It is hard looking at a patient and knowing that if he or she had done the right thing at the right time, we wouldn’t have to treat him or her now. Want some examples?
A patient has bone loss around the back side of a second molar. Why? Because the patient decided not to get out his or her wisdom teeth before they did damage to that bone. If the wisdom teeth had been removed by the age of 17, the patient who is now 35 wouldn’t have to see me to grow the bone back. Not every wisdom tooth needs to come out, but if it does, it’s a much better and easier to take it out by the age of 17 rather than waiting for it to be fully grown.
A patient has a hole between the mouth and the sinus. Why? Because the patient chose to keep an infected tooth too long. The excuse. “It wasn’t bothering me that much.” But what happened is that the infected tooth was adjacent to the sinus. It supplied bacteria to the interface between the tooth and the thin bone under the sinus. The thin bone dissolved and now there is an infection coming from that tooth into the sinus. Root canals often prevent this situation. But if there is still pain after the root canal, the infection is likely continuing. Better to remove the tooth early than face a sinus opening that requires a significant surgical procedure to close.
A patient has major gum recession and wants to know if I can recover the exposed roots. Yes, some of the time, but it’s a lot easier if I’m able to see the thin gums before they recede rather than after. Here’s a hint: If your child has a lower front tooth that sticks out toward the lip and needs braces to put the tooth back into the right position, chances are very high that the gum tissue is weak. It needs a gum tissue graft and if it’s done in the child’s teens, the chance of gum recession goes down dramatically.
A three year old goes to the dentist because all of his or her teeth in the front have decayed. Why? Because as a baby, the child was put to bed with a bottle in the mouth. It acted as a pacifier. But the milk in the bottle is full of lactose, or milk sugar. The sugar dissolves the teeth, and the baby teeth need treatment or extraction.
A denture wearer can no longer wear his or her dentures. Why? Because dentures often cause the underlying bone to melt away. If the patient has thin bone, that bone melts away faster. Sometimes, so much bone is gone that the patient needs major bone grafts before implants can be placed. The answer: Get an x-ray, or better yet, a dental CT-scan early to find out your bone profile. That way you know the risks of waiting.
You can prevent these problems. Get a good exam. Take the necessary x-rays. Don’t ignore problems. By doing so, you can improve your dental health and reduce your chance of major dental damage.
Lee N. Sheldon, DMD