Case Presentation: Maxillary Dentures

With the rise of implants and implant dentistry, many patients assume that dentures are no longer a "modern" treatment option. On the contrary, dentures are a great way to replace missing teeth without the need for additional surgeries or trauma. Pictured above is a complete upper denture fabricated for one of our patients. It is in the wax try-in stage: this is a proposed shape for the final denture made out of adjustable wax. Once we confirm the fit and cosmetics of the prosthesis, we will have a permanent acrylic version made by our lab. 

Dentures have a number of advantages of implant supported prosthetics (and vice-versa). From a functional standpoint, dentures allow us to "replace" both teeth and soft tissue. A well made denture can create the appearance of gums in deficient areas or level out resorbed bone. Implants have a more limited range of soft tissue enhancement and frequently require other procedures to get the full effect. Furthermore, dentures have a considerable cost advantage over implants, especially for replacing full arches of teeth. 

When this denture is seated in the patient's mouth, it will be nearly undetectable during daily activities. However, some may find the idea of having a removable dental device objectionable. This is why our office offers a number of restorative services- from bridges and dentures to implants. If you would like to know more about the tooth replacement options available to our patients, please give us a call!

Dentistry Through The Ages: Elderly Patients

Greetings and welcome to our on-going blog series, Dentistry Through the Ages. In these blog posts, we will cover age-group specific dental needs and concerns. Your life is constantly changing, and we want to equip you with the best information possible to keep your teeth healthy!

In this article, we will be covering the dental needs of our elderly patients. Current projections estimate that persons aged 65 and older represent between 13% and 17% of the current United States population. As such, the dental healthcare industry is becoming better adapted and prepared to handle the needs of an aging population. Our office wants to take a moment to highlight some predominant oral health concerns to keep you aware and healthy!

Dry Mouth (formally known as xerostomia) is one of the biggest concerns when treating elderly patients. As we progress into old age, our bodies become more susceptible to diseases, injuries and other medical concerns. These conditions will often result in new prescriptions and medications- many of which decrease saliva flow or limit the function of salivary glands. This, combined with the natural degradation of the parotid gland (a major salivary gland) with age, leaves many patients with little to no resting saliva.

Our saliva are crucial to limiting the activity and progress of cavity forming bacteria. As such, many patients will see an increase in cavities as they transition to old age. Certain biological factors put the elderly population at particular risk for root surface cavities, where decay arises in areas of gum recession or where the tooth meets the gum tissue. However, there are a number of great products to counteract the progression of cavities in old age. Fluoride products, remineralizing gels and xylitol rinses can all help keep decay and bacteria at bay. As an added bonus, xylitol products can help stimulate saliva flow to help combat dry mouth directly!

In addition to xerostomia, many elderly patients will encounter increased incidences of periodontal disease. Limited salivary flow, years of bacterial attacks and reduced immune response can all culminate to a loss of gum tissue and bone level. Many patients will be candidates for deep cleanings or a more frequent cleaning schedule to keep plaque and tartar levels down. Others with advanced periodontal disease may even be candidates for the services of a periodontist (gum tissue specialist).

For patients with very aggressive periodontal disease, teeth may need to be extracted. Depending on the extent of the condition, number of extractions needed and patient’s overall health, our office offers a number of tooth replacement options. Single teeth can be replaced permanently with bridges and implants or removably with a partial denture (depending on the location of the gap). Partial dentures use a metal framework to replace teeth and gum tissue back to a natural appearance. They benefit from using clasps to mount to permanent teeth and sit on the gum tissue.

Full dentures can provide the same esthetic results as partial dentures for edentulous (toothless) patients. Full dentures typically require about four to five appointments to take proper impressions, fabricate the denture, adjust it and deliver the final product. While this process is lengthy, it helps ensure a great fit that minimizes irritation to the gum tissue.

We hope you found our review of oral health concerns in the elderly informative and helpful. Our office is fully committed and equipped to care for aging patients and wants you to know you are in great hands.  If you have any questions about your oral health needs, our treatment options or any other concerns, please give us a call. We are always available to answer your questions!

Dentures

One of the greatest aspects of modern dentistry is our ability to replace missing or extracted teeth. Today, patients typically seek out implant crowns and bridges as quick and safe methods of restoring their smiles. But what about dentures? The name alone might conjure up pictures of older relatives and seltzer tabs, but they are still an excellent way to fix a gap in your dentition. At Thousand Oaks Family Dentistry, we offer a number of denture options for patients needing everything from temporary single tooth replacement to permanent appliances for entire arches. No matter what your needs, there is likely a denture solution to fit it!

Patients who still have some existing teeth are typically eligible for partial dentures. These appliances bridge one or more empty spaces between teeth to recreate a natural smile. They usually require healthy molars or premolars to snap on to and give them rigidity. Some partial dentures are made entirely out of acrylic. These are commonly referred to as “flippers” and typically serve as temporary solutions until an implant can be placed or a permanent denture can be made. Because they are plastic, they need to be made thick for rigidity. Likewise, flippers can feel bulky and uncomfortable and are prone to becoming brittle. Still, they are an excellent interim esthetic solution for patients missing teeth.

a full acrylic partial denture or "flipper"

Partial dentures can also be made using a combination of acrylic and cast metal. These devices are stronger, thinner and typically more comfortable than flippers. When you smile or open your mouth, pink and enamel colored acrylic hide the metal framework beneath and the appliance looks like natural tissues. Rigid metal partial dentures are appropriate for long term use and are often the most comfortable option. If you have enough teeth to anchor the device, they can fit snugly and comfortably in your mouth.

A partial denture with metal framework

If you are missing all teeth on an entire arch, you are likely eligible for full dentures. Full dentures are made out of acrylic and stay in your mouth using the suction created between your gums and the denture base. Since they rest on your gum tissue, full dentures can take some time to get used to. Many patients will feel sore spots or an uneven “rocking” sensation until they become accustomed to the feeling of the appliance. Our office can make small adjustments to dentures to better accommodate your mouth, but they will never feel as natural as something anchored to your teeth. Still, they are a great alternative to smiling, chewing and speaking with no teeth.

a full upper and lower full denture

A final subset of dentures are implant supported dentures. Here, an acrylic appliance is mounted to 2 or more implants (depending on the number of teeth replaced) through rubber snaps. These are typically the most comfortable denture style for replacing whole arches of teeth. However, this treatment option is both costly and time consuming; Implant placement can take up to six months to become healed and sturdy enough to support a denture. Still, many patients are extremely satisfied with the resulting product, as the implants keep the appliance rigid and out of contact with gum tissue.

A diagram of how implant supported dentures are mounted

No matter what type of denture we are making, our office needs three types of impressions: one impression of the teeth (or gums) on which the dentures will be made, one of the opposing teeth and one of how the teeth come together when you bite down. Once we take these impressions, we send them off to a lab along with instructions on tooth color, transparency and brightness. From there, the lab will either fashion your permanent denture, make a wax try-in (a soft, denture lookalike used by our office to ensure fit and esthetics), or send us custom trays. Custom trays are impression trays that precisely fit the dimensions of your mouth. These instruments insure a perfect impression (and a better fit) for the final denture. Once we are ready to deliver your appliance, you will return to our office for a short fitting appointment where we can make minor adjustments.

The true scope of dentures extends into many different devices, materials and mounting styles. We like to have a lengthy discussion with every patient prior to taking impressions, to make sure they will satisfied with the final product. Only a consultation between you and Dr. Hong can show us what kind of denture is appropriate for your specific needs. If you would like to know more about dentures or any other type of appliance offered at our office, please give us a call. We are always happy to walk you through any and every procedure!