Q: I had bad teeth my whole life; fillings, crowns root canals. I let myself go years ago and just recently had all my teeth fixed; 28 crowns, root canals, extractions, implants, etc. I went to supposedly the “best” in my city. I visited a local dentist after some of my crowns loosened and came off with a bad smell associated with it. He took x-rays and found that most of my crown work needs to be re-done due to what he called “open margins”. Can you explain what this is, why do I have it and how do I not have this the second time around.
A: Firstly, let me offer my sympathy for your predicament. Last Friday I gave one of my free seminars to the public and told a story on how I met this couple who were financial planners at a stand-up comedy work shop. (I actually graduated first in the class and got to emcee open mic night at the Improv. I killed.)
The couple stated that they recommend to their clients that $100,000 of their nest eggs should be earmarked for dental expenses in the future; mainly for re-doing or fixing dental work that has failed or wore out. I then lectured on how to prevent that from happening. The answer is getting the job done right the first time with modern dental techniques, materials and equipment.
I have had several cases this year alone whereby the patients had full mouth reconstructions done in Beverly Hills, New York City, Atlanta, Miami and Palm Springs. In one case the patient spent $100,000 on just that one case!
They had two things in common. 1. Too much tooth structure was removed in preparing the teeth for crowns or veneers and 2. Ill-fitting crowns or veneers resulting in gaps (open margins), allowing bacteria to get in and rot the teeth under the dental work.
Solution: Digital impression scanners vs. the old “goop”, Diode laser retraction of the gums just before the scan vs. retraction cord threads and conservative tooth reduction to prevent any micro movement of restorations.