Hello Dr Patel. I have had advanced gum disease for about 20 years owing to my fear of going to the dentist, previous traumatic experiences at the dentist and poor hygeine. At the age of 42 I have now fortunately overcome my fear and found a lovely gentle dentist and I am now having regular checkups and hygeine sessions. I also been referred for and have undergone peridontal treatment in the last two years, and I am maintaining good dental hygeine every day. However my degree of gum disease has led to a significant amount of bone loss. I currently have most of my teeth, but many of my upper teeth are loose and my dentist does not hold out much hope for me holding on to them long term. I have a crown on one front tooth, and a veneer on the other front tooth. My gums have receded so far that the crown peg is visible now and the tooth with the veneer is similarly receded, exposing the part of the tooth which originally would have been hidden in the gum. My other top front teeth are discoloured and gappy and I am very self conscious about my teeth. My bottom teeth are reasonably secure. I really would like some advice about what to do next. My dentist is reluctant to replace my front veneer as the tooth is already loose and he doesn’t want to disturb it further. My crown will have to be replaced shortly I think. I would like to know what the options might be for someone like me who has significant bone loss. Are implants out of the question, or am I really now facing the prospect of wearing dentures before I am 50? I would really appreciate your advice regarding my options and the possible costs involved if implants could be an option – at least for my top front teeth.

Many thanks.