Posts for category: Dental Procedures
It’s a common problem for denture wearers: after years of a comfortable fit, your dentures now seem to be uncomfortably loose. The reason, though, may have more to do with bone loss than the dentures.
Bone is a living tissue with a life cycle — it forms, it ages, and it eventually dies and dissolves (resorbs). It’s replaced with new bone and the cycle repeats. Additionally, the forces generated when we bite or chew are transmitted from the teeth to the jaw, which helps stimulate new bone growth. When the natural teeth are missing, however, the bone no longer receives this stimulus. Resorbed bone isn’t replaced at a healthy rate, which leads over time to bone loss.
Denture construction can also contribute to bone loss. The denture palate rests for support on the bony ridges that once held the teeth. Over time the compressive forces of the dentures apply damages and reduces the volume of gum tissue and eventually does the same to the bone. Combining all these factors, the reduced gum and bone volume will eventually alter the denture fit.
There are a few alternatives for correcting loose dentures. One is to reline them with new plastic, as either a temporary fix performed during an office visit or a more permanent relining that requires sending your dentures to a dental lab. Depending on the rate of bone loss, a patient could go through several denture relinings to accommodate ongoing changes in the jaw. At some point, though, it may be necessary to create a new set of dentures.
A third alternative that’s becoming increasingly useful is to incorporate dental implants into the denture design. Implants can of course be used to replace individual teeth, but a few strategically placed implants (usually of smaller dimension) can serve as a support platform for a removable denture. This relieves some of the compression force of a traditionally worn denture and can slow bone loss.
If you’re having problems with your denture fit, call us for an appointment. We’ll help you decide on the best alternative to improving the fit and making your dentures more comfortable and secure.
If you would like more information on refitting loose dentures, please contact us today to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Loose Dentures.”
Although primary (“baby”) teeth have a lifespan of only a few years, they’re still important to a child’s current and future dental health. In the present, they help a child eat, speak and smile properly. They also help create a healthy future as placeholders for developing permanent teeth yet to come in.
If, however, a child loses a primary tooth prematurely due to decay, the corresponding permanent tooth could come in misaligned. That’s why we do what we can to help a decayed primary tooth reach its full lifespan. And there are different ways to do this depending on the type of tooth.
With front teeth, which don’t encounter the same chewing forces as those in the back, we may use a tooth-colored filling. This approach is also preferable for appearance’s sake since front teeth are highly visible when a child speaks or smiles.
Primary molars, on the other hand, need a more robust solution. A filling may not be able to withstand the level of long-term chewing forces that these back teeth normally encounter. And because they’re less visible than front teeth, there’s less concern about aesthetics.
That’s why many pediatric dentists prefer stainless steel crowns for molars. Just like their permanent teeth counterparts, a primary crown fits over and completely covers a tooth. They’re typically pre-formed, coming in different shapes and sizes that can then be customized for the tooth in question. After preparing and removing any decayed material from the tooth, we can usually install the crown in one visit with local anesthesia and a sedative (if the child needs it for anxiety).
While a steel crown isn’t the most attractive restoration, it typically handles the higher chewing forces in the back of the mouth better and longer than a filling. That’s especially critical for primary molars, which are some of the last teeth to fall out (as late as ages 10-12). And besides preserving it as a permanent tooth placeholder, a crown also helps the tooth function effectively in the present.
Regardless of what method we use, though, preserving primary teeth is a primary goal of pediatric dentistry. And with a stainless steel crown, we can keep those important back molars functioning for as long as they’re intended.
If you would like more information on caring for primary teeth, 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 “Stainless Steel Crowns for Kids.”
Edentulism, the loss of all of a person’s teeth, is more than an appearance problem. As one in four Americans over 65 can attest, total tooth loss can lead to emotional suffering, social embarrassment and a lack of nutrition caused by limited food choices.
But there are solutions like the removable denture, an effective dental restoration for more than a century. In its current advanced form, the removable denture is truly a functional, affordable and attractive way to restore lost teeth.
Creating an effective denture begins first by taking detailed impressions of a patient’s gum ridges. We use the measurements obtained from this process to create a plastic resin base colored to resemble the natural gums. Using old photos and other resources documenting how the patient looked with teeth, we choose the best size and shape of porcelain teeth and then position them onto the base.
Finally, we fine-tune the dentures the first time they’re in the patient’s mouth to make sure they have a secure fit and a balanced bite when the jaws come together. We also want to be sure the dentures are attractive and blend well with other facial features. The result: a new set of teeth that can do the job of the old ones and look nearly as real and attractive.
