The Mid-Life Years - part 3

Intro:
In the first of its kind dentists-to-patient podcast, you’ll gain incredibly valuable insight into the mouth-body connection. You won’t hear any fluffy filler here. You’ll actually be able to connect the dots. Join us for a worthy jolt of insight on the Total Health Dentistry podcast with Dr. Ali.

Dr. Ali:
Hey everyone, it’s Dr. Ali. In this episode you’ll gain a worthy jolt of insight about Total Health Dentistry for the midlife years part three. In the last episode, we focused on Total Health Dentistry for the midlife years part two. If you’ve missed the opening five-part series which laid out the framework for what constitutes Total Health Dentistry, make sure you go back and check out the first five episodes as it will give this episode and future ones greater context. So in the last episode we discussed some solutions to the wars of dentistry; mercury amalgam fillings, root canals, missing teeth; with a heavy emphasis on options and the pros and cons. In this episode, which is part three of three, we will discuss a continuation of the great options and solutions we have available to us today. And we’ll touch on one of my favourite topics, which is, is your mouth ready for retirement?

So why is this even a three-part series? Well, if you’re in this age group, say 45 to 65 but that is just a guide, then in all likelihood, you’ve been through a lot of dentistry and despite the industry’s best efforts, some of the treatments may not have given you the intended results. And now you may have missing teeth, missing gums, missing bone and misaligned bite and some resulting facial changes. So in part three, we will finish with some of the wonderful solutions we have available to us and finish up with an important question. Is your mouth ready for retirement?

So in part two, we ended with discussing the many benefits of dental implants including metal-free or ceramic dental implants. Okay, so that’s all fine and good, dental implants being the best tooth-replacement option. But what if you’ve been missing the tooth for a year or longer? Maybe 20 years? Well, when we lose teeth, we lose the jaw bone around the tooth because the chewing forces that are the stimulation or the exercise to the jaw bone is gone. No stimulation, no jaw bone, so almost certainly if you lost a tooth many years ago, you don’t have enough jaw bone for a dental implant. Does that mean you can’t have an implant? Well, no. Just means that you need bone regeneration first. What is often called bone graft is in most cases more appropriately called bone regeneration. See, in bone regeneration we don’t have to harvest a piece of bone from one part of your jaw and graft it to another area.

It is done; we do still do bone grafting, but it’s more rare and rare these days. It’s really reserved for more extreme cases of missing bone. What I do in my office on a regular basis is what I call bone regeneration. We use our patient’s own growth cells from their own blood, which stimulate stem cells to form new bone as well as some human source calcium chips to act like starter wood to start a good fire. The end result is the patient has new bone growth, which is 100% composed of their own bone cells. So at the end of the day, it’s all their own bone and it’s very healthy, very natural, very predictable. Then we can place an implant and give the patient back what they lost years ago thanks to these modern dental techniques. And best of all the pain and discomfort with these newer techniques is far less than some of the older techniques and certainly has fewer complications.

Now moving on, a bad bite and missing teeth can cause gum recession as well, which leads to exposed roots, which can be sensitive and can make us more prone to cavities. Roots are more prone to cavities and regular enamel, so similar to bone regeneration. I’ve been doing gum regeneration for many years now where in many cases we don’t need to cut the roof of the mouth and we can, you know, not have to use the patient’s own gum tissue, which would be called a gum graft. Instead, we use human-sourced collagen and the patient’s own blood growth factors to stimulate their stem cells to grow more gum. Best of all the discomfort and pain is really virtually nonexistent and the results are very, very good.

So as we discussed in episode 12 and 13 breaking parts of teeth, missing teeth, tipped teeth, it usually leads to bad bites over the years. If you’ve got a bad bite, you probably have an idea or a notion that you do. We discussed some of the signs of a bad bite, like not knowing where your bite should be, not feeling comfortable biting on your back teeth, wanting to bite more on your front teeth, etc. Now fixing this problem, fixing bad bites is complex dentistry. It’s a big commitment of time and money from the patient’s viewpoint and it’s a big responsibility for the dentist as he or she is undertaking to correct the person’s bite, which affects a person’s airway and balance and posture. It’s a big deal.

I personally love the challenge and I’ve treated hundreds of complex cases in my career and for those who need it, wow, it’s pretty powerful. The patients who do undergo fixing their bite universally it has been my experience that they are very happy and would do it again if given the chance. As a Total Health Dentistry listener, if you’d like me to bring on some of my patients who have gone through comfortable bite treatment or some other treatment and you’d like to pick their brains, please let me know in comments and we will invite some of these patients to the podcast for your Q and A.

So how is it done? How do we fix bites? Well, in broad strokes, we start with a trial bite, which is basically plastic teeth built up over a patient’s existing teeth. Matt, you’re not going to have to worry about this. Okay? Your age category is not going to have to worry about this I’m sure, but okay, so these trial bites are pretty robust so you can eat and talk well with them. They typically stay in for about three to six months while we tweak and find the most comfortable bite for a person and it’s unique to each person. Then once we’ve found the comfortable bite, we simply convert the plastic built up teeth into porcelain crowns or porcelain covers, and those are the new teeth. That’s their new bite.

Matt: Nice.

