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Tooth Replacement due to Gum Disease

02/05/2017

Sterilising dental equipment

Very often we are unaware of tooth or gum disease. We pick up signals, but there is often no pain and, in our opinion, no real urgency to head to the clinic. When we finally dedicate time and effort to visit the dentist it is often too late.


SIGNS OF TOOTH/GUM DISEASE


  • Colour of gums: Dark greyish border around teeth with bright red ulcerated gums with loss of the pink triangular gum in-between teeth. Teeth are often mobile.
  • Large holes in teeth: unrestored cavities keep growing and generally give symptoms of pain – however not always. Normally within a 3 year period the cavity would have reached the nerve of the tooth, requiring a rootcanal treatment.
  • Multiple missing teeth: on-going carelessness and lack of concern for tooth loss would often land you many missing teeth. You realise that by your early 40s, you have lost many of your teeth, especially your posterior ones. At the time you wouldn’t be very concerned as the teeth might not show on smiling but, in time, you notice you are being more selective on your food due to not being able to chew properly. Remaining teeth often over-erupt or drift or space out leaving spaces and food traps.
  • Tooth movement: this is common in our later years as teeth move throughout our life. There is however a limit to natural tooth movement. Common complaints include spaces in the front upper teeth, inclining teeth. Patients often say their upper front teeth have always protruded but not as much, and they have somewhat worsened!
  • Halitosis: This is often brought to someone’s attention through a partner or a member of the family. Although the cause of bad breath may come from the stomach or tongue it is more likely to be poor oral health and gum disease. It is common and necessary to visit the dentist twice a year for a routine scale and polish but in many routine cases a more thorough scaling is required below the gum line. A hygienist performs this. The technical term used is periodontal treatment involving hand scaling and root planning. Patients who undergo this treatment modality feel an immediate difference, not only in the colour and smell but also in taste and comfort.
  • Longer looking teeth: Gum disease causes the bone to be lost and the gum follows suit exposing the roots, appearing longer. Teeth are also left more sensitive. • Mobile teeth: loss of bone and supporting tissue causes teeth to move. Of course, prior to replacing any lost tooth, the initial cause must be eliminated or at least stabilised and kept that way. Gum treatment is mostly simple and straightforward. All you have to do is brush your teeth twice daily, using a proper technique, and to have them cleaned professionally at the hygienist.

A CASE STUDY

A middle-aged woman notices her upper front middle tooth is rotating, moving outwards, looking longer and becoming more spaced out. Radiographs show little to no gum and bone attachment. Luckily, she had good bone above the root. The tooth is mobile, but symptomless; there is no pain.

Aesthetically, she wants it sorted and looking good. She is very conscious of it. Her options were either using a removable denture or a fixed bridge or dental implant. She opted for the best option, a dental implant. Here is the sequence of events:

1. Extraction of tooth and same day insertion of implant with same day placement of a fixed plastic tooth. The tooth was placed in the correct alignment and angulation.

2. Four months later, the plastic tooth was changed to an all ceramic, highly aesthetic metal-free crown with a customised zirconium post.


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