what to do about missing front tooth?

littlerock

OK I have all my lower front teeth and the upper central front four. Then on the right upper side there is a gap, then another tooth then another gap.

The second of the two front gaps, the further back one, is concealed by my lips and has been there a long time. The first gap is much more recent. To cu:t a long story shortish, it seems I grind my teeth and as I am now in my early 60s have been doing so for many years.

No dentist ever told me this until I consulted one about the latest gap, last year. It seems when I finally lost the remaining portion of the latest tooth (freak accident), it was already weakened by years of grinding and there is very little room to insert a replacement because lower tooth beneath gap is very close to it.

The proposed solution is a rool canal and crown on the newest gap together with building up all the upper front teeth to lift them clear of the lower ones and putting veneers on the front. (Otherwise the grinding will continue and any single replacement tooth will soon be weakened and crack and break off again. )

This is all very well but it is going to cost 000s which I do not have. And to be honest at my age I only want to look presentable. There is of course the second gap separated from the first gap by only one tooth but it seems stable for now. Anyone got any suggestions?

Toothsmith

It's impossible to make any meaningful suggestions without being able to see you.

Did the dentist not give you any alternatives?

If you can't afford what he/she thinks is the best treatment, then what about a back-up plan that you could afford?

mal4mac

Ask him what's available under the NHS, which (at most) should only be £222.50 if you are in England:

http://www.which.co.uk/consumer-rights/problem/what-nhs-dental-treatment-am-i-entitled-to

littlerock

dentist does not take adult NHS patients. Said could patch up gap with crown possibly but as there is very little space because i grind my teeth, it will soon snap off again.

I was wondering if anyone had had a similar problem and if so how they had sorted it short of major rebuilding treatment costing thousands. Then I could enquire about something similar of another dentist.

mal4mac

What about a partial denture to replace the two teeth? You can take that out at night so it shouldn't add to the grinding problem! (Dentures are available on the NHS...)

DigForVictory

Short term get a mouthguard you can sleep in so the grinding whilst asleep is eased off.
Medium term, find an NHS dentist & get a second opinion!
Long term, either spend £ on teeth or counselling to accept the things you cannot change?!

Toothsmith

mal4mac wrote: »

What about a partial denture to replace the two teeth? You can take that out at night so it shouldn't add to the grinding problem! (Dentures are available on the NHS...)

As I said in my first post - without seeing the patient, it's really impossible to give any meaningful advice - so I don't think anyone should.

Dentures are all well and good - but in a grinding patient, when they are left out at night, (as they should be) it just means more force is going through the teeth that are left, and then they are much more likely to break down more quickly. If a patient keeps them in at night - then they just break their denture all the time.

It could very easily be that this dentist is on to something that others have missed, and this treatment plan will be the best thing for your mouth.

It is highly unlikely that in the 'patch them up and send them out' world of NHS dentistry that anyone would decide a huge long-term treatment like this was 'necessary' and you would continue to have things patched up as and when they break.

There is obviously something about the dentist that the OP doesn't trust though - so another opinion from another dentist might not be a bad thing - but I wouldn't recommend an NHS dentist, as there is no way anything as complex would be noticed! Maybe it's just that the original dentist needs to explain things better?

littlerock

it isn't I am not trusting - it's just too expensive an option as it would cost 000s I don't have. Also I am not in the public eye, and not getting any younger so cannot really justufy borrowing so much money. I rather hoped something less expensive but which would enable me to feel less self conscious would be an option. Sadly that does not seem to be available.

justme111

I am sure it is available. There are many many shades of grey. From what you described it is possible that one could root treat post crown that tooth while building up other teeth with composite. Not so secure option but can go with occasional change of one of those composites for years. I would agree the best bet is to see private dentist and ask what they can do for not mega ££ but more compromised. Very likely the original dentist you seen can offer other options as well if you make it clear you are looking for more budget solution.
Not much point in asking any particular dentist to do something they did not volunteer to do themselves other than to make sense of different opinions

mal4mac

Toothsmith wrote: »

As I said in my first post - without seeing the patient, it's really impossible to give any meaningful advice - so I don't think anyone should.

What's wrong with advising that he check out NHS options? Don't need to see the patient to give that advice!

Toothsmith wrote: »

Dentures are all well and good - but in a grinding patient, when they are left out at night, (as they should be) it just means more force is going through the teeth that are left, and then they are much more likely to break down more quickly. If a patient keeps them in at night - then they just break their denture all the time.

If dentures are all "well and good" then where is the problem? If the teeth all eventually get ground away, you can have full dentures.

It could very easily be that this dentist is on to something that others have missed, and this treatment plan will be the best thing for your mouth.

Bit it may not be the best thing for your wallet. If you are having to borrow to pay the dentist then that could lead to all kinds of other problems..

It is highly unlikely that in the 'patch them up and send them out' world of NHS dentistry that anyone would decide a huge long-term treatment like this was 'necessary' and you would continue to have things patched up as and when they break.

Is that so bad?

There is obviously something about the dentist that the OP doesn't trust though - so another opinion from another dentist might not be a bad thing - but I wouldn't recommend an NHS dentist, as there is no way anything as complex would be noticed! Maybe it's just that the original dentist needs to explain things better?

How can you dismiss NHS dentists so readily? Don't they have same intensive training, and (like most dentists) basically good intentions?

Why not at least see an NHS dentist, it will only cost £20 for a check up. Go armed with all the questions before hand, and don't expect a chummy conversation - they do tend to keep to the point, time is definitely money in the NHS.

brook2jack

The treatment of this type of wear is one of the most challenging problems in dentistry.

"Simple" fixes don't last. Teeth are the strongest substance in the body and if they break and wear down whatever you replace them with is only second best and will never be as strong as the original teeth.

Eventually you get to the stage where there is no room left to replace missing/broken teeth.

You are left with two choices

1 accept things as they are , wear a bite shield to try to minimise wear. The problem with this is for many people with a very strong Clench reflex this will only make things worse, it may also mean it is impossible to replace the broken/damaged/missing teeth .

2 start on a long and complex course of treatment to try to stop /minimise the damage and then repair . This is clinically very demanding, will take months, will be expensive and will need ongoing repair and replacement.

With this sort of case there is no easy quick fix .