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Dentistry/Tooth extraction

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QUESTION: Hi, hope you can help me. I'm 30 years old female and hasn't been for dental check ups for a long time. Recent years I realized my teeth has been growing out of directions. Is this normal? Especially my two front molar below are both slanted with some tooth decay symptoms. How do I solve this? Tooth extraction? Will my teeth grow back again? Do they stop growing new teeth until a certain age?  Besides tooth extraction what other alternatives do I consider?

My gum bleeds sometimes during brushing but there's no pain.

ANSWER: Fries - I am so sorry to hear what is occurring.  When you brush your teeth and your gums bleed, is all over your mouth or just some areas? When you were younger, did you have any teeth extracted?  Besides brushing your teeth, do you use dental floss?

So get back to me and try to answer my questions and hopefully I will be better able to define the cause of your problem?

---------- FOLLOW-UP ----------

QUESTION: Hi! The gums bleed at just some areas I think but I'm not too sure. It bleeds whenever I brush my teeth. Probably 1 or 2 teeth extraction around 20 years ago (estimate). I have fear of going to the dentist since very young. How do I overcome this fear? Therefore I didn't take good care of my teeth since young.

I realize some black marks (tooth decay symptoms?) at a few areas mainly towards the inner area. Dental plaque can also be seen. And black gums and black marks at some areas of the teeth root.

I'm a little worried since I'm in my 30s now and the teeth would not grow again after extraction. If so, what other options do I have?

Will teeth cleaning at the dentist help? Does using mouth wash at home help too?

I do not use dental floss.

This has been affecting my confidence especially when smiling or even talking.

Hope you can advise me.

Thank you.

Answer
Fries - well it sounds like, from your description, that you have periodontal gum disease.  This alone can produce premature loss of teeth.  Below the gums are the ligaments that hold the teeth to the bone.  If the gums become inflamed there is a loss of the ligaments that hold the teeth. This along with the loss of teeth to create more room allows the tilting and drifting of teeth.  

After extractions there will be no teeth to follow.  You need to save as many as possible via periodontal treatment and then once the remaining teeth are stable and sound bridges can be made to replace the missing teeth.

So my suggestion is to see a good dentist who does periodontal treatment or see a periodontist.  The periodontal tissues are the foundations of the teeth so you need to save the remaining teeth and then replacements can be made.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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