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Question:
I have been told I have bone loss on the back side of tooth #11. There is no gum disease and a periodontist just did a surgery to determine if the tooth has a fracture. It doesn't.
Both he and my general dentist seem mystified. The only thing they did was try and adjust my bite, thinking I may be hitting the tooth while biting or I may be grinding my teeth. I am not aware of grinding.
I will lose the tooth if the bone loss continues. It is an anchor for a bridge. If they don't know what's wrong, they can't help me. Do you have any ideas? ... Visitor from MI
Answer:
The problem is either a fracture, bacterial and/or occlusal.
Fractures can be difficult to see. In most cases they are untreatable. In order to determine if the tooth is fractured the bridge would need to be removed along with any buildup material. If the tooth was treated with a root canal and a post, it becomes more challenging. Most endodontists have specialized instruments to remove the post and high power surgical microscopes that allow small fractures to be located.
Bacterial problems can cause localized bone loss. There are in-office DNA tests that will determine if the bacteria is causing the problem. Several companies manufacture antibiotics that are placed in the problem area to arrest the bacteria. In some cases a bone graft can be placed to restore the bony defect.
Occlusal (Bite) problems generally have multiple symptoms. Teeth have wear marks, fractures, grooves at the base of the gum, and/or muscle tension. A comprehensive history and examination can determine if their is an occlusal problem.
The canine tooth serves as the "cornerstone" of the mouth. It is has the longest and widest root. The bump you feel when you rub your finger on the gum above the canine tooth is where the jawbone is thicker. In most patients this tooth plays a role in protecting the back teeth by taking the full load as your jaw moves from side to side.
It is imperative that the problem is resolved, or that the canine tooth is properly extracted and replaced with an artificial root (implant) while there is sufficient bone. If you wait until so much bone is resorbed that the tooth becomes loose, there may not be enough bone to place the proper size implant.
Then a bridge will have to continue all the way to your front tooth. As the bridge gets longer, and it is held in place by smaller teeth, the life expectancy of the bridge will continue to decrease.
Editorial Staff
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