A 65 year old woman came in with pain and discomfort in the lower front teeth. One look revealed that there was an old bridge that was loose because of the loose teeth underneath it. The bridge was moving quite a bit and the patient was in obvious discomfort. Unfortunately those teeth had to go! Not only were they a sore sight, but over the years they had “supra-erupted” i.e. they had climbed out of their sockets because of an unstable bite. The upper front teeth were also awaiting a similar fate!
So what was the solution? Back to basics! The case was studied through an “examination diagnosis and treatment planning” protocol to find the “Why”.
Teeth are encased within bone but are never stationery. They are constantly moving. This is why when a tooth is lost the adjacent tooth begins to drift into the empty space.
Back to our patient….It was ascertained that the lower teeth did not have a stable resting point and had supra erupted out of the bone in order to reach the upper front teeth. This is what had caused them to extrude out of their sockets. This had resulted in the teeth shaking too much and the bridge that rested on those teeth was resultantly “flapping”.
The treatment involved changing the upper bridge, removing the lower front bridge and the underlying unrestorable teeth. Following a healing period implants were placed in the lower front jaw. Implants once anchored into bone cannot extrude out of bone. Even if the caps supported on the implants don’t touch the upper front teeth, it is of little consequence. The patient’s smile line was thus corrected and she has been very stable ever since! The best part of treating this lady was that she finally realised that due diligence on her part is also important. I was pleasantly surprised to note impeccable oral health on her subsequent recall visits. As the old adage goes…. Better late than never!