Is it reasonable to grind down the enamel of adjacent teeth to make way for dental implants?
I have received two dental implants, located at positions 27 and 47.
After the dentist had already placed the implants, I was informed that the adjacent wisdom teeth would interfere with the placement of the abutments, so the enamel of the wisdom teeth needs to be ground down to accommodate the abutments.
Both implants are in the same situation, and both wisdom teeth are healthy, although slightly misaligned.
I am concerned that grinding down the enamel may lead to sensitivity or discomfort in my oral environment.
Is this approach reasonable? Are there any other suggestions or alternatives, or should I consider not proceeding with the implants and explore other types of prosthetic treatments? Both opposing wisdom teeth have already been extracted.
Thank you for your response.
Huang Mao, 60~69 year old female. Ask Date: 2023/10/11
Dr. Lin Jiayong reply Dentistry
Hello: Teeth are inherently consumable; even if they do not occlude throughout a lifetime, the enamel will experience mechanical wear on the adjacent surfaces due to physiological activities.
Therefore, it is academically acceptable to reduce the tooth structure by up to 3mm for the purpose of reshaping or restoring.
Since you have already chosen dental implants and the implant has been placed, it is advisable to complete the entire treatment process.
Otherwise, removing the implant would require another surgery and additional costs.
Reply Date: 2023/10/11
More Info
Grinding healthy enamel to accommodate dental implants is a topic that raises significant concerns among patients and dental professionals alike. In your case, the decision to grind the enamel of your healthy wisdom teeth (27 and 47) to facilitate the placement of dental implants is a complex one that warrants careful consideration.
Firstly, it is essential to understand the purpose of grinding enamel in this context. When dental implants are placed, they require a specific amount of space to ensure proper alignment and function. If neighboring teeth, such as your wisdom teeth, are positioned in a way that interferes with the implant placement, some dentists may suggest modifying the adjacent teeth to create the necessary space. However, this practice can be controversial, especially when it involves healthy teeth.
From a clinical perspective, grinding healthy enamel can lead to several potential issues. The enamel is the outermost protective layer of the tooth, and once it is removed, it does not regenerate. This can expose the underlying dentin, which is more sensitive and susceptible to decay and temperature changes. Patients often report increased sensitivity after enamel grinding, which can lead to discomfort or pain, particularly when consuming hot or cold foods and beverages. Additionally, removing enamel can compromise the structural integrity of the tooth, making it more vulnerable to fractures or other dental issues in the future.
Moreover, there are alternative approaches that could be considered before resorting to grinding healthy enamel. One option is to evaluate the positioning of the dental implants more thoroughly. In some cases, a slight adjustment in the angle or position of the implant can avoid the need to modify adjacent teeth. Additionally, orthodontic treatment may be an option to reposition the wisdom teeth or other nearby teeth to create the necessary space without sacrificing healthy enamel.
Another consideration is the use of temporary solutions, such as a removable partial denture or a bridge, which can provide functional and aesthetic benefits without the need to alter healthy teeth. These options can be particularly appealing for patients who are concerned about the long-term consequences of grinding enamel.
Ultimately, the decision to grind healthy enamel should be made collaboratively between you and your dentist, considering all potential risks and benefits. It is crucial to communicate your concerns about sensitivity and the integrity of your wisdom teeth. If you feel uncomfortable with the proposed treatment plan, seeking a second opinion from another dental professional may provide you with additional insights and options.
In conclusion, while grinding healthy enamel may sometimes be deemed necessary for dental implant placement, it is essential to weigh the potential risks against the benefits. Exploring alternative solutions and ensuring that you are fully informed about the implications of such a decision is vital for your long-term dental health. Always prioritize open communication with your dental care provider to ensure that your treatment aligns with your preferences and concerns.
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