Posts for tag: dentures
While dental implants are considered the gold standard for tooth replacement, removable dentures are still a viable choice, especially for patients with edentulism (complete tooth loss). Removable dentures have also undergone considerable advancement to improve their function, appearance and longevity.
But even with these advancements, dentures still require a fair amount of skill, experience and — of utmost importance — a sense of art. If you’re considering this option, long-term success depends on a careful process of construction, fit adjustment and regular checkups to maintain that fit.
Our first step is to determine exact tooth placement on each denture. Using facial features (or photos before tooth loss) we establish placement landmarks so that corresponding upper and lower teeth align properly. We also consider tooth size, their orientation in relation to the lip, and the needed space to leave between the upper and lower teeth when they are at rest. We make these determinations based on accepted standards of beauty, but also taking into account your particular comfort level with any features that might alter your appearance.
The denture’s gums must also look realistic when you smile, especially if your upper lip rises above the teeth to expose more gum tissue. We also want to match the color and texture of your natural gums, as well as incorporate palatal rugae, the little ridges behind the upper front teeth that aid with speech and chewing food.
When we first place the new dentures in your mouth, we may need to adjust them for balance between the upper and lower sets when they come together. An imbalanced fit could have an adverse effect on your ability to bite, chew and speak normally.
Your dentures should have a good, comfortable fit. Over time, however, you will encounter some degree of bone loss because you no longer have your natural teeth to stimulate bone growth and absorb the forces created during function when your teeth contact. This and other factors may cause your dentures to become loose and uncomfortable to wear. For that reason, it's important for you to visit us regularly to maintain that good fit and check the health of underlying tissues and bone.
Careful planning and denture construction help ensure your new dentures successfully restore form and function to your mouth. Regular monitoring will also ensure they continue to serve you well for as long as possible.
If you would like more information on removable dentures, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Removable Full Dentures.”
While dental implants are the preferable choice for teeth replacement, your life circumstances may cause you to postpone it or some other permanent restoration. In the meantime, you need a temporary solution for your tooth loss.
Removable partial dentures (RPDs) have met this need for many years. RPDs are traditionally made of rigid, acrylic plastic resin and fasten to existing teeth with metal clasps. While effective as temporary tooth replacements, RPDs do have their drawbacks: they can be uncomfortable, develop a loose fit and are prone to wear and staining.
Recently, though, new RPDs made of a flexible type of nylon are addressing some of these drawbacks. Because the nylon material is thermoplastic (able to change shape under high heat), it can be injected into a cast mold of a patient’s mouth to create the denture base, to which life-like replacement teeth are then attached. And rather than a metal clasp, these RPDs have thin, finger-like nylon extensions that fit snugly around existing teeth at the gum line.
The new RPDs are lightweight, resistant to fracture and offer a more comfortable, snugger fit than the older RPD. And because the nylon material can be made to closely resemble gum tissue, the base can be designed to cover receding gum tissue, which may further improve the appearance of a patient’s smile.
On the downside, these new RPDs are difficult to reline or repair if they’re damaged or the fit becomes loose. And like all RPDs, they must be regularly removed and cleaned thoroughly to prevent any accumulating bacterial biofilm that could increase the risk of gum disease or tooth decay (the attachment extensions are especially susceptible to this accumulation). They should also be removed at night, since the reduction in saliva flow while you sleep can worsen bacterial buildup.
Still, the new flexible RPD is a good choice to bridge the time gap between lost teeth and a permanent restoration. They can restore lost function and improve your smile during the transition to implants or a fixed bridge.
How much do you really know about Revolutionary War hero and famous disturber-of-the-peace Paul Revere? Take this quiz and find out! True or False:
- Paul Revere cried “The British are coming!”
- Paul Revere rode to Concord, Massachusetts.
- Paul Revere practiced dentistry.
The first two answers are false: Revere, like most colonists, considered himself British at the time (but might have said “the regulars” are coming); and he never made it as far as Concord, though one of his midnight-riding companions did. The last statement, however, is true: When things got slow in his regular trade of silversmithing, Revere hung out a shingle to broadcast his skills as a dentist.
“Paul Revere can fix [teeth] as well as any surgeon dentist who ever came from London, he fixes [dentures] in such a manner that they are not only an ornament but of real use in speaking and eating,” his advertisement in a Boston newspaper is supposed to have read. Revere specialized in fitting dentures made of metal and walrus ivory in his patient’s mouths. (There is no record, however, that he ever worked on George Washington’s false teeth.)
The practice of dentistry has come a long way since 1776. But the ideal set of dentures — one that’s both aesthetically pleasing and fully functional — remains a valid goal today. But now, instead of going to a metalworker, you’ll visit a denture specialist: your dentist.
We understand that dentures need to have a perfect, comfortable fit so they can do their work. That’s why we take the time to make an individual mold of your mouth as the first step of the process. Then we choose prosthetic teeth in the shape, size and shade that’s right for you. When everything is satisfactory, the dentures will be custom-fabricated in a dental laboratory using high-quality materials that are lifelike and durable. Finally, we will make sure that your new dentures look, feel and function the way they should.
If you have older dentures that no longer fit as they should, come in to our office for a check-up. It’s sometimes possible to repair or re-line dentures; in other cases, it’s best to have a new set made. Ill-fitting dentures aren’t just uncomfortable — they can also lead to oral infections and nutritional difficulties.
For more information about dentures or denture repair, please contact our office to schedule a consultation. You can learn more in the Dear Doctor magazine articles “Loose Dentures” and “Removable Full Dentures.”
