It’s so sad to see unfortunate cases such as this. Mostly because it is preventable, and secondly because it is a long hard road to any future recovery. The causes of such extensive damage are many – fear of dentistry, poor diet, poor hygiene, lack of understanding the process of decay, medical issues such as reflux or bulemia, drug use, or a lack of access to a dentist. Treatment will depend on what this person wants, can tolerate, and can afford. I always quote my favourite three C’s – Comfort, Cosmetics, Cost
Comfort – the best option would be to save all the teeth possible, and replace the missing teeth with implants. This would look and feel like a full set of natural beautiful looking teeth. The problem is each tooth is so damaged it would probably need a root treatment and crown, and at roughly $5000 per implant tooth, this patient is unlikely to be able to afford such a complex treatment. This is why I do my best to educate and help people understand the need to prevent this damage in the first place.
Cosmetics – the above result can look perfect, but so can a really well made denture. I see very few people that can eat well with full dentures, although some tolerate a full upper denture reasonably well. I emphasise tolerate – most people with dentures have forgotten how good it used to be to have teeth and just deal with it as best they can. As they get older, the bone in their mouths becomes less able to support the denture, and I end up seeing many older people with intolerable dentures – usually blaming the fact that they can’t eat, have pain, and blame the fact on not being able to find a dentist that knows how to make a denture that fits. These people really need an implant to help stablise the denture – back to cost.
Cost – it is all about balance at the end of the day. If I was the above patient I would want to save whatever teeth I could – depending on my finances. We could probably patch the decay and slow the breakdown process. make some partial dentures to replace the spaces and build up the teeth which have worn down from the incredible workload.
The bottom line is – if you have teeth, prevention is better than cure (see my segment on general dentistry). If you have damage to your teeth, the sooner you get them looked at the better. If you have damage to your teeth, there are many options to get your mouth back on track. You need to find a dentist who can discuss the options with you. Finally – you have to be realistic – about your future level of care, or your budget, or what expectations you have. You can’t get complex treatment, implants, and crowns for the price of a denture, and you can’t get a denture that feels like your on teeth.