This is the most common perspective a human been has to their teeth, i call it the esthetic perspective. We see our smile and what we see in the mirror is what is most important. If our reason for going to the dentist is "that we never take out our face and put it in a cup (wearing a denture)" then we must see this from the engineering perspective.
- When we try this perspective we start from the joint (tmj) it's just like scissors, if you are going to cut an electric cable with scissors you don't cut it with the tip of the scissors, you shove it all the way back into the joint and lean on it. The closer we are to the joint the greater the force your jaw is able to exert.
-Teeth are not all the same, all back teeth are the same and all front teeth are the same, all back teeth are the columns and studs that keep the building sanding and square. All front teeth are the doors and windows that "hang" off the front of the house but are not weight bearing structures. (that means they cannot bear weight or they will break)
-We don't have a hundred teeth back there, there are only four supporting structures to each side, two are columns and two are studs each has an upper and a lower half. Many people get their first toothache and they choose to have the tooth extracted because you can't see it. (esthetic perspective) New definition an extraction is an amputation.
- Columns or molars are about two and a half times the size of a stud or premolar, so if that first extraction was your second molar which is next to the hinge you just lost almost 50% of your ability to grind food on that side.(chewing power) Just one extraction. Opposing tooth is neutralized, can't clap with one hand.
-Out of habit or fear or lowest fee, demolishing the house seems to be the most convenient way to deal with the inconvenience. Until one good day we realized that teeth are not figurines on a mantle, they are the blades of the grinding machine which enables you to eat. And without them nothing is the same, you don't look like yourself and you can't eat. The complete loss of form and function is not something which makes humans feel better. The bone that holds a tooth shrinks from 30-70% in the first 12 months, after this the human face only shrinks.
-How many teeth are missing in the back? To be a functioning unit you need a tooth that faces and engages another tooth completely.
1- teeth are amazingly hard to grab, i would use a dental slide hammer. After a complete exam and radiographs, it might be just a piece of cement. I do not advocate for someone who has never done this to try.
2-if you have termites in your house and the thing looks like its going to hit the ground at any second, what would you have to tell the contractor that would mean a fast fix? after an exam there might be no fast fix, other than an immediate denture.
3- if the tooth is still complete, the crown and post are still complete and the difference between first contact and complete closure can be cleared with an aggressive adjustment (grinding the back of the crown) maybe.
Test- push the crown back in until it feels like it went home, keeping your index finger on it holding it in place. Now bite down on your back teeth until they all touch like when you are chewing comfortably. Now you see your bite broke the tooth not the apple, and the distance from where the tooth was to where your bite wants to put it is how much needs to be cut out for it to fit where it used to be. This is a changing structure. The area of dentistry called occlusion seeks to create a stable structure. No change through time.
Joe Reed, DMD, MAGD
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