Dentures, though, do have one major drawback: they can’t stop bone loss, a common consequence of missing teeth. In fact, they may even accelerate bone loss due to the pressure they bring to bear on the gum ridges. Continuing bone loss could eventually cause their once secure fit to slacken, making them less functional and much more uncomfortable to wear.
But a recent innovation could put the brakes on bone loss for a denture wearer. By incorporating small implants imbedded at various places along the gums, a denture with compatible fittings connects securely with the implants to support the denture rather than the gum ridges. This not only relieves pressure on the gums, but the titanium within the implants attracts bone cells and stimulates their growth.
Thanks to this and other modern advances, dentures continue to be a solid choice for tooth replacement. Not only can they restore a lost smile, they can improve overall health and well-being too.
If you would like more information on dental restorations for missing teeth, 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.”
If you’re thinking about getting dental implants, you’re in good company. Dentists have placed more than 3 million of these popular devices since their introduction in the early 1980s.
But if you have multiple missing teeth, you might think the cost of all those individual implants could put them out of your league. Yes, replacing multiple teeth with individual implants can be quite expensive—but implant technology isn’t limited to one tooth at a time. A few well-placed implants can impart their proven durability and stability to other types of restorations.
For example, we can incorporate implants into a bridge for a series of missing teeth. Conventional bridges are normally fixed in place by altering and then crowning natural teeth on each side of the missing teeth gap with a fixed row of prosthetic (false) teeth in the middle to fill it. Instead, two implants placed at the ends of the gap can support the bridge rather than natural teeth. This not only provides greater stability for the bridge, it also avoids permanent altering the natural teeth that would have been used.
Implants can also support a fixed bridge to restore complete tooth loss on a jaw. The new bridge is attached to a few strategically placed implants along the jaw line to equally distribute biting forces. This can result in a strong hold with excellent durability.
We can also use implants to improve traditional dentures. Dentures normally rest directly on the gums’ bony ridges, depending on a snug fit for stability. But bone loss, a natural consequence of missing teeth, can still occur while wearing dentures, which may in fact accelerate the rate of loss due to the appliance’s constant pressure and friction against the gums.
Instead, just a few implants placed along the jaw can, with attachments built into the denture, hold it securely in place. This not only decreases the pressure on the gums, but the natural bone growth that occurs around the implant may even deter bone loss.
Depending on your situation, there could be a viable restoration solution involving implants. Visit our office for a complete examination and evaluation to see if implants could help change your smile forever.
If you would like more information on implant 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 “Dental Implants 101: the Most Significant Innovation in the Past Century.”
For generations, dentures have helped people avoid the dire consequences of total teeth loss. Now, implant technology is making them even better.
Composed of life-like prosthetic teeth fixed within a plastic or resin gum-colored base, dentures are manufactured to fit an individual patient’s mouth for maximum fit, comfort and performance. But dentures also have a critical drawback—they can’t stop bone loss in the jaw.
Bone is constantly regenerating as older cells dissolve and then are replaced by newer cells. In the jawbone, the forces generated when we chew travel through the teeth to the bone and help stimulate this new cell growth. When teeth are missing, though, the bone doesn’t receive this stimulus and may not regenerate at a healthy rate, resulting in gradual bone loss.
Dentures can’t transmit this chewing stimulus to the bone. In fact, the pressure they produce as they rest on top of the gums may actually accelerate bone loss. Over time then, a denture’s once secure and comfortable fit becomes loose.
In the past, most patients with loose dentures have had them relined with new dental material to improve fit, or have new dentures created to conform to the changed contours of the jaws. But implant technology now offers another alternative.
Implants are in essence a tooth root replacement. Dentists surgically implant a titanium metal post directly into the jawbone that naturally attracts bone cells to grow and adhere to it over time (a process called osseointegration). This not only creates a secure and lasting hold, it can also stop or even reverse bone loss.
Most people know implants as single tooth replacements with a porcelain crown attached to the titanium post. But a few strategically placed implants can also support either removable or fixed dentures. Removable dentures (also called overdentures) usually need only 3 or 4 implants on the top jaw and 2 on the bottom jaw for support through built-in connectors in the dentures that attach to the implants. A fixed bridge may require 4-6 implants to which they are permanently attached.
There are pros and cons for each of these options and they’re both more expensive than traditional dentures. In the long run, though, implant-supported dentures could be more beneficial for your bone health and hold their fit longer.