I attended a wedding reception several weeks ago and sat at a table with strangers. The topic of back pain gave way to various home remedies, which expanded to back surgeries and their related rehab. After 40 minutes of discussion, the topic closed with the summation, “Well, you just have to fix it because you can’t live without a back or in chronic pain”. No one at the table knew my profession, so I added, “the same goes for your teeth”. I was astounded that many at the table just admitted, to complete strangers, that they just deal with the pain for as long as they can and then have teeth removed. They quipped that, after all, they started out with so many that they can live without a few, especially in the back.
Vanity aside, there are five strong reasons for replacing teeth. Each person at the table would probably prioritize the reasons differently, and none would have thought through the consequences of removing an occasional tooth. The most obvious one is under-chewed food, which makes swallowing more difficult and doesn’t introduce enough digestive enzymes from the saliva, necessary for proper digestion. Now, the stomach, and related passageways, must work harder – three times a day. This is related to bone deterioration in the jaw, because the absence of sturdy teeth that used to absorb a chewing load means that the jaws take the abuse. I have x-rays of patients who have 25% of the original bone density remaining in their lower jaw. These patients are at risk of breaking their jaw when in a car crash, playing with kids, or petting a happy dog. Further complicating this is the fact that teeth no longer “stand up” in the U-shape of the jaw, touching each other at 2 points, when even one is removed (unless it is a wisdom tooth). Some tip, some rotate, and some drift away from the U-shape. Patients start telling me that food “gets stuck” between teeth. Patients over 40 attribute their age to their “sagging” cheeks, when they often just lack the teeth to fill out the bottom half of their face. And finally, patients who lose teeth and don’t replace them upset the function of the jaw joint, known as a temporal mandibular joint. These muscles are meant to keep the jaws aligned but, when missing teeth force people to alter their chewing patterns for years, an imbalance is created. Pain results. Now they need surgery to correct the imbalance, not to mention the discomfort from surgery and the urgent need to do something in the mouth to restore balance.