Advice Column, Health, Lifestyle, Parenting

The Big Ouch

  • Dr Gerald B Kaplan
  • Category Advice Column, Health, Lifestyle, Parenting

A specialist prosthodontist is trained to treat adults who present with severe dental problems. Restoring a broken down mouth back to good health is a major challenge and oftentimes very costly in terms of time and effort and expense.

Patients want to regain their lost dental health. They are looking for the ability to eat well; look good; and smile to the world. They don’t want to wear dentures at all costs.

The question that needs to be asked is “Why did such a compromised situation result?” That is a very difficult question to answer and can be the result of many factors.

Clearly there is one element in the equation that has a solution… Teeth are designed to last a lifetime and dental care should begin from early childhood.

Let me tell you a story…

I was asked to prepare a lecture for a group of nursery school parents to teach the importance of baby teeth and how to look after them. I wanted a photograph of a young child to include in my presentation. In searching for such a picture I walked past a young lady of five years old and thought that she would be the appropriate candidate. As she smiled I noticed that she was missing a back baby tooth. That really upset me greatly. Why should such a young person lose a baby tooth? The loss of such a tooth has major consequences in terms of long-term dental health. It changes the bite and sets the patient up for future (probably unnecessary) orthodontic treatment during her early to late teens.

I suggested to the mother that she bring the young child in for a quick look see. She agreed and the clinical examination revealed the presence of seven teeth in need of restorative dentistry. That begs the question –  Why was the decay not diagnosed earlier and why did she have to lose a tooth unnecessarily. Dental decay in a baby tooth should be done promptly. It spreads fast because the tooth enamel is thin.

Now the young lady needs a general anaesthetic and placement of a space maintainer to prevent the loss of space while the jaw continues to grow to allow. The permanent tooth will erupt at the appropriate age and it needs space to fit into a healthy dental arch.

If that shock was not enough, I then had the pleasure of meeting her eight-year-old brother. I was aghast. This young man already has a mixed dentition, that is, both baby teeth and primary teeth are present in the mouth which is in the process of growth and development.

Not only not only were his teeth laden with plaque and widespread decay on the baby teeth, but a permanent molar tooth was ravaged with decay. This was revealed with disclosing solution. Plaque is invisible and effective tooth brushing needs to be checked.

The first permanent molar tooth erupts into the mouth at the age of between six and seven years of age and they should last a lifetime if properly cared for. These teeth are the most vulnerable teeth in the mouth for a young person and the teeth most frequently lost as the years go by. The problem is preventable with effective dental care both by the dentist and by the responsible parents.

Now both of these gorgeous children have compromised mouths. They are fearful of sitting in the dental chair. They can only be treated under general anaesthetic with all the risk and anxiety that it entails. And what about the expense that could have been avoided with effective tooth brushing; regular fluoride treatment; and a proper diet.

Let me end off by saying that restoring the mouth of an adult patients is challenging and oftentimes very difficult. Why let such a situation develop at all?.

Teeth are not to be taken for granted. They are precious as pearls.

How wonderful it is look forward to the enjoyment of sound dental health for one’s whole life.

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