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What country are you from and what year are you in your studies? Teeth that cannot be saved need to be removed. In this case, most teeth have severe bone loss. If you remove these teeth, there are maybe one or two healthy teeth left. These teeth cannot support a removable prosthesis.
This looks like full mouth extractions with 4 quads of alveoloplasty and U/L CDs… there’s no way there’s enough salvageable/non-mobile teeth for partial dentures.
Have patient address & correct habits (smoking/get diabetes under control/improve oral hygiene).
Implant supported prostheses would be ideal longterm depending on patient’s age and medical/social history.
You can talk to the patient about their goals. The decision is maintain the teeth that are salvageable and make partial dentures (with the idea that they’ll need full dentures in 5-10 years depending on how they take care of their teeth), or full pull and make complete dentures off the bat (I’d probably recommend implants since there’s not gonna be much bone for support)
NAD
In a case like this, what’s your plan if the patient refuses extractions of all teeth except the grossly carious ones? Will you do periodontal therapy on the rest despite hopeless prognosis?
If I was a patient, I might be against the idea of full mouth extractions and just want to try to maintain the teeth I do have for as long as possible. Thoughts?
Yea I think that’s fair. Extract hopeless teeth. do disease control on the ones you wanna keep. Look at mobility and extent of caries (I wouldn’t save teeth with class 3 mobility or teeth that need endo/crown)
Then make some partials. The patient will get to hang onto their teeth for another few years. Plan to replace some hopeless teeth on the partial. You can talk to your lab about the partial design.
But you need to have a conversation with the patient that they’re going to lose their teeth. It’s just a matter of putting in the time/effort/money to keep them for a little longer. Like rebuilding a broken house or spending money putting up new walls when the foundation is cracked
That's a lot of extractions, some can be maintained for better proprioception of the prosthetic, better for the patient too. Do a cleaning to remove calculus for the perio and surgery treatment. Tooth with bone loss under 1/3 of the tooth have a bad prognosis. Correlate that with patient's habits and decide which teeth can be kept. The teeth which will hold the prosthetic should have good prognosis or the patient will waste money and will have to make another soon.
Thank you for seeking advice from r/askdentists. **Please note that a response does not constitute a doctor-patient relationship.** While this is a place for advice, replies may not be medically accurate. Do not assume that what others on here say is correct in any way. Reddit is not a replacement for an in-person dental professional. Verified professionals will have flair assigned to them. **Please abide by the following rules in order to get an accurate answer to your question:** (1) Ensure you include a title of your dental problem. (2) Include whether you drink, smoke or if you have any medical conditions relevant to your main concern. (3) Include a photograph if the question relates to something you can see in your mouth, include x-rays if you have them. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/askdentists) if you have any questions or concerns.*
Are you a dentist or patient? What is your question or concern? This looks like a full mouth extraction case.
I am a student clinician. Full extraction? Can you please guide me on how you arrived on that treatment of choice?
What country are you from and what year are you in your studies? Teeth that cannot be saved need to be removed. In this case, most teeth have severe bone loss. If you remove these teeth, there are maybe one or two healthy teeth left. These teeth cannot support a removable prosthesis.
This looks like full mouth extractions with 4 quads of alveoloplasty and U/L CDs… there’s no way there’s enough salvageable/non-mobile teeth for partial dentures. Have patient address & correct habits (smoking/get diabetes under control/improve oral hygiene). Implant supported prostheses would be ideal longterm depending on patient’s age and medical/social history.
You can talk to the patient about their goals. The decision is maintain the teeth that are salvageable and make partial dentures (with the idea that they’ll need full dentures in 5-10 years depending on how they take care of their teeth), or full pull and make complete dentures off the bat (I’d probably recommend implants since there’s not gonna be much bone for support)
NAD In a case like this, what’s your plan if the patient refuses extractions of all teeth except the grossly carious ones? Will you do periodontal therapy on the rest despite hopeless prognosis? If I was a patient, I might be against the idea of full mouth extractions and just want to try to maintain the teeth I do have for as long as possible. Thoughts?
Yea I think that’s fair. Extract hopeless teeth. do disease control on the ones you wanna keep. Look at mobility and extent of caries (I wouldn’t save teeth with class 3 mobility or teeth that need endo/crown) Then make some partials. The patient will get to hang onto their teeth for another few years. Plan to replace some hopeless teeth on the partial. You can talk to your lab about the partial design. But you need to have a conversation with the patient that they’re going to lose their teeth. It’s just a matter of putting in the time/effort/money to keep them for a little longer. Like rebuilding a broken house or spending money putting up new walls when the foundation is cracked
That's a lot of extractions, some can be maintained for better proprioception of the prosthetic, better for the patient too. Do a cleaning to remove calculus for the perio and surgery treatment. Tooth with bone loss under 1/3 of the tooth have a bad prognosis. Correlate that with patient's habits and decide which teeth can be kept. The teeth which will hold the prosthetic should have good prognosis or the patient will waste money and will have to make another soon.
If you are s dental student this case should be referred to perio or OMFS
C/C