Posts for tag: dentures
People have depended on dentures for generations—and they still do. That's because they work, both in restoring dental function and a smile marred by missing teeth.
But they have one major drawback related to bone health. That's because living bone has a life cycle: as older cells die, new ones form to take their place. The pressure generated when we chew stimulates this growth. But when this stimulus goes missing along with the teeth, the cell replacement rate slows and bone volume and density gradually diminishes.
Traditional dentures can't transmit this chewing pressure stimulus. And because they rest directly on the gum ridges, they can adversely affect the underlying bone and actually accelerate bone loss.
But implant technology potentially solves this bone loss problem with dentures by using implants rather than the gums to support them. It's a two-fold benefit: first, the implants relieve much of the irritation to the gums and bone caused by traditional dentures. Primarily, though, the implants themselves can slow or even stop continuing bone loss.
Most implants are made of titanium, not only because it's compatible with the body, but also because it has an affinity with bone. Over time bone cells grow on the titanium post imbedded in the jawbone. This process not only creates stability and durability, it can improve bone health.
In recent years dentists have incorporated implants with dentures to create two exciting treatment options. With one option, the dentist installs two or more implants in the jaw, to which a specially fitted removable denture can be attached. You would still have the ease of removing the denture for cleaning, while gaining greater stability and a reduced risk of bone loss.
The other option is a fixed denture (or bridge) attached permanently to implants. For this option, a patient's jawbone must be adequate and healthy enough to support at least four to six implants. A fixed denture is also often costlier and more complex than a removable denture, but it can feel more like real teeth. It also promotes better bone health too.
Although both options are more expensive than traditional dentures, they can pay dividends for long-term dental health. Implants could help you enjoy your new dentures and resulting smile for a long time to come.
If you would like more information on dental implant-supported restorations, 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 “Overdentures & Fixed Dentures.”
After a long struggle with dental disease, you have finally lost the last of your remaining teeth.Â Like over a quarter of Americans in their 60s and 70s, this unfortunate development can have a profound impact on your health and self-image.
While there are a number of advanced methods for replacing lost teeth, there's one tried and true option that's centuries old — the removable denture. It's the option millions of people have chosen to lessen the impact of missing teeth.
Fashioned properly, removable dentures restore the form and function you once had with your natural teeth. The prosthetic (false) teeth are precisely placed in an acrylic, gum-colored base that closely follows the contours of your gums. Because they're removable, they're fairly easy to clean and maintain.
They do have a disadvantage, though, and it's related to bone health after tooth loss. Like other living tissues, bone has a life cycle: as older cells die, new cells form to take their place. The forces your teeth generate when you chew stimulate new bone growth. But without teeth to provide this stimulation, new bone won't keep up the pace of replacement at a healthy rate. As a result you may gradually lose bone, as much as a quarter of its normal width within a year of losing a tooth.
Dentures don't transmit any stimulation to the gum and bone from chewing. Furthermore, the compressive forces transmitted to the gum and underlying bone tissue contributes to bone loss. As the bone continues to diminish, your denture fit becomes looser to the point you will eventually need them relined with new acrylic material or have a new set made.
There is another alternative when patients loose all of their teeth: an implant-supported removable denture. Dental implants can be used to keep the dentures more secure and can also slow or even halt bone loss where the implants are placed. In this case we strategically place a few implants to serve as supports for a removable denture. The denture has connection points that join up with the implants to hold it more securely in place. As few as two implants are needed in the lower jaw, while the upper jaw does better with three or four implants.
Losing all your teeth can be traumatic, but there are effective ways to overcome it. With new technology, the traditional restoration of removable dentures may be the vehicle for achieving that.
If you would like more information on restoring missing teeth with 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.”
Some patients who wear dentures face a kind of Catch-22: their denture fit may have loosened and become uncomfortable over time due to continued bone loss, yet the same bone loss prevents them from obtaining dental implants, a superior tooth replacement system to dentures.
But there may be a solution to this dilemma that combines the stability of implants with a removable denture. A set of smaller diameter implants — “mini-implants” — can support a removable denture with less bone than required by a conventional implant.
Like all living tissue, bone has a life cycle: after a period of growth, the older bone dissolves and is absorbed by the body, a process known as resorption. The forces generated when we bite or chew are transmitted by the teeth to the jawbones, which stimulates new bone formation to replace the resorbed bone. When the teeth are lost, however, the stimulation is lost too; without it, resorption will eventually outpace bone growth and repair, causing the bone mass to shrink.
Removable dentures also can’t supply the missing stimulation — bone loss continues as if the dentures weren’t there; and due to the compressive forces of a denture, bone loss accelerates. As the jawbone structure used to originally form the denture’s fit eventually shrinks, the denture becomes loose and difficult to wear. It’s possible to adjust to the new jaw contours by relining the dentures with new material or creating a new set of dentures that match the current bone mass. Without adequate bone, fixed crowns or bridges anchored by conventional implants may also be out of the picture.
On the other hand, mini-implants with their smaller diameter need less bone than the traditional implant. A few strategically placed within the jaw are strong and stable enough to support a removable denture. One other advantage: these mini-implants can be installed in one visit with local anesthesia and usually without the need for incisions or stitches.
If you would like more information on dentures supported by mini-implants, 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 “The ‘Great’ Mini-Implant.”
Dentures, removable restorations for missing teeth and gum tissue, can take a number of different forms, but are usually of two different types: complete and partial. A complete denture replaces all the teeth in a given arch. A removable partial denture (RPD), on the other hand, replaces several missing teeth while using the remaining teeth as support.
A common type of RPD formed of plastic is known as a “flipper” because it’s lightweight enough to be “flipped out” or moved around with the tongue. They serve an important purpose as a temporary appliance for use between periodontal treatment, implant placement and similar treatments before obtaining a more permanent restoration. In fact, they’re often referred to as “transitional” RPDs because they’re not designed for permanent tooth replacement.
Because of their low cost relative to other restorations, however, they often become the permanent choice for many people. While a well-constructed, properly fitting RPD in a healthy mouth can be an affordable alternative for people on modest budgets, their long-term use may increase the risk of dental disease and accelerated bone loss. Decades of research verify that people who permanently wear RPDs encounter more tooth decay and periodontal (gum) disease than non-wearers.
This is because the attachment points of a plastic RPD to remaining teeth increases bacterial growth, which can cause both tooth decay and gum disease. This doesn’t only endanger the survival of the remaining teeth, it can lead to bone loss that will affect the RPD’s fit.
While the better course is to consider RPDs as a stepping stone to dental implants or a fixed bridge, there’s an intermediary RPD constructed of cast vitallium or gold alloy that could be considered a permanent choice. These are even lighter weight than plastic and less obtrusive in their attachments in the mouth, which can reduce plaque stagnation and promote a better oral environment.
Regardless of your choice in dentures, it’s always important to maintain good consistent oral hygiene with daily brushing and flossing and semi-annual professional cleanings and checkups. Keeping a healthy mouth will help reduce your risk of dental disease and increase your satisfaction with your denture of choice.
If you would like more information on RPDs and other denture restorations, 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 Partial 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.”