Is it necessary for my son to get all of his teeth pulled?

My son is 23 years old. He is a drug addict who is in recovery, and his teeth are completely ruined. The dentist at the clinic says he should just have all of them pulled and replace them with dentures.

Right now, I recognize that this is the only avenue open to us. The teeth have to come out. He is only able to chew with a couple of teeth towards the front of his mouth.

My question is whether or not all of this can be done in one visit. It seems like a lot–he has 26 teeth that need to come out. Would they be able to fit dentures when they’ve just removed all those teeth? It doesn’t seem like they could do that until after his gums heal

Any advice you can offer would be appreciated. This has been a long, hard road.

Serena in Overton

Dear Serena,

This treatment plan is too extreme. It may seem like the easiest solution to the dentist, but it means a lifetime of dental trouble for your son. He is much too young to have all of his teeth removed.

As soon as all his teeth are removed, your son’s jawbones will start to shrink. When a tooth is lost, the body reabsorbs the bone of the jaw at the location of the missing tooth. When ALL the teeth are removed, eventually that person will experience “facial collapse”. You have probably seen pictures of people whose faces look as if they have collapsed inward. This happens when the jawbones deteriorate to the point that the patient cannot wear any kind of denture at all.

If he is in his early 20s now, this could happen by the time he is 40. He will be unable to eat normal foods, and at that point the repairs are much more complicated and expensive.

If at all possible, the goal should be to retain as many of his natural teeth as possible. They may not be in perfect condition, but every tooth that can be saved represents a more stable jawbone. Those remaining teeth could be used to anchor partial dentures or dental bridges.

If in fact none of his teeth can be saved, dental implants will work just like natural teeth to preserve the structure of his jawbone. The least expensive option would be mini-dental implants, where two implants per arch are placed and used to anchor dentures. Having ALL the extractions done in one sitting is too much. The amount of Novocain required to numb the upper jaw for a full set of extractions is significant, and poses a correspondingly significant risk.

It is time to get a second opinion. We recommend looking for a dentist that really makes you feel like he cares about your son, and your situation. Your son is on the road to recovery, and needs compassion to get the care he needs.

This blog is posted courtesy of Lafayette Louisiana cosmetic dentist Dr. Mike Malone.