Ask The Dentists: June 2013
Dear Dr. Winter, I have a gold crown for 30 years in my back bottom molar and it now has a little worn away spot on the top of it. The tooth underneath does not have a root canal, should I get it repaired (gold foiling) or do I have to get a whole new crown. The dentist seems to think he can foil it, what should I do?
Dear Mary Ann, the fact that your dentist does gold foils tells me he is an older dentist that has the skill to place a nice small gold restoration.
Most dentists today do not know how to do direct gold fillings anymore as it is no longer taught in dental school.
If the price is reasonable you could do a repair but if they feel the crown needs to be replaced then you may want to consider that. Chances are
a meticulous dentist that offers gold fillings would not suggest that restoration unless the rest of the crown margins, contours and occlusion were
good.
Go for the gold! It’s better than plugging it with Silver.
Dear Dr. Winter, I understand that deep cleanings can close or reduce the gaps in one’s gum line. Is the gap improved because the gums shrink up (thereby exposing more tooth)? Or is the gap improved because the gum now adheres to the cleaned tooth surface?
Dear Sue,
Deep cleanings allow for bacterial removal, biofilm removal, soft tissue healing and shrinkage of inflamed tissues. These tissues with their attachment apparatus will attach to the healthy root surface where the surface of the root is clean, healthy and free of
restorations. It will not prevent gaps of any type. Tissues that are puffy may shrink to acceptable levels but in general tissues that have receded due to bone loss and tissue migration will not come all the way back if there has been underlying bony destruction.
Dear Dr. Winter, I have top and bottom dentures that are held in with implants. I have 2 implants for the top and 2 implants for the bottoms. The top denture has cracked 3 times and has been repaired at a cost of almost $300 each time. The dentist blames my bite for them cracking and says the only way to correct the problem is to put more implants in on top and a new denture to correct the bite. What do you think? I can’t afford these repairs!
Dear Dave, your dentist is correct. Two implants is never advised to support an upper denture. You need additional implants for support and probably a metal reinforced implant overdenture. Upper dentures cover the entire palate and whenever you chew it creates spreading forces that will lead to cracks down the middle of the denture. Having two implants leads to rocking. If you draw a line across the two implants it’s like a teeter tater where the denture can rock forward and backward over this pivot line. You need more implant support, possible grafting to have enough bone and most likely a new denture. We are happy to offer our readers a complete x-ray and examination visit with a courtesy if you mention this article. Please call us at 414-377-5711 to schedule your visit today! You can read more about our dentistry, see photos and videos and learn about our financing at www.winterdental.com
Richard Winter D.D.S. M.A.G.D. D.I.C.O.I.
Master Academy of General Dentistry
Diplomate International Congress of Oral Implantologists
