September 2016 - Prosthodontist in Johannesburg
archive,date,ajax_fade,page_not_loaded,,hide_top_bar_on_mobile_header,qode-theme-ver-9.5,wpb-js-composer js-comp-ver-6.0.5,vc_responsive

September 2016

Let me share a true story with you of how little a patient really knows about what’s going on in their mouth.

This afternoon a lady in her late 40’s consulted with me asking to replace a tooth with an implant.

Crown Falling Out – Upper Premolar

The reason for her visit was that a tooth had been crowned and was most uncomfortable. The crown was often falling out and always at the wrong time. She knew there was something wrong and it had to be attended to. Nobody that she had recently been to see could help her properly!

Thanks to Dr Google she found our office. She has certainly come to the right place. A specialist prosthodontist is trained to offer comprehensive dentistry by treating the specific problem and making an overall assessment of the entire mouth.

A single tooth may present with a problem that needs attention. But a tooth does not stand alone. It is part of the whole mouth of teeth which all function together and work in harmony to provide comfort and function. The jawbones, the muscles, the teeth, tongue all function together and form the beginning of the digestive tract.

Besides this particular problem, a complete examination of her mouth revealed a host of other problems that she was totally unaware of. She is missing lower back teeth which have caused the collapse of her bite and increased wrinkles on her face.

Panoramic x-ray

She now has crooked front teeth. Amazingly she says she has no difficulty in chewing. This may be true at the moment because of adaptation over time but in the long run things are only going to get worse with the possible loss of more teeth. She does not realize the consequences.

Because of the loss of back teeth one may start to experience pain in the joints of the jaw and even gaps may develop between the front teeth. Chewing becomes difficult. Some foods need to be avoided and digestive problems may occur. These are chewing problems that are avoidable and if they occur, are difficult and costly to treat.

Many of her remaining lower teeth are problematic and are coming to the end of their usefulness.

Back Teeth

In general, I often wonder why so many patients loose back teeth so nonchalantly. Somehow they don’t realise the importance of them or the consequences of their loss.


Back teeth: right hand side

So now, what does one advise this lady going forward… She certainly does not want to be like her elderly parents who now wear dentures and who didn’t have the benefits of modern dentistry in their day. (Fortunately many denture wearers can now also derive the benefit of implants but who wants to be in that position in the first place).

There is shock, disappointment and dismay when coming to the realisation that the treatment of this single tooth is not an isolated procedure and that her past treatment has not provided for sound long -term dental health.


Back teeth: left hand side

The recommended approach to treatment is hard to digest (excuse the pun). Treatment is now costly and time-consuming. It all could have been avoided with proper dental care.


If your teeth could speak to you is this not what they might be saying?

  • Please spend the time twice each day to brush me and floss me well. I want my gums to also be healthy. I want to have a pleasant breath.
  • I would love my teeth in your mouth to remain healthy and sound to last you a lifetime. I want to be able to help you chew your food well and be part of your beautiful smile.
  • Please look after for me by taking me to the dentist regularly to have me checked and cleaned.
  • Please be careful not to give me too many sweets, chocolates and cold drinks. If you do indulge, please rinse me thoroughly afterwards so that the sugar doesn’t linger.
  • I don’t want to get cavities! But if I do unfortunately have to have a tooth treated, please let the dentist that you take me to explain the options of treatment. I don’t want my filling to be done quickly, sloppily and cheaply. I am too precious to you to be taken for granted and so casually.
  • I don’t want the same tooth to be worked on over and over again so that the cavity becomes bigger and bigger and then I land up having to have a root treatment.
  • I am told that root treatments can sometimes fail and then I may have to be extracted with the unfavourable consequences. This could have been avoided in the first place.
  • I don’t want you to suffer from a chronic abscess.
  • I also know that implants are a wonderful option but not a panacea for the real thing. They really can be costly.
  • I’m also told that our medical aid is not an ATM just to get money out of.
  • Please familiarise yourself with the medical aid scheme rules that we belong to. Don’t allow the health professional that you have taken me to, to be limited by what the medical aid will pay. I want the best for myself and for you. I don’t want you to be dictated to by a third party about what can or can’t be done. They are our teeth – not theirs.
  • I don’t want to crack or break and cause you inconvenience and pain because I was not treated properly the first time round.
  • Please don’t book an appointment for me if you are not going to keep it for us. I don’t want to feel the embarrassment.
  • I don’t want to cause you unnecessary expense if prevention is so effective.
  • Don’t you think that if you take me to a prosthodontist initially, you will be looking after me so much better? He is so much more knowledgeable and better trained than a regular dentist.

I really love being so closely connected and attached to you. I want to be with you for a lifetime!