1. I’m missing a bunch of teeth, the ones I have are bad, should I just get dentures?
This question and slight variations on this question are very common in our practice. Sometimes it comes from a patient who is almost joking around, perhaps frustrated with recent dental problems in their life. Occasionally it comes from a patient who is half joking and half serious, not really sure where they stand and truly wanting some advice. Often times, it is from a patient that is completely serious and already knows that it is likely the next or only option up for discussion. Every case is different and every patient is different.
Rolling Oaks Dental is not a discount denture focused practice. We are a privately owned dental practice focused on building long term relationships in our community. We believe in treating people right, and from there good things happen for everyone. All new patients at Rolling Oaks Dental that are interested in dentures receive a comprehensive exam and complete set of x-rays. Before any treatment plans are proposed, we discuss with patients their goals and expectations when it comes to their oral health. What “should” you do? It is our philosophy that that is up to the patient. It is our job to examine patients and present them with a clear account of our findings. If patients want to know what treatment options exist, we go into as much detail as someone wants. What “should” they do? Patients “should” do what they want. The days of “doctor’s orders” and “my dentist told me I have to do this” are gone. We’re all adults and no one needs to be told what to do! We provide patients with all of the information to make the best choice for themselves.
For a patient with natural teeth that are failing, a denture can be a healthy, pain free, and infection free alternative. Many patients don’t realize how infected teeth in their mouth are dragging their body down. Others don’t realize that their lack of confidence to smile is dragging their spirit down. If you don’t have your health and you don’t have your spirit, what are you left with? Not much.
For a patient with only a handful of dental problems that can be easily solved with other treatment alternatives, a denture may not be appropriate. A denture is a great treatment idea for a patient with no other alternatives. For patients that still have many teeth and restoring those teeth is possible, this is usually the best way to go. Nothing can ever truly replace your natural teeth, and dentures should only be considered if they are the best long term treatment option.
2. I have a denture that shows a lot of gums, is this normal?
I can think of three possible reasons your denture shows a lot of gums. One possibility is that it is worn out and no longer fits properly. It is time for a new one. The teeth that we display when we smile and speak changes as we age. A denture that is several years old may need to be reset or remade. Another possibility is that the denture wasn’t set properly in the first place. Great care must be taken in the selection of the shape and size of the teeth, the position of the edges of the front teeth, and the amount of tooth showing when a patient smiles. If great care isn’t taken in this process, you can end up with a result where a patient shows too much gums and the denture doesn’t look natural. Here’s what it comes down to with the esthetics of the front teeth on a denture: if you like the way it looks, it’s good. If you think it doesn’t look good, it’s bad. When dentures are made by inexperienced technicians or with inexpensive materials, you can get variable results. A quality dental lab chooses from a bank of hundreds of shapes, sizes and shade when it comes to selecting teeth for a denture. It is by no means a “one size fits all” matter. The third possibility is that the appropriate amount of jaw bone was not removed during surgery from one of the patient’s jaws to achieve an aesthetic result.
3. My dentures fit great, but the teeth are worn out, can we just replace the teeth?
Yes we can. Some patients grind a denture down and just want to replace the teeth. This is a simple, straightforward procedure that can be performed for almost any patient that has a denture. It typically only takes a day or so. If necessary, it can be rushed and started morning and back to the patient by the end of the day.
4. My denture is loose, do I need a new one?
A loose, ill-fitting denture can cause a lot of irritation and harm to the tissue. A loose denture needs to be either relined, remade, or reinforced with dental implants. Relining is a process where material is added to the inside surface of the denture to “tighten” it up on the ridges where it lays. A reline is a great way to get a little bit more life out of a denture that you may have had for a while. While it isn’t uncommon for our practice to do relines, we find that most patients with ill fitting, worn out dentures would rather just have an entirely new one made. As many patients are well aware, relining and remaking can only get you so far when there isn’t adequate jaw bone left to support. Dental implants are often the only option for a loose fitting denture that can’t be remedied by any other solution.
In many cases, dentures stay in pretty well when they’re first made. As time passes, the bone that used to hold the teeth in starts to resorb and shrink, and the denture gets looser and looser over time. Several relines and remakes later, it becomes harder and harder to get the thing to stay, simply because the bone goes away over time. Without natural teeth or dental implants, the bone just shrinks away.
