 The Clarinet BBoard
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Author: Ray Hagstrom
Date: 2024-12-04 21:43
Single-reed player (Alto Sax), age 77.
Cracked front upper incisor requires post/implant; it's all a bit urgent.
I have a great dentist, but he does not grasp the delicate nuances of embouchure and he's quite willing to tolerate asymmetry in my bite.
Unfortunately, Gregory Smith does not seem to be in Chicago right now so that I need to reach out for wider sources of advice/experience/recommendations.
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Author: ruben
Date: 2024-12-04 22:04
Take your mouthpiece, reed, etc. with you the next time you go to the dentist's and show him what's involved. I did this with my dentist and she was very open to the issue and willing to learn the peculiarities of embouchure.
rubengreenbergparisfrance@gmail.com
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Author: lydian
Date: 2024-12-04 22:13
I have crooked teeth and have played essentially on one front tooth my whole life. Zero negative effects on my embouchure. Let the dentist do what's appropriate for you to eat and speak normally and maintain your oral health. Your embouchure will adapt.
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Author: David Eichler
Date: 2024-12-05 04:01
lydian wrote:
> I have crooked teeth and have played essentially on one front
> tooth my whole life. Zero negative effects on my embouchure.
> Let the dentist do what's appropriate for you to eat and speak
> normally and maintain your oral health. Your embouchure will
> adapt.
Why wouldn't he just make the artificial tooth the same shape, size and angle as the remaining real one?
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Author: Kalashnikirby
Date: 2024-12-05 12:07
Dentist here: Please relax. First off, if the tooth is to be extracted, you need to wait for some time to have the bone heal a bit. Then, when an implant is inserted, the so called osseointegration ALSO takes some time, at least 2 months, until a crown can be securely... mounted (for lack of better words, I'm German, so a bit sketchy to translate the medical stuff)
Not to be mean, but fitting that crown into your set of teeth is the smallest issue here. There's types of implants that can (theoretically) immediately withstand the load of daily use, BUT especially as a reed player I wouldn't want to risk it. There's few to no studies on how dental prosthesis affect wind players, and certainly it is impossible to estimate how a single implant would affect your playing.
Depending on your dental situation, a bridge might be indicated.
"I have a great dentist, but he does not grasp the delicate nuances of embouchure and he's quite willing to tolerate asymmetry in my bite."
Now that is a bit presumptuous, I'm sorry to say. If he's competent, he will know how to "fit in" the implant crown. Don't assume he doesn't do his best. If you have serious doubts, look for a second opinion.
Best regards
Christian
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Author: Ray Hagstrom
Date: 2024-12-05 19:52
Retired scientist here...I didn't want to get into a lot of personal stuff but I see some is needed.
I have developed my embouchure twice; it took 6 years starting at age 12 and 11 years starting at age 65. I'm really slow at it.
I have every confidence in my dentist's producing a matching pair of normally functional teeth, but he intends to leave me with one post and one natural root. Their force/deflection curves will be different; one tooth will be natural, the other will be stiffer...think of walking with one stiff leg. I will listen to reason, but I don't like the odds.
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Author: Ray Hagstrom
Date: 2024-12-05 20:02
I have a funny story that you might like.
Professional Blues player in Chicago left with one tooth in his head (the same one I'm about to loose). Of course his eating and cosmetic situations were miserable. His friends urged him to have the tooth pulled and to get complete dentures, but "No, it'll change my SOUND, man!"
This story is funny because it is true. The guy went to his grave with only one tooth.
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Author: Ray Hagstrom
Date: 2024-12-05 20:25
Your advice is right on the money.
To clarify things, I see three ways to maintain an equal bite. Ranked in order of time to recover an adequate embouchure:
1.) Both teeth are capped preserving both natural roots. (My dentist doesn't like this because the major crack is below my gum-line).
2.) Both front teeth get posts at the same time.
3.) Bridge replaces both front teeth.
I point out that the last time I recovered an adequate embouchure took over a decade.
I am willing to take some risks and I am not cost-sensitive.
Is it possible for an ethical dentist to place a cap onto a tooth fractured below the gum-line?
Is there some downside to twin posts of which I may not be aware?
Is an avoidable bridge a good idea under any circumstance?
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Author: Kalashnikirby
Date: 2024-12-05 22:44
Hello Ray,
"Their force/deflection curves will be different;"
Well yes, that is fairly true: As an implant lacks any sort of periodontal tissue, it almost literally doesn't move a bit, while the natural root will have a certain amount of give. Apart from the so called proprioception giving you feedback where the implant does not.
