Your options if you have many missing or damaged teeth

People who have not followed adequate dental care for some years may have already lost most of their teeth and feel a little hopeless.

Sometimes they ask a dentist to remove the remaining teeth as they are often broken and have deep cavities.

It’s true that, sometimes, removal of the remaining teeth and replacing them with full dentures is the only option.

But more often there are other options available.

Some or all of the remaining teeth could be repaired and used in conjunction with a partial denture. While a full denture replaces all of the teeth on the upper or lower jaw, a partial denture replaces some of the teeth.

If only a few weak teeth remain on the upper jaw, it might be preferable to have them extracted and a full upper denture made. Full upper dentures can be more secure than lower ones as the upper denture gets added stability from the palate and is not easily dislodged by the tongue.

If only a few teeth remain on the lower jaw, however, the dentist will usually aim to save them and use a partial denture if necessary.

Ideally, all teeth that can be saved should be saved but this is not always possible – often due to finances.

In such cases, having teeth removed and dentures may be the only option.

Why cavities aren’t just for kids

Tooth decay or cavities result from destruction of the tooth enamel and can lead to a range of problems from toothache to bad breath.

Cavities occur when foods containing carbohydrates (sugars and starches) such as milk, sugared drinks, cakes or candy are frequently left on the teeth.

Bacteria that live in the mouth thrive on these foods, producing acids as a result. Over a period of time, these acids destroy tooth enamel, resulting in tooth decay.

Many people associate cavities with children but the changes that occur with aging make cavities an adult problem, too.

Recession of the gums away from the teeth, combined with an increased incidence of gum disease, can expose tooth roots to plaque.

Tooth roots are covered with cementum, a softer tissue than enamel. They are susceptible to decay and are more sensitive to touch and to hot and cold. The majority of people over age 50 have tooth-root decay.

Decay around the edges of fillings is also common to older adults. As many of them did not benefit from fluoride and modern preventive dental care when they were younger, they often have a number of dental fillings.

Over the years, these fillings may weaken, fracture and leak around the edges.

Bacteria accumulate in these tiny crevices causing acid to build up which leads to decay.

You can help prevent tooth decay by following these tips:

– Brush twice a day with fluoride toothpaste
– Clean between your teeth daily with floss or interdental cleaner
– Eat nutritious and balanced meals and limit snacking

It’s also worth asking your dentist about supplemental fluoride, which strengthens your teeth, and about dental sealants, a plastic protective coating which is applied to the chewing surfaces of the back teeth to protect them from decay.

In addition, it’s important to visit your dentist regularly for professional cleanings and oral examination.

Action steps to prevent gum disease

Gum disease is a major cause of tooth loss in adults but it can be prevented or reversed if you take the right steps.

It’s caused by plaque – a sticky film of bacteria that constantly forms on the teeth. These bacteria create toxins that can damage the gums.

However, you can help avoid gum disease by caring properly for your teeth and having regular dental checkups. These are some steps you can take to keep your teeth and gums healthy:

Brush your teeth well twice a day: This removes the film of bacteria from the teeth. Be sure to use a soft-bristled toothbrush that is in good condition. Toothpastes and mouth rinses containing fluoride strengthen the teeth and help prevent decay.

Clean between your teeth every day: You need to remove the bacteria and food particles that a toothbrush can’t reach so you should clean between your teeth with floss or interdental cleaners every day. Your dentist will show you how to do this properly without injuring your gums.

Even if you already have early stage gum disease, it can often be reversed by daily brushing and flossing.

Eat a balanced diet: A good diet based on a variety of foods from the basic food groups, such as grain products; fruits; vegetables; meat, poultry and fish; and dairy products will help your teeth. It’s also a good idea to limit snacks between meals.

Visit your dentist regularly: To prevent gum disease, it’s important to have regular dental checkups and professional cleaning.

Taking the right steps will help you avoid gum disease and can even reverse it if you catch it in the early stages.

Tips for people with difficulty handling a toothbrush

There are many people who find it difficult to look after their dental health properly because they have problems handling a toothbrush.

This can be due to a severe physical disability or simply basic dexterity problems.

There are a few simple steps you can take to make it easier for people who find it difficult to hold on to a toothbrush or dental floss.

Here are some simple ‘home remedies’:

– Use a wide elastic band to attach the brush to the hand

– Enlarge the brush handle with a sponge, rubber ball or bicycle handle grip

– Wind an elastic bandage or adhesive tape around the handle

– Lengthen the handle with a piece of wood or plastic such as a ruler, popsicle stick or tongue depressor

– Tie floss into a loop for easier handling

– Use an electric toothbrush or commercial floss holder

Your dentist will be able to provide specific guidance and further tips for people who need an easier way to handle a toothbrush and floss.

The early years of dentistry and teeth

Although there have been huge advances in dental care in recent years, there are records of people dealing with teeth going back over thousands of years.

Here are some of the key dates from the early years in the development of dentistry.

5000 BC: A Sumerian text describes tooth worms as the cause of dental decay.

2600 BC: Hesy-Re, an Egyptian scribe, often called the first dentist, dies. An inscription on his tomb includes the title the greatest of those who deal with teeth, and of physicians.

500-300 BC: Hippocrates and Aristotle write about dentistry, including the eruption pattern of teeth, treating decayed teeth and gum disease, extracting teeth with forceps, and using wires to stabilize loose teeth and fractured jaws.

166-201 AD: The Etruscans practice dental prosthetics using gold crowns and fixed bridgework.

500-1000: During the Early Middle Ages in Europe, medicine, surgery, and dentistry, are generally practiced by monks, the most educated people of the period

700: A medical text in China mentions the use of silver paste, a type of amalgam.

1130-1163: A series of Papal edicts prohibit monks from performing any type of surgery, bloodletting or tooth extraction. Barbers often assisted monks in their surgical ministry because they visited monasteries to shave the heads of monks and the tools of the barber trade sharp knives and razors were useful for surgery. Following the edicts, barbers assume the monks surgical duties: bloodletting, lancing abscesses, extracting teeth, etc.

1210: A Guild of Barbers is established in France. Barbers eventually evolve into two groups: surgeons who were educated and trained to perform complex surgical operations; and lay barbers, or barber-surgeons, who performed more routine hygienic services including shaving, bleeding and tooth extraction.

1400s: A series of royal decrees in France prohibit lay barbers from practicing all surgical procedures except bleeding, cupping, leeching, and extracting teeth.