5. I have to use denture adhesive to keep my denture in, is that normal?
No. If you’re using any adhesive on a denture, it’s not good for the tissue in your mouth long term. If you can’t stop using denture adhesive, there’ three things that could be going on:
- Your denture doesn’t fit and needs to be relined. See your dentist as soon as possible.
- There’s simply no more bone or retention left naturally in your ridge. Denture adhesive for a little while, not long, but you must consider implants if it is an option for you.
- You’re addicted to adhesive. I’ve seen patients with dentures that fit very well that still insist on using adhesive. They really want that connected feeling to eat and speak comfortably. The problem is, the comfort this provides won’t last forever. Denture adhesive addiction can get very expensive over time. Depending on how much you use a week, in a few years you could end up paying for the cost of a better treatment option just in adhesive! Consider implants if this sounds like something you are going through.
6. My denture has suction on top, but not on the bottom. Can anything be done to give the bottom one suction?
Not really. Some patients are very lucky and have excellent retention on their lower denture without the aid of implants or adhesive. Will-power and a positive attitude is typically the only thing holding in a lower denture!
In health care, we talk a lot about this concept called the “standard of care”. For instance, a patient comes into the office with no dental decay and wants veneers made for a more attractive smile. We use one of the best dental labs in the country to fabricate amazing looking veneers. This type of treatment is considered above the “standard of care”, because we went above and beyond. If a patient walks into a dental practice with a small chip on a front tooth, a tooth colored composite restoration is typically the treatment of choice. This is what many dentists would agree is “standard of care”. Here’s the thing. Most dentists now agree that a complete lower denture with no type of implant retention is actually below the standard of care in modern dentistry. Most dentists do not recommend this as a solution of any kind!
7. Are there different qualities when it comes to dentures?
Most certainly. The quality of materials and craftsmanship has a tremendous impact on how good your denture looks and how well it functions. Without adequate information, patients assume a lot of things. The first thing is that the fees at a low cost dental office focusing on dentures are significantly better than having the treatment performed in a private practice. While the costs might be shuffled around a little differently (for example, the denture is free but the surgery seems to cost more, or there is a fee for follow up adjustment visits which are normally included in the fee in a private practice), the costs are generally comparable. The second assumption many patients make is that a denture is a denture and it doesn’t matter who makes it. The fact is a poorly made denture can cause years of agony and frustration for a patient without them ever realizing what they are missing. A well-made denture and a poorly made denture don’t differ significantly in cost to ever justify the savings.
8. Can I get implants added to my denture?
There are very few patients with dentures that are NOT candidates for implants. Implant retained dentures literally change people’s lives. One of the most interesting things about implant supported dentures is that it is extremely difficult to find a patient that wishes they hadn’t done it. I don’t think I’ve ever heard a patient say, “I miss having a loose denture, can’t we just have it flopping around in there like it used to?”. Every patient’s needs are different, and what makes the most sense for a particular patient is a very individual thing. A comprehensive examination and discussion of the options is always the best place to start.
9. Will I be able to eat better if I get my denture attached to implants?
Yes. Imagine this. A patient with all of their natural teeth can function at 100% capacity. Makes sense, right? A patient with no teeth and just dentures and no implants can only function at about 10% capacity! That’s not a lot of force to eat steak or corn on the cob or apples or anything. Forget about it. Patients with complete dentures attached to implants, like the All on 4 Technique, can function at 90% capacity. That’s incredible!
10. How do I figure out what is the best combination of dentures and implants for my budget and my desired outcome?
I commend anyone that does their homework and researches what their dental needs and options are before they come to see me in my practice. A patient that has some concept of treatment options is easier to educate on the details of their own needs. Some patients are very confused when they come to the office, and educating them with a few models is typically all it takes to get a patient up to speed on what’s available.
There’s simply no amount of Internet research you can do or phone calls that you can make that can substitute a comprehensive dental examination followed by a treatment discussion that’s tailored to your exact dental needs and desired outcomes. It can’t be done on the Internet and it can’t be done on the phone.
If you live in San Antonio, TX and the surrounding areas, call our practice today to schedule a comprehensive examination. We can discuss your specific needs and tailor a plan of action that is appropriate for you. We see patients every week that haven’t been to a dentist in 10 or 20 years that are tired of living in pain and fear of dentistry. We do everything we can to make patients feel welcome and at home -something they aren’t used to in a dental office. Our aim is to keep personal attention and high quality of care a top focus in health care, as it should be. Call us today.