Dr. Ali:
This allows the patient to regain a balanced bite and gives them a better airway as well as many other benefits. Now, one other common sign of a bad bite and a restricted airway is a very retruded chin.

Remember in a previous episode we talked about facial cosmetics and profile as being one of proportions, profile and shade of teeth.

Matt: Yep.

Dr. Ali:
People always think about the shade, but it’s the proportions and it’s the profile that are also very, very important. So a very retruded chin is a potential sign of a restricted airway. While the only solution you may have known until now is perhaps chin implants or some other jaw surgery, if the entire jaw is too far back, then we can bring the whole lower jaw forward often without surgery, and all of a sudden, voila, the chin is present and the proportions are restored and wow, major, major facial profile improvements.

This is one of the most dramatic things we can do. And again, sometimes you can do this without surgery.

Matt: Nice.

Dr. Ali:
Again, this type of treatment would not only have cosmetic advantages but also major improvements to the airway and the jaw muscles and the joints. Now it may come as a surprise to you that changes in our teeth affect our face, not just in our appearance, but in terms of structure. As we discussed briefly in episode 11, the front teeth support the lip. The back teeth support the face; they are the pillars. So when we lose or break these teeth, we use the support beams for our facial architecture. Simple. So by building up the back teeth and fixing a bad bite, we are restoring the pillars and the face looks more full and restored versus more caved in and collapsed from a bad bite. It’s not unusual that after doing comfortable bite treatment for a patient that they look 10 years younger, while not unusual. This is not an exaggeration, this is just very, very normal and it really, truly is a nonsurgical facelift.

Matt: Wow.

Dr. Ali:
You wouldn’t do it for somebody who doesn’t need it, but if somebody’s had a bad bite, they can fix their bite. Oh yeah. And as a side effect, they look 10 years younger.

Matt: It’s pretty good side effect.

Dr. Ali: 
That’s an acceptable side effect. Further nonsurgical facelift benefits can be seen by addressing the front teeth. So while the back teeth support the face, the front teeth support lips and maintain a permanent volume to the lips. So when you work on the front teeth and you put the front teeth in the right position and get them looking in good proportions, oftentimes now they become sort of permanent plump lips.

Matt: Yeah, right.

Dr. Ali: Where it’s not, doesn’t need to be repeated. It’s, it’s the teeth themselves that are supporting that lip. Often due to airway restrictions, the front teeth are actually get crowded and they’re getting more crowded. I hear this all the time. My patients in this age group will tell me my teeth are getting crowded and more crowded, more crowded year by year by year, and this pushes the front teeth inwards, leaving the lips with less support and more wrinkling.

This is often due to airway restrictions. Now addressing the airway and getting the aesthetic proportions right leads to remarkable and lasting improvements in lip support. I’ve been doing this type of facially generated cosmetic dentistry for years now and it is a part of Total Health Dentistry. Looks great and feels great. That’s Total Health Dentistry. Another one of my favourite questions is, you know, is your mouth ready for retirement? I just had that conversation today with a patient. Unfortunately, he retired a couple of months ago and we both had a good chuckle because I said to him, I said, “John, you finished, your mouth was ready for retirement and you retired.” He knew it. He knew his mouth was ready for retirement and he retired and it was all good.

Matt: Nice.

Dr. Ali:
In episode six though, I discussed how this kind of age-related lens that I view my patients through how it’s a foreshadowing and treating my patients’ dental health issues through this age-related lens has been so effective. And basically the proof is in the pudding. It does work. So here’s another example. Like I mentioned, you know, for my patients in the mid-life stages a few years before they retire, I asked them a very relevant question, is your mouth ready for retirement?

What do I mean by that? Well, in general, retirement usually means a lower cash flow than the working years. So just as a person might make a concentrated effort to fix up overdue maintenance on their house so it won’t cost them so much after retirement, they can do the same with their dental health.

Matt: Okay, yeah that makes sense.

Dr. Ali:
Also, many people lose their dental benefits after retirement. So after all these reasons, a few years before retirement, I’ll sit down with my patients and see if there are some loose ends to tie up. Meaning are there a few heavily filled teeth that need crowns or gums that are receded or a bad bite that is only going to get worse with time and all these things can be costly to fix and can be more costly to fix later into retirement. So I like to give my patients a chance to address these things now while they have insurance and while they have better cash flow. So it comes back to the question, is your mouth ready for retirement?

Legal:
Please note that Dr. Ali Farahani is a general dentist and that Total Health Dentistry is not a specialty of dentistry. While we make every effort to broadcast correct information, dentistry is a constantly changing science and art. One doctor may have a different way of doing things from another. Dr. Ali Farahani is simply presenting his views and opinions that will be as evidenced-based as possible. We welcome any comments, suggestions, or corrections of error.

Dr. Ali Farahani takes no money from drug or device companies. By listening to this podcast or reading this blog you agree not to use this podcast or blog as medical advice to treat any medical condition in either yourself or others, including, but not limited to patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or blog. Under no circumstances shall Sante Family Dental, Dr. A. Farahani Dentistry Professional Corporation or Dr. Ali Farahani, or any of their employees, associates, or affiliates, any of the guests or contributors to the podcast or blog, be responsible for damages arising from use of this podcast or blog.