Tooth Loss: Alternative Medicine Considerations

 

I recently had a new patient, a female in her mid-50’s, who presented with deep decay on her first molar. After removing the decay the pulp area was exposed, and the space showed a pulp exposure that did not bleed. This usually indicates that the pulp is at least partially dead or totally necrotic.

This patient is aware of alternative medicine considerations when it comes to teeth. Having root canal therapy would be a normal choice, but alternative medicine practitioners recommend against that. The reasons include that the tooth is dead and the electricity does not flow properly through the body with the root canal in existence. Another consideration is that all of the bacteria cannot be removed from the area and can be a problem later on. Keep in mind that this is NOT a mainstream view, especially in the dental community. At least in this case, the amount of deep decay was so profound that even with a root canal and a crown, the prognosis is less than excellent.

The tooth will be coming out soon, but what will replace it? Leaving a space is always a thought, in which case nothing is done. The down side to this is that the tooth behind it may drift forward at an angle, or the opposing tooth (in this case an upper first molar) will start to erupt into the space (teeth will erupt until it meets an opposing tooth to chew with). If the bite is very locked in, there will probably be little to no movement. However chewing is difficult where a large tooth is missing.

A removable appliance will help hold the space from chewing, but that is an annoying choice, having to take it out at night plus getting use to the appliance. On the extreme end, it may come out and the patient could swallow it. Having said this, some people manage well with the appliance.

The next step up is to have a dental fixed bridge. The teeth on either side of the space a prepared (drilled) for crowns, and the missing tooth has a crown that is connected to the 2 prepared teeth. This was the preferred treatment until implants. The down side to this is that 2 teeth need to be drilled for crowns even though by themselves the tooth may need no treatment. Also, over time, the abutment teeth (teeth supporting the bridge) may decay and need to be replaced. Hope care around bridges is much more difficult, requiring special tools to get between the bridge and the gum tissue under the bridge.

From a dental view, a dental implant is the preferred restoration. The down side: it is a surgical procedure. The up side: the 2 adjacent teeth do not need any preparation and it feels like a natural tooth. The alternative medicine people do not like this because the implant is made of titanium and the alternative medicine people are concerned with that. There are zirconium implants that have come out, and the alternative medicine people seem to like that more. The problem with these is that they are much newer and have had some failures, more so that the titanium ones which seem to do very well.

The long term goal is to be able to develop a tooth, perhaps from a tooth bud similar to how the way teeth are formed naturally. Stem cell research may prove very positive on this!