The One Visit Denture

Marilyn is 87 and lives in an assisted living home.  She is active and feisty: loves to play cards and billiards. She dresses with great care, but she had a habit of removing her denture – probably because it didn’t fit or wasn’t comfortable. So last week she removed it in the dining room and placed it in a napkin (NEVER do this, I tell my patients!). A denture wrapped in a napkin is looking to get discarded – and that is just what happened. Marilyn was without her teeth and she was, understandably, very upset.

 

Her daughter read on the internet that I make great fitting dentures in just four visits. She called me and she asked if I could make a denture in even less time so Marilyn could have teeth sooner rather than later. I told them to come in the next day, and I would have a new denture for her in four days. They were both thrilled. I condensed the fabrication process into one visit but I couldn’t guarantee that we would be happy with the result. I explained to them that if we weren’t happy with the teeth, then this denture would be counted as a temporary denture, and it would take just a few more visits to make a denture that satisfied us all.

 

The next day mother and daughter came in for mom’s visit – I took impressions and measurements. I consulted with my fabulous denture laboratory. Four days later I delivered a new denture, and the result was spectacular – looks great, fits snugly and functions well. Let’s just hope Marilyn doesn’t take this denture out and place it in a napkin! But if it is lost, at least I always put the owner’s name on the inside.

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Marilyn lost her upper teeth!

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Now Marilyn can smile again!

 

It always strikes me that people never seem to be as concerned about losing a back tooth as they are about losing a front tooth. But back teeth also count!!  You need your back teeth so you can chew properly. Back teeth also protect the front teeth, and they help to maintain your facial structure. If even one back tooth is missing, the adjacent teeth will drift to close the space; they may loosen and a pocket of infection may form. The opposing teeth may erupt into the open space. Your bite will start to collapse. The front teeth will begin to splay forward.

The following patient was missing all of her back teeth. She was putting a lot of stress on her front teeth because she didn’t have back teeth for chewing. The front teeth were beginning to splay forward. She elected to have implants placed. We placed four implants on the top and two on the bottom and gave her new front crowns – a great result and a very happy patient:

Posterior Implants Picture

 

The following patient lost her lower back teeth, and consequently the top teeth have super-erupted into the space. This weakens the top teeth and they become susceptible to loss. We did some periodontal crown lengthening and placed five crowns on the top teeth in order to restore them to their proper position. Four implants were also placed on the bottom and will soon be uncovered so implant crowns can be placed:

Posterior Implants before and after picture

Did you know?

Did you know that more than 33 million Americans have no teeth

178 million Americans are missing at least one tooth.

Over 27% of the US population over age 65 have no teeth at all.

Only 9% of people without teeth wear dentures.

The average life expectancy of a denture is six to ten years. (But we can do much better than that!)

What is the greatest concern of the prospective denture wearer?  “I don’t want to have to take my teeth out at night.”  People still have childhood memories of grandma’s teeth floating in a glass by the bedside.  But rest assured – you don’t have to remove your dentures at night.  Well-made dentures today are quite unlike those bulky, loose dentures that your grandmother wore.  The processing is more high-tech.  Custom dentures fit much, much better and look very natural.

Dentures can remain in the mouth overnight.  Just take them out to clean and a short soak in a denture cleanser.  We have many patients whose spouses don’t know that they have lost their teeth and that they wear dentures.  Sure, implants are great and they don’t come out at all – but they are not for everyone.  We still see lots of dentures – their death is greatly exaggerated.

Check out our dentures.  Check out our implants.

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Bernice’s old dentures were uncomfortable and unattractive and she could only eat soft, mushy foods.  In just four visits (three weeks total), with the help of our wonderful custom denture laboratory, we created new dentures for her.  She looks fabulous, eats everything (even steak and apples), and she is so comfortable, she says she often forgets that she is wearing dentures.  What more can you ask for?

 

Denise’s teeth were severely decayed, and we determined that they could not be saved.  We elected to remove her remaining teeth and replace them with an immediate denture.  This is a two visit procedure.  We take custom impressions. The immediate dentures are then fabricated by our fabulous denture laboratory. The teeth can then be extracted, and the immediate denture is inserted the same day – thus “immediate.”  The patient is NEVER without teeth. This takes careful planning!

The healing process then takes several months because the bone and soft tissues remodel where the teeth were extracted.  As the healing progresses, we reline the immediate denture so it fits the altered tissue.  We will see you for a reline as often as needed – sometimes once or twice, sometimes more.  Once the tissues are relatively stable, we will take custom impressions of the altered tissue and fabricate a new denture that will look great, function superbly and be very comfortable.  How good is that?

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Everyone is interested in dental implants but they often have trouble visualizing the process.  I notice a lot of confusion about implants among prospective patients.  You should know that the dental implant is that portion of the implant crown that is embedded in the bone and which acts like the root of a natural tooth (see diagram below).  Typically an oral surgeon or periodontist performs the surgery to place the implant in the bone.  The implant needs to heal, and several months later, the restorative dentist will place an abutment (or implant post) on top of the implant (see diagram below).  And on top of the abutment an implant crown is attached (see diagram below).  So the implant crown consists of three pieces: implant, abutment, and implant crown. But sure your dentist and surgeon explain the procedures and the costs for all three pieces – and be sure to budget for all three pieces! imgres-3

Implant, Abutment, and Implant Crown

Is your lower denture loose?  Do you have to use gobs of denture adhesive and you still can’t keep the denture in place?  Your upper denture functions well, so why do you have problems with the lower denture?

An estimated 8% of the U.S. population has no teeth in at least one dental arch.  In people 75 years and older, 44% have no teeth in one arch.  It is more frequent for the upper arch to be edentulous than the lower arch.  That is, more people wear upper dentures than lower dentures.  But lower dentures cause most of the problems, resulting in a decreased quality of life.

The extraction of a tooth results in a loss of bone width by 25% and a loss in bone height of 4 mm during the first year.  The loss of bone width occurs on the lip side of the ridge so the ridge is shifted back.  This bone loss continues throughout the patient’s life, thus making retention and stability of dentures more and more difficult.  The remaining bone is sharper and irregular – resulting in sore spots.  Muscle attachments and the tongue are also closer to the resorbed lower ridge, thus causing the lower denture to lift up during use. The upper ridge also resorbs when teeth are missing but the larger surface area of the palate allows for better retention of the upper denture as opposed to the lower denture.

However if dental implants are placed, the bone loss is minimized.  Implants help stabilize dentures and also preserve facial height.  A revolution in dentistry!