Dentures

 

Your first visit to Dr. Chapman's office promises to be a pleasant experience.  Many times patients are relieved to find out that their periodontal health is better than they thought it was!  Don't wait until it hurts.  The sooner you begin to get your mouth healthier, the better!  Gum disease frequently has no symtoms unless it is quite severe.

Making sound decisions about your dental care and oral health is an easy thing to do with the right preparation beforehand:

  • Make a list of questions to ask our office, so you don't forget anything on the day of your appointment. This includes any concerns you have, or oral problems you've been experiencing.

  • If you have dental insurance, remember to bring your insurance card with you.  Also, if your dentist has given you X-rays or a referral form, please bring them with you as well.

 

Periodontics is a dental specialty that involves the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

Who is a periodontist?

A periodontist is a dentist who specializes in the prevention, diagnosis and treatment of periodontal disease and in the placement of dental implants. A periodontist typically has had two to three years of additional training in diagnosing and treating gum disease and its associated problems. Periodontists are experts in the most successful techniques for diagnosing and treating periodontal disease. Additionally, periodontists can perform cosmetic periodontal procedures to improve your smile. Often, dentists refer their patients to a periodontist when their periodontal disease is advanced.

During your first visit, Dr. Chapman will review your medical and dental history, as well as any medications you may be taking. This will be followed by:

  • A complete oral and periodontal exam of your gums to check for gum bleeding and swelling, and gum recession; your jawbone, to help detect the breakdown of bone surrounding your teeth; and your teeth, to determine their proper alignment and if any are sensitive, loose and how they fit together when you bite.
  • An assessment of the depth of the spaces, known as periodontal pockets, between your teeth.
  • X-rays, to show the bone levels between your teeth to check for possible bone loss.
  • Once the exam is completed, Dr. Chapman will in most cases immediately discuss with you his diagnosis and recommendations for treatment. He will answer your questions and you will have a thorough understanding of what your situation is and what needs to be done for optimal health. 


Treatment choices include:

  • Root Planing and Scaling, which is one of the most effective ways to treat gum disease when it is caught in its early stage, before it has progressed to significant bone loss. This is a thorough cleaning and removal of the disease -causing deposits on your teeth called tartar and is done by a dental hygienist. 
  • Pocket Reduction Treatment  (PRT) is without a doubt the most successful and time tested treatment for moderate and advanced cases of periodontal disease available today!  PRT is so effective because it involves the complete removal of tartar and the recontouring of the bone that supports the teeth to bring it back to the healthy shape that it is supposed to have.   Pocket Reduction Treatment is very beneficial when pockets are 5mm or greater.  With PRT the diseased pockets are very predictably reduced by 50%!  This allows your toothbrush to keep the now healthy pockets clean and leads to long term periodontal health!
  • Bone Grafting/Bone Regeneration is a very valuable procedure done at the same time as Pocket Reduction Treatment where Dr. Chapman places a special material into indentations in the bone caused by periodontal disease that commonly occur next to teeth.  Bone grafting helps to re-build some of the bone that supports the teeth.
  • Soft Tissue Grafts including: Connective Tissue Grafts which help to cover up the exposed root surfaces of teeth and can be a cosmetic problem as well as cause sensitivity;  Free Gingival Grafts, which move healthy gum tissue from one part of the mouth to another, and Pedical Grafts, which shift gums to cover areas where healthy tissue is needed.
  • Implants  are the most natural, most functional, best looking replacements for lost teeth that dentistry has today!  Think of an implant as a man-made tooth root that your dentist places a crown (cap) on.  Alternatives include a bridge where your dentist drills down on the teeth next to a space and the bridge is glued onto those teeth replacing the lost tooth in between.  This can lead to tooth decay (cavities) on those teeth, and can also put too much pressure on those teeth in some cases leading to additional tooth loss.  Another option is a partial denture, an appliance that you take out at night and put back in in the morning.  Many patients find that partials are cumbersome and difficult to chew with, not to mention unsightly.
  • Ridge Preservation  is done to help decrease the natural loss of bone that will occur after a tooth has been extracted.  This is commonly done in an area where an implant is to be placed.
  • Ridge Augmentation may be recommended if the bone where an implant is to be placed is too narrow and needs to be widened.
  • Crown lengthening is the lowering of the gum around a tooth, most often done so that your dentist can gain access to a cavity or fracture below where the gumline was. 
  • Cosmetic surgery is done to help reveal a beautiful smile where patients have too much gum tissue covering their teeth giving the appearance of very small teeth.  This is a  simple procedure that can have a dramatic effect on a persons smile!
  • Frenectomy is another easy procedure where excess gum tissue is removed from between the upper two front teeth that may be causing a spece to exist.  This is usually requested by an orthodontist who is trying to straighten teeth and close gaps between them. 
  • Fiberotomy is the easiest of all procedures again done at the request of an orthodontist to assist in the long term maintenance of straighter teeth. 

  

A denture is a removable replacement for missing teeth and adjacent tissues. It is made of acrylic resin, sometimes in combination with various metals.


Types of dentures



Complete dentures replace all the teeth, while a partial denture fills in the spaces created by missing teeth and prevents other teeth from changing position.

Candidates for complete dentures have lost most or all of their teeth. A partial denture is suitable for those who have some natural teeth remaining. A denture improves chewing ability and speech, and provides support for facial muscles. It will greatly enhance the facial appearance and smile.

Complete or full dentures are made when all of your natural teeth are missing. You can have a full denture on your upper or lower jaw, or both.

Complete dentures are called "conventional" or "immediate" according to when they are made and when they are inserted into the mouth. Immediate dentures are inserted immediately after the removal of the remaining teeth. To make this possible, the dentist takes measurements and makes the models of the patient`s jaws during a preliminary visit.

An advantage of immediate dentures is that the wearer does not have to be without teeth during the healing period. However, bones and gums can shrink over time, especially during the period of healing in the first six months after the removal of teeth. When gums shrink, immediate dentures may require rebasing or relining to fit properly. A conventional denture can then be made once the tissues have healed. Healing may take at least 6-8 weeks.

An overdenture is a removable denture that fits over a small number of remaining natural teeth or implants. The natural teeth must