The Root of It All

Top Tips for a terrific smile

By Joyce Wiswell, Michigan Prime - July 2016

Michigan Prime July 2016

If it ain’t broke, don’t fix it. We’ve heard those words all our life, but Bruce Smoler, D.D.S., begs to differ.

“When it comes to teeth, people also say, ‘No pain, no problem.’ But that is not necessarily true,” says the Westland dentist, who advises older patients to be proactive with their dental health in recognition that life expectancies continue to grow. “A lot of dentists were trained in the 1950s, ‘60s and ‘70s when life expectancy was lower. I have had patients who were told they are old, so why save your teeth? Now they are 83 and a dental cripple. But patients well into their 90s and 100s can keep their teeth.”

Robert Gryebet, D.D.S., agrees.

“My mother is 85 and has lost only one tooth – a wisdom tooth,” says the Sterling Heights dentist, who credits his mother’s success with excellent dental hygiene. “She is diligent with her home care.”

What about the many who were more lax with brushing and flossing? Better late than never, dentists say, and when you do encounter problems, face them head-on rather than going for a Band-Aid fix.

The notion, for instance, that back teeth are easily sacrificed because they are out of sight makes Smoler apoplectic.

“I can’t tell you how many times people are being told by their dentist, ‘It’s only a back tooth, and no one sees it,’” Smoler says. “You need your back teeth to chew with! That 60-year- old who is missing back teeth will have bone loss and gum disease from overusing the front teeth, which are the weakest.”

The solution, he says, is a dental implant, an artificial tooth planted in the jaw.

“The bite is the foundation, and missing teeth cause the others to shift and drift,” Smoler says. “Replacing those missing teeth gives a patient a stable bite. And implants never get decay, never need a root canal – done right, they will last a lifetime.”

Brushing Up on Hygiene

Another common malady in mature adults is gum recession, which Gryebet calls inevitable.

“It’s a part of the aging process that happens in 100 percent of people,” he says. “Those who recede more have more plaque buildup.”

Receding gums are not just unattractive; they are unhealthy because they leave open a “pocket” that collects bacteria.

“An exposed tooth is much more prone to decay,” Gryebet notes.

A white filling can cover the exposed area, or skin is grafted from the roof of the mouth in a procedure that has evolved to be less invasive and painful.

“There are techniques that are better than ever,” Smoler says. “We can do a pinhole or tunnel technique with one surgical site and minimal, if any, stitches; there’s only soreness for a day or two.”

Whitest and Brightest

Aging teeth, especially those often exposed to coffee and red wine, often become darker, Gryebet says.

“But anybody can get their teeth bleached, including my 85-year-old mother,” Gryebet says. “We have new techniques that will not hurt sensitive teeth.”

There are many other new-and- improved methods. Jawbone, which is essential for implants or partials, can be regrown in six weeks to four months, Smoler says.

“We take the patient’s own blood, put it in a centrifuge and cultivate bone growth factors,” Smoler says. “It is not at all painful because it’s your own blood. You can grow bone and then get a dental implant.”

Gryebet recommends professional cleanings three times a year and, for home care, a Sonic electric toothbrush, which is timed to run for two minutes.

“They make my teeth feel better,” he says. “And nobody does two minutes with a hand toothbrush.”

Sweet Teeth

Dentures are viewed as a last resort.

“I have been a dentist for 33 years, and when I first started, we were doing a lot of dentures. These days, we are doing next to none,” Gryebet says. “That’s good because the upper denture can be very functional and look great, but the lower is a problem; they’re terrible.”

Smoler agrees: “Dentures are not a way out; they are the start of serious problems.”

In fact, he says people with dentures live five to eight years less than their counterparts with natural teeth, in part because of poor nutrition.

“Denture wearers have a low bite force and don’t have the ability to chew up food well,” Smoler says.

Implants cost about $2,000 to $3,000 per tooth, he says, but their real worth is priceless.

With proper care, Gryebet says, everyone can keep his or her teeth.

“There used to be a mindset that we are going to lose our teeth,” he says. “Now we really stress that it does not have to happen.”