Broken Teeth to the Gum Line?

As a Periodontist, we evaluate all teeth to see if they are worth saving.  We evaluate the  following:

1- Crown/Root ratio 

2- health of the patient

3- amount of bone support and the extent of the surgery..worth the effort?

4- overall treatment plan and prognosis

5- restorative treatment plan

6- finances and patient feedback

7- implant options

In summary:  You should have a full set of quality digital x rays and  have a comprehensive treatment plan with a highly trained Laser Periodontist to go over all your options including the latest laser techniques in extractions, implants and bone regeneration.

The best way to restore these teeth will be with dental implants.  The important thing will be to graft the extraction sockets at the time of extraction in order to preserve as much of the bone as possible.

Teeth which are broken off at the gumline can many times be saved and restored to function and appearance.  The normal treatment for this is Endodontic therapy, a Post and Core build up and a Crown.  The cost for doing this may actually be  quite a bit less than removing the tooth, placing and implant, and then restoring the implant abutment. In many cases the Extraction and Implant route does not produce a better, healthier, or more cosmetic result.  I would suggest getting several opinions before having any teeth removed and most importantly finding someone skilled in Endodontics (root canal therapy) and Restorative Dentistry.

Dental implants are the ideal option for teeth replacement. They may be placed immediately at time of extraction if appropriate (determined by surgeon) or placed in delayed fashion once the sites heal (typically 2-3 months). A transitional prosthesis can be made by the restorative dentist while the sites or implants are healing. In some circumstances, implants may be immediately restored so a patient can have a fixed set of teeth on same day. This is only done, again, if appropriate as determined by the surgeon and the restorative dentist team.

You can immediately insert a partial denture or full denture if your appearance will be compromised. You could consider immediately inserting dental implant if bone quality and quantity is present, or you could place a bone graft in the extraction sites and in 6-8 weeks consider the removable prosthesis, fixed bridge or dental implants good luck

Kevin Coughlin DMD, MBA, MAGD      CEO Baystate Dental PC

It depends on how cosmetically conscious you are.  If it doesnt bother you, from a look point of view, you don't have to do anything. You can just go around with no teeth.  In reality, we (human beings) do not need our teeth to do anything except to look good.  With the advances in cooking and appliance technology, we don't really need our teeth to eat anymore. But if the look of you being toothless bothers you, you should consult a dentist who can give you a wide array of choices before and after the extractions. Depending on your finances and your social status in life, these choices can range from a " one tooth removable bridge" to a full mouth "implant supported dentures, caps and / or bridges". Search for a dentist with advanced traning who can recommend these options.

If quite a number of teeth have broken down to the gumline and if all of you teeth have to be extracted, we need to first restore your dentition to proper function.  After radiographs including a panoramic study are taken, a proper diagnosis and treatment plan can made with you and your dentist.  Accurate occlusal or bite records that follow facial proportions need to be taken along with pre-operative photographs.  An immediate denture might be a good idea to start with.  If you have adequate bone, adequate support structures and if your health history is non-contributory, implants might be the best option.  If these conditions are met, implants can be placed at the same time your broken teeth are extracted.  This will reduce the overall treatment time of you case.  When dental implants are placed, you may have a choice of either a fixed or removable prosthesis.  If implants are not an option, a final removable denture can be fabricated once all the hard and soft tissues heal.  Good luck and keep us posted.

Prior to even having the extractions, your dentist can make you an immediate denture to wear so you do not have to walk around without teeth after the extractions are completed. Further down the road, you can explore more options such as dentures that are implant supported, or implant crowns to replace the missing teeth. Not everyone is a good candidate for an implant, it depends on the amount of bone present, and factors in your medical history. No matter what, your dentist will be able to provide a restorative option for you so that you will have replacement teeth.