that the bone augmentation healing requires. Does this sound about right to you?. Long story, but the first set of dentures for temp or otherwise would be free! I am really miserable about the prospect of having a plastic plate on my upper patate since it causes bad breath, feels awful and interfers with taste buds. Not that I'm a wine taster by profession, but still. Woe is me..... My teeth are like my children to me and I'm already mourning their loss to be. I wonder is there Is there a self-help book for people who dread dentures? I would buy it. (good idea for a dentist-writer) >Someone actually proposed removing 8 and making a NINE-TOOTH-BRIDGE >from 3 - 9 (Doesn't seem like a wise idea to me regarding longevity and >a some what extravagant, time consuming, painful way to hold off >dentures a little while longer - Other than that, the alternative is to >to the dentures, impanted or otherwise Thought about that too. You may consider an over-denture rather than an implant supported FPD. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com I meant to say they proposed a nine tooth bridge from 3 to 11 (not 3 through 9) I meant to say they proposed a nine tooth bridge from 3 to 11 (not 3 through 9) >Can you please tell me the number of the tooth (from the exray) which >is also said to be in trouble...I can not tell which one it is. Thanks > >http://tinypic.com/view.html?pic=29zgxj Looks like # 8 to me. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com Now we're getting somewhere. (snip) > Here my pet peeves or fears about having my upper teeth extracted: > #1 - I don't want my palate covered. This is a reasonable fear. Some people cannot tolerate a full palate. However, many folks who fear they won't tolerate a full palate in fact do; others have trouble at first, but actually wind up doing well in time. > #2 Transplants can be annoying and painful. Implants involve surgery, and there is pain involved in surgery. But the pain is short-lived, and generally the potential for annoyance in the implants long term is no more (and frequently less) than for natural teeth. > #3 my gums are not straight from bridges being removed and remade over > the years...one side of my gums is much higher than the other. Will [quoted text clipped - 3 lines] > that are slanty and I hate their look. I always wonder why the patient > didn't complain? Good question. My guess is that these may well have been immediate dentures. When immediate dentures are made, the impressions of the jaws are made before all the teeth are extracted. The teeth are broken off the model and the denture fabricated on the altered model. There is no way to try in the denture before processing (because the natural teeth are in the way) so sometimes the tooth arrangement is off. The other possibility of course is that the dentures were just poorly made. I would say though that usually even if several teeth are still present before the denture is made, this is USUALLY not a major problem. As far as your gum is concerned, the denture is fabricated to basically replace bone, gum and dental tissues in general shape, so the lips and cheeks are properly supported. The tissues under the denture should be firm and not flabby. If they are flabby sometimes it is necessary to re-shape the tissue surgically. > The periodontists, along with a consulting prosthodontist want to pull > out all the teeth at once and perform bone augmentation and have me get [quoted text clipped - 12 lines] > transplant and that augmentation in necessary areas should solve the > problem. If it works it is also helpful for regular dentures. The reason for the full palate is for stability and retention (suction) of the denture. If the palate is removed, you will generally have to augment the suction some other way--adhesives or implants. Having said that there is a wide range of adaptabilities in patients to dentures, and what may work well in one patient may be a disaster in another. The rub is that you can't try the denture and then go back to teeth. You can of course go to implants, if ya got the bling bling. > But here's another fact: I have an over bite in my front 6 teeth. If > that part of the gum shrinks toward the rear, wouldn't that help lose > the over bite? But, would I be trading and over bite for those awful > wrinkles in the upper lip that some people get? As I said, the plastic of the denture flanges should be made to give adequate support of the lips and cheeks. In fact the bone of the jaws does resorb more or less quickly, and in fact it does in the manner you imply: the outside of the upper ridge tends to resorb more, and the INSIDE of the lower jaw tends to resorb more. Over time, this means that the lower jaw winds up being wider than the upper jaw--exactly the opposite of what is normally seen in a mouth with a full set of teeth. This presents problems for tooth placement, but there is no reason to get into that at this point. Are those wrinkles > from shrinking gums? I don't know why else they would appear since they > don't seem to be in my family genes. My parents used to say I [quoted text clipped - 4 lines] > Do you know of any famous attractive people with dentures? It might > help me if I knew about them.. Thanks. I agree. It would be a public service--but most denture wearers generally don't like to publicise it. I'm sure there are some. I did once see Zero Mostel do something very gross with his upper denture on TV, but he was hardly a beauty. ;-) Steve > Jonesy SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >>>>>Good question. My guess is that these may well have been immediate dentures. When immediate dentures are made, the impressions of the jaws are made before all the teeth are extracted. The teeth are broken off the model and the denture fabricated on the altered model. There is no way to try in the denture before processing (because the natural teeth are in the way) so sometimes the tooth arrangement is off. <<< Can it be adjusted back at the lab? Either by lengthing the teeth quite a bit on one side or by remolding the plastic? I am pretty certain the dentist will make immediate dentures --- and I will get a bridge back that is not level... and I will wind up (disgruntled?) -- unless something is done first to perhaps level the gums -- or after the gums have healed and -I might consider having another made by a cosmetic dentist as the only alternative to having a slanty smile where one side in a half inch (not kidding) higher than the other. Woe is me.......................................... >>>> As far as your gum is concerned, the denture is fabricated to basically replace bone, gum and dental tissues in general shape, so the lips and cheeks are properly supported. The tissues under the denture should be firm and not flabby. If they are flabby sometimes it is necessary to re-shape the tissue surgically.<<<<< So Tell me: How soon after having teeth removed can a patient have a mold made of the gums???? Right after or a month later or what?? I could walk around with an allergy mask (I would, too) for a few weeks if it would do anything toward assuring me against slanty smile syndrome in the future. > |
Enable EMail Alerts
Start New Thread
Reply to this Message