Cheyenne Advanced Dental Arts

L. Scott Brooksby, DDS, DICOI

Prosthodontist

8960 W. Cheyenne #190

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  • Why teeth are lost

    Dr. Brooksby,

    I try really hard to take care of my teeth, but one of my teeth has started to bleed and is getting loose. I went to a dentist and he told me I needed to clean my teeth better. What more can I do? Frustrated.

    Dear Frustrated,

    Are bacteria the only cause of tooth problems?

    In dental school we were taught that bacteria were the cause of all dental problems from cavities to gum disease. We have discussed in other articles how decay can be cause not only by bacteria, but also acid saliva and excess stomach acid. In my thirty years of practice I have met a lot of people that are meticulous in cleaning their teeth, yet one or two teeth start to have bleeding gums, pus, redness and looseness. Many indicate that one day the tooth just came out on its own.

    Some teeth are simply rejected by the body.

    While it would be difficult to create a study that could prove what I am about to say, I would like to suggest something as an alternative rationale for this type of problem. It is my opinion, that somewhere in the life of the tooth, whether due to trauma, bacterial contamination or something else, the chemistry of the tooth changes and the body ceases to recognize the tooth as part of the body. It then begins to try and sluff the tooth away. This is similar to the situation if a sliver were to get caught in your finger. It would begin to fester if you did not remove it. It would get red, swollen, full of puss and eventually it would come out and then everything would return to normal.

    I have seen a lot of patients where the tooth was part of a bridge. When we look at the tooth it looks bad and there is major bone loss evident on the x-rays. In many of those cases when we cut the tooth from the bridge, the tooth literally pops right out of the mouth with no need for an extraction.

    If this is the case, attempting to treat the tooth with antibiotics or leaving it alone to try and milk the tooth is futile. The longer it stays in the mouth, the more bone it destroys. It is best in this case to remove the tooth, let the area heal for about 9 months and then replace it with an implant and crown.

    Immediate implants vs Delayed Healing of Implants

    Dr. Brooksby,

    I have has several consultations regarding dental implants to replace a couple of missing teeth. What, if anything, do you do different? Inquisitive.

    Dear Inquisitive,

    Most of my patients come to me because they want teeth that will last a long time and give them the least amount of hassle. Many offices are advertizing immediate implant placement or placement of minimal numbers of implants to keep the costs low. Unfortunately these have higher failure rates over the long haul. While there are times when these are viable options, those times are usually infrequent. We usually wait about nine months after the extraction for the bone to mature. Implants work better and last longer if they have a solid sound foundation.

    We will begin growing more bone sooner if it is needed. We determine this need by using CT scans which allow us to see the quantity and quality of the bone without resorting to surgery just to get a look see.

    Cemented vs Screw retained implant crowns

    When we make the crowns on top of an implant we usually try and make it so that it can easily be removed to make repairs if something breaks. Most dentists will screw a coping or “abutment” on top of the implant and then cement a crown on top. If the crown breaks or the screw for the coping comes loose, they have to cut the crown off and then make a new crown. This substantially increases the cost later. Our crown can be screwed on and off without destroying the crown. Repairs are usually minimal to just a couple of hundred dollars saving you a lot of money over the long haul.

    There is a saying “penney wise and pound foolish.” For the slightly higher cost why not have something that will last a long time, require minimal upkeep and be easy to repair.

    Dr. L. Scott Brooksby was selected as the Best Proshtodontist in Las Vegas for 2009, 2011 and 2012 by the United States Consumer Association.

    If you would like to meet Dr. Brooksby or if you have any kind of dental concern and would like a fresh look at what choices are available to you call . Schedule a free consultation and lets see what we can do to help you. If you have questions you would like answered you can e-mail Dr. Brooksby at scott@lvimplant.com.