I have a question Bryanna. Firstly I am not in any way considering implants. But, is the above statement true In rereading it, I guess it makes perfect sense.

I find your posts very interesting and full of information. Thank you

Hi Kitt,

Yes, it is very true. Every healed extraction has at least 50% bone loss in the space where the tooth was. Over time, the bone becomes progressively less until the bone level is flat.

If bone graft material is placed in the surgical socket at the time of the extraction and the material integrates well with the jaw bone, then the bone loss is minimal and natural degeneration of the bone may or may not occur as we age.

The bone surrounding a tooth is called alveolar ridge bone and it's sole purpose is to support the tooth. As soon as the tooth is removed, this bone begins to degenerate and collapse both horizontally and vertically. It is not impossible to place an implant once this has happened but it requires a special bone graft procedure to ultimately hold the implant in place.

There are actually two types of bone grafting that can be done in old extraction sites that were not filled in with graft material and have lost horizontal width and vertical height of the bone. One procedure is called Block Bone Grafting. This is when bone is harvested from another area of the mouth or body and screwed into the area of the mouth where the implants are going to be placed. It takes about 6 months for this to heal before the implants can be put in. Another type of bone grafting surgery is called Bone Expansion. This is when a series of different size drills are used to make a large hole in the bone where the implant is going to go and it is filled with bone graft material and then usually sutured closed an allowed to integrate with the jaw bone for about 6 months before the implant is placed.

Hope I was able to answer your questions........and thanks for the kind words!

Bryanna

Bryanna, One more question. What about when a person has false teeth. The bone is flat or nearly as you say after the teeth are gone for awhile.

So do false teeth, or can they, fit pretty well even though the bone is flat I would think that would be true (that they would fit pretty well) since there are many who do have false teeth. And I would guess that the false teeth are made to fit the flat surface At least I would think so. Thanks so much for your help

Hi Kitt,

If the ridge is flat, no the false teeth do not fit well. People with this situation have to put some type of denture adhesive in their denture so it doesn't move around.

The best way to get a good fitting denture is to have a denture put it at the time of the extractions. These are called temporary immediate dentures and they serve not only as a bandade to protect the surgical wounds, but they help shape the bony ridge and gum tissue during the healing phase so the new permanent denture will fit more snug.

It is almost impossible to properly fit a denture in someone who had extractions years prior. For the upper denture, if the palate has not flattened out completely, sometimes the fit will be "ok" because the palate acts as a form of suction cup for the denture. With a lower denture, if the ridge is flat, a denture will move around constantly. Sometimes on the lower even if there is a ridge, the denture moves around alot because there is no suction like there is from the palate.

Did I explain that ok?? Feel free to ask as many questions as you want to!! I try to peek in here every day..... sometimes I miss a day or two...... but I'm never too far away!!

Bryanna

Hi Bryanna. I guess I should explain a bit. My potential problem at some point is this. 47 years ago my four front teeth were pulled and then a temporary denture was put in and hooked, if that's the word, to the eye teeth. That was worn for I believe about 3 months and then a bridge was put in and the eye teeth were capped and that's how the bridge is anchored. At that time, the eye teeth were ground down to points I do believe. They probably don't do that now.

At any rate, I suspect at sometime in my life the bridge will break down or whatever and I will need some teeth. I do not plan at all to have implants so then it would be false teeth. And, I suspect we would be talking about the front four teeth plus the eye teeth as I am certain they would be ruined. And boy are caps, bridges, etc. expensive now. Can't believe it but guess it's all relative.

The palate you talk about is the roof of the mouth? Mine is by no means flat. So then I guess there would be some suction there, correct? I still have all my teeth less wisdom teeth and one back molar on the bottom. Hopefully, I will retain most of them.

It was so ridiculous for me to lose my front teeth way back then. I say that because they were perfectly healthy - no cavities - and it was done instead of getting braces. How I regret that as I now know what can happen. But, I was young and talked into it by my parents. Wish that could be done over again but of course it cannot I have a small mouth if that means anything.

I have always heard that bottom dentures pretty much move around. My husband has that now with only two teeth left on the bottom. But adhesive is doing a pretty good job and the lining the denture man did. Tomorrow he gets a new one so we'll see how that goes. At some point, he will lose the other two lower teeth and so will have a full lower denture. But whatever works, works

You explained things very well and I really do appreciate it. I hope you can follow where I'm coming from as well. Thank you so very much for your help

Hi Kitt,

So sorry to hear that your teeth were pulled instead of doing braces! There is nothing you can do about that now and that may have been the only option available to your parents at that time. The bridge that you have for about 47 years has certainly exceeded the normal longevity of most dental bridgework. Generally, dental bridges are replaced around 15-20 years old. The cement that holds the anchor crowns on eventually wears out and this allows bacteria to get in underneath the crowns. It would be wise to periodically have your bridge checked for mobility and radiographs taken to check the health of those anchor teeth.

Anytime a tooth is going to have a crown, the tooth is ground down to a small size. Some dentists still grind the tooth to a pointy stub and others are more conservative with the preparation of the tooth. The more tooth structure removed, the more likely to injure the nerve and cause the tooth to die. But in your case, you may be one of the fortunate ones!!

If you had to have that bridge replaced and the anchor teeth were still healthy, then only minimal tooth preparation would be done mostly around the gumline and a new bridge would be fitted. If the anchor teeth were not healthy, then you may be given the option of root canal therapy or extraction. If you opted for the root canals and you ended up with a bad infection in one or both of those anchor teeth, then a whole new bridge would have to be redone again after the tooth/teeth were extracted. So if that incident ever occurs, you may want to weigh out all of your treatment options so you can make the best long term decision for yourself.

Yes, the palate is the roof of the mouth and it's good that yours is not flat should you ever need to wear a denture or partial denture!

Bryanna

Hi Bryanna, Firstly, no it wasn't the only option my parents had. The first time, when I was still at home, they opted not to have braces done. Then when I was out on my own and had a job and all the rest is when I was talked into pulling the teeth. I was, at that time, all set to go ahead with braces and pay for them on my own. But, I got talked into the other.

Yes, I feel I am lucky to have the bridge this long. Apparently the dentist at the time did a good job. In the past year, one of the eye teeth developed a very small cavity which was filled right away. I go in every six months and have my teeth checked and cleaned by a hygenist. (sp). The bridge is checked and it is fine so hopefully it will last even a lot longer I hope so.

When the time comes and if the anchor teeth are not healthy, then I would opt for false teeth. I would not do a root canal either. That does not sound wonderful to me with everything I have researched before as well. Then I would be dealing with a "dead" tooth which would break down sooner than a live one in my opinion. Think that's been said before too.

My cousin had crowns done and then found out that they didn't do root canals so had the crowns taken out and they did the root canals and put the crowns back. I would never have done that but it was her decision. I feel live teeth are better than dead ones. JMO.

My husband got his new bottom teeth today and they are really good he says. He has the two teeth remaining on the bottom. So anyway, I'm glad for that.

Again, Bryanna, thank you so very much for explaining things to me and giving me all the information. I do appreciate it very much

Bryanna, Would you roll back to page 1, the 3rd paragraph of my last note to you - and address my concerns about complaining to the state dental board? You've suggested it before, but you've never addressed the legal limitations of going to them. I wish I could just get a meeting with the dean and all those concerned with this plus a few people on MY side besides me and my daughter. I feel if everyone spoke together, we could work together.

It's like a game of "gossip" - you know - where one person whispers a fact to another - and on down the line. When the last person in line states the fact as heard and changed just a bit by each person playing, it's a totally different thing. That's what I feel is happening at the school.

They probably feel (and rightly so) that I'm not going to do anything other than what I've done. And that's certainly been ineffective. This type of treatment is going to continue until someone makes a public issue of it and they then have to, at least, respond.

My health is deteriorating so fast with all this going on with other longstanding problems that I might not last to sue them, complain to the state board or take it public. I feel they might be counting on that, too. If I ask for my records, I'm sure they will dismiss me as a patient or charge me a mint for copies which I can't afford.

Again, can you really talk with me about the factual aspects of complaining to the board or suing the school? I understand if you'd rather not. Thanks, anyway. Jon

Hi Jon,

I reread the paragraph that you are referring to and I'm unsure that seeking the advice of the state dental board would eliminate your right to legal action. Did you call the dental board directly and ask them if they could help you directly or offer some advice as to what organization helps people who believe they are being mistreated at the state dental school?

Jon, I understand your frustrations and I know this is taking it's toll on your health. It doesn't sound like you are not up to a legal battle against the school, am I right? You basically would need someone of importance who can intervene and say...... hey, this guy feels he's being jerked back and forth and before anyone proceeds with any more treatment, he needs some answers. I understand that you are compelled to make this a public issue if not for yourself but to warn others. Hear me when I say....... your situation is a common occurance at most dental schools. The patient usually gets so fed up, they just stop treatment or seek it from a private practice. It's been going on like this since the beginning of time.............you my friend, are not going to change the dynamics of which they run their dental school.

Your interpretation of the "gossip" game is pretty close to how this profession works. It's actually more of the "ego" game and in dental school the egos are elevated like you would not believe. When one gets bruised another one gets boasted......... and so on. It's really ridiculous.

I went on the website of the school that you are going to and found that you can email the head of the departments. Perhaps you could convey your concerns via email to those who have spoken to you about your treatment? It's not like you are trying to step on anyones toes, you just want to know what the options are, what the recommendations of treatment are, who is doing what and what is the long term prognosis?

Unfortunately dental schools have acquired a bad reputation because they generally have no patient sensitivity training. A professional never learns patient relations in school. He only learns that after he's been in practice for awhile and his ego has been bruised a few hundred times! The general attitude is that the people who elect to have major reconstructive dentistry at the school are doing so because of the reduction in fees. Therefore, you get a mixture of inconsistencies because you get whoever is available at the time and they are all still learning so none of them have perfected anything. Then in walks the big guns and as he peeks over their shoulder, he barks out a few demands and everyone in the room snickers behind his back. So of course the treatment will change according to who has you in the chair at the time! Some people don't mind this but they are usually the ones who are not having the extensive work that you are.

I don't know if they will charge you a fee to copy your xrays, but it is a daily, common practice for patients to request their xrays because people seek second opinions all of the time. I really think you need someone to sit down with you face to face and explain your options and why. It may actually help take some of the anxiety out of what has already occured and make sense of what is yet to happen.

I truly feel that you should not be thinking about suing the school..... you will get nowhere........and only seek advice from the dental board if they have the ability to intervene on your behalf in a positive way. Meaning, if the patient advocate from the school can't help you then does the board know who can?? I don't know what their legal protocol for filing a complaint is or how restricted it is. Only they can tell you that.

Please consider a second opinion from someone that will sit one on one with you and don't hesitate at all to request your xrays from the school.

Bryanna