Americans today can expect to have a longer lifespan than ever before. And, as our population ages, our concern is no longer just longevity… it becomes, in addition, the quality of life. These days, the task of helping an older person — perhaps a parent, relative, or friend — to maintain a good quality of life often falls to adult children or others in the extended family. These caregivers have a crucial role in deciding how best to provide for an older person's care.
Eating a healthful diet, getting moderate exercise and having an invigorating social life are factors that can improve quality of life for a person of any age. But we would propose adding one more item: keeping a healthy smile. By age 74, about one in four people have lost all of their permanent teeth. Many more have failing teeth, or only a few teeth remaining. According to actuarial tables, these folks can expect to live, on average, to age 86 — and some will live much longer. That's a long time to go without good replacement teeth.
The Old School: Bridges and Dentures
What's the best method of tooth replacement? The answer depends on several factors. If just a small number of teeth are missing, the best options available are a fixed bridge (also called a fixed partial denture) or a dental implant. If most or all teeth are failing or lost, either complete or partial removable dentures, or implants, may be considered. We'll come back to implants later, but let's look at other methods first.
The dental bridge is a traditional method of closing a gap in your smile — but it has some drawbacks. It requires crowning or “capping” healthy teeth on either side of the gap, so they can be used to anchor a series of prosthetic teeth. This means a significant amount of tooth material must be removed from “good” teeth, which may leave them more susceptible to decay. Root canal treatment may also be required. A bridge can make gum disease more likely, and it is generally expected to need replacement in about ten years.
Removable dentures, both complete and partial, have been around even longer than bridges — in fact, they go back centuries. Denture problems, too, are legendary: They include problems with chewing and speaking, unpleasant smells and tastes, the inability to eat many favorite foods, and the tendency of dentures to become loose and ill-fitting over time. Many of these problems force a person to make compromises in their lifestyle; the last one, however, points to a serious flaw with dentures.
When teeth are lost, the underlying bone in the jaw begins to be resorbed (melted away) by the body's natural processes. This causes the jawbone to become weaker — and, as support for the facial features is lost, it can result in the appearance of premature aging. Dentures don't stop bone loss, in fact, they accelerate it. When dentures stop fitting properly, it's evidence of the process of bone loss at work.
A Modern Solution: Dental Implants
There's a great way to stop bone loss and restore teeth to full function: the dental implant. Whether it's a single tooth or an entire set of teeth that are missing, dental implants are the new gold standard for tooth replacement. Because of the way they become fused with the living bone tissue of the jaw, implants stop bone loss form occurring. They “feel” and function like natural teeth — and they can be almost impossible to tell from the real thing.
A single missing tooth can be replaced by one dental implant, where a bridge would require a minimum of three prosthetic teeth (one for the missing tooth, and two for the supports). On the other hand, an entire arch (top or bottom row) of replacement teeth can be anchored by just four to six implants. And, with regular care, implants can last a lifetime.
So if you're helping someone choose between different methods of tooth replacement, be sure to consider the advantages of dental implants. It's an investment in quality — both the quality of the implant itself, and the enhanced quality of life it provides. If you would like more information, or wish to schedule a consultation, please call our office. You can learn more in the Dear Doctor magazine articles “Dental Implants” and “Removable Full Dentures.”
What does the term “two-implant overdentures” mean?
For more than a century, complete dentures were the only care option for edentulous (toothless) people. As a solution, these left a lot to be desired, particularly for the lower jaw. Now dental technology has developed a better alternative that combines two strategically placed dental implants and a traditional lower denture that has been modified to fit over the two implants — thus the term.
What are the problems with traditional dentures?
The problem is that when you lose teeth, the bone that supported the missing teeth begins to shrink away. This is known as resorption, and it is the reason that dentures fitted too soon after teeth are lost quickly become loose. Bone loss happens most rapidly during the first year and is four times greater in the lower jaw than in the upper.
Why not just use dental adhesives to hold dentures tightly to the lower jaw?
Zinc, a major ingredient in most dental adhesives, has been associated with neurological disorders and may be unsafe. In addition, dental adhesives are expensive and the cost of frequent usage adds up.
Besides dental adhesives, are other health problems associated with dentures?
Yes, edentulism has been related to poor nutrition. Many edentulous people switch to soft foods with high fat content because they find healthier foods like vegetables and proteins difficult to chew.
What are dental implants?
Dental implants are replacements for the roots of teeth, the parts that are below the gumline and anchored in bone. They are usually covered with a crown that shows above the line of the gums.
What are the benefits of implants?
Most importantly, implants reduce the amount of bone resorption. Studies have shown about 75% less resorption in parts of the jaw with implants compared to areas without them. Since most of the bone loss occurs within the first year after tooth loss, it is important to place implants within this time period.
Is a complete set of dental implants a good solution for edentulism?
Yes, it can be a good solution, but it is not for everyone. Some patients, who have lost a great deal of bone support, need another solution for cosmetic reasons that offer more facial support like an implant overdenture. In addition, depending on their resources and insurance, some people require a less expensive solution.
Why does the two-implant overdenture work better for the lower jaw?
Based on differences in bone volume, density and other factors, we think that four to six implants are needed to retain an upper implant overdenture. Thus a two-implant overdenture is a good solution to consider for a lower jaw, but other options might be preferred for an upper jaw.
Contact us today to schedule an appointment to discuss your questions about dentures and implants. You can also learn more by reading the Dear Doctor magazine article “Implant Overdentures for the Lower Jaw.”