Learn about the importance of choosing the right dental provider and questions to ask.
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Dr. Carl Misch: Now over the last 30 years, dentistry has evolved into a completely different discipline than we had in the past. When people have lost teeth before, which about 70% of our population has lost at least one tooth, the primary method to replace it was by grinding down the adjacent teeth, then luting them together as one unit and cementing something in there to replace that particular tooth. What we understand today is that one out of five of those restorations end up decaying between ten and 15 years. When they decay, the often end up with the root canal and about one out of four of these teeth end up with the root canal as a consequence of it. The problems that we have with root canal is that if we use about one out of ten times, it doesn’t work and the tooth is lost, another one out of ten times, the tooth breaks, ended to this locks. As a consequence, one out of three of these fixed replacements need to be replaced within ten years and one out of two need to be replaced within 15 years. When they are replaced, they often miss another two. As a consequence of that, we go from replacing one tooth to two teeth and then four teeth and then our partial denture, something that’s removable and then a complete consequence of that. Within ten years, one out of three these devices are lost and within 15 years, one out of two of these devices are lost. When the bridge needs to be replaced, the often takes it to with it. So when this bridge of missing one tooth is replaced, it often ends up replacing two teeth. When that bridge needs to be replaced within ten or 15 years, it’s now missing something enough that you have to go to a removable partial denture, we call it a removable partial denture rather than something that’s fixed in the mouth. The removal partial denture then access a lever on the teeth as a test tube, then the patient ends up losing both teeth, then the patient ends up with a denture to a point that in this country we have 10.5% of the population, the old population have no teeth at all and another 7% of our old population have no upper teeth. That’s a total of 17% of the population ends up with no teeth in the United States, that’s 30 million people. To put that in perspective 30 million people is equivalent to the black population in the United Stated. 30 million people is equivalent to the entire population, men and women above the age of 65 in the United States. We have 30 million people with no teeth and then all starts with replacing one tooth by cutting down the adjacent teeth and luting them together and making it impossible to clean and more likely to end up the root canal. It causes a cascade of destruction of our patients’ mouths. What we now realize today is that it’s best done to start this process with an implant. If you loose a tooth, the best thing to do is to have an implant to replace that tooth. Then the implant access a manmade root which then has a crown has attached to it and the adjacent teeth don’t end up decaying, they don’t end up with root canals and they don’t end up with loss. In addition to this cascade of destruction that leads to no teeth, we now understand that the bone that holds the teeth is there primarily because the tooth stimulates the bone. When the tooth is lost, the bone starts disappearing. They lose 25% of the bone width within the first year that a tooth a lost. It’ll continue to lose and then the bone decreases in width and it decreases in height. As a consequence, then the muscles that attach bone to face start unattaching and the jaw start deforming the face and the chin rolls over that called which is chin implant plastic surgery, the face -- get more lines in the face. As a result the face then dramatically ages as a consequences of that. We have a understanding of osteoporosis that every woman at the age of 40 is aware that after the menopauses, she starts losing bone mass. While the bone mass that these women lose is bone density, this volume the bon