Another Anecdote: Famous (now deceased) Horn player Hermann Baumann is said to have had teeth issues for his whole life, which has to do with a car accident when he was younger. From what I could tell: He must have gotten a denture at some point, but it's all hearsay. All I want to convey is that he still played fantastically well
Developing an embouchure is always an issue. My "horn embouchure" is probably much cleaner than my "clarinet embouchure" because I learned horn later in my life and had an excellent teacher. Gosh, only now that I play these two different instruments (and enjoy having had anatomy lessons) I'm becoming aware of how many weird mistakes we get used to doing with our lips, muscles and air. Maybe consider taking lessons once your dental work is done and who knows, you'll find ways to improve? On top of my head, especially since you're a sax player, why not try a double lip embouchure? In fact, I'd imagine that any sort of prosthesis should allow to have any rough edges removed and polished to your liking. In theory.
Regarding your embouchure issues: I fear you're right any form of prosthesis will have an impact on that. But please consider: IF there is a fracture in the longitudinal axis of your root, the tooth is indeed done for. Get rid of it, or you'll have some sort of inflammation at some point.
If the neighbouring tooth is fine, then a single implant might make sense. Again, keeping some "OEM" parts up front is better than any replacement?
Re bridge: ahh, that depends on too many factors to give you an honest recommendation, without any x-rays and whatnot.
What I'm saying is general advice, but you'll have figured that out on your own. Any "remote diagnostics" are to be taken with a grain of salt.
Post Edited (2024-12-05 22:46)
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Author: hans
Date: 2024-12-05 22:54
Ray,
I'm 79 and have had 7 implants by oral surgeons. All were successful.
FWIW, here is my opinion:
A cracked tooth is susceptible to infection.
A bridge requires two teeth to do the work of three or more, which may cause the support teeth to break. I have had two bridges fail this way, requiring
replacements by implants. Without a tooth in place, the bone under the bridge will shrink.
To prepare for an implant requires surgical extraction (not simply pulling it out), to preserve as much bone as possible. During extraction, a bone graft can be placed if necessary. Healing before implant placement requires several months and can't be rushed.
Eventually an implant will feel like your own teeth. They have never affected my embouchure or tone.
I hope this is helpful.
Best wishes,
Hans
Post Edited (2024-12-06 04:25)
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Author: Philip Caron
Date: 2024-12-06 05:01
Assuming neither tooth will be loose, I'm surprised that the embouchure would put enough pressure on the teeth that force/deflection differences between them would make an appreciable difference.
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Author: m1964
Date: 2024-12-06 05:20
Philip Caron wrote:
> Assuming neither tooth will be loose, I'm surprised that the
> embouchure would put enough pressure on the teeth that
> force/deflection differences between them would make an
> appreciable difference.
Right- I had a few implant myself. It is a lengthy process.
I would not insist on removing the 2nd tooth that can be fixed by placing a crown because a crown is much safer procedure.
There is much less danger of developing an infection and no risk of implant not fusing well.
Since those are upper teeth, one crown+one implant will be fine. There will be a crown on top of the implant so both crowns can be matched in dimensions.
A thick MP protector patch is all that will be needed.
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Author: Kalashnikirby
Date: 2024-12-06 22:01
You guys posted so much half knowledge that I first wanted to write up a length answer, but nevermind.
Don't make assumptions about OPs individual risks or his (anatomical) preconditions and say something like "ah, this and that is easy and surgery sure is problematic"
When in doubt, OP should also talk with a dental surgeon.
It's not even that I'm all for implants, as I'm more specialised in root canal treatment and revisions, but you guys really shouldn't use your own (prosthodontic) experiences as a measure for his treatment. Duh.
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Author: Claudia Zornow
Date: 2024-12-14 04:47
I had to have an upper front incisor (#8) extracted and replaced with an implant three years ago. I was very concerned about being able to continue clarinet playing, but it hasn't been an issue at all. The implant doesn't have the same pressure sensitivity as the teeth around it, but I got used to that quickly.
During the healing period, starting a couple of weeks after surgery, I played while wearing a clear tray over my upper teeth; it had a fake tooth in place of the extracted one for cosmetic purposes. Playing with that was no problem either, though I noticed that I salivated more, which got annoying at times.
Good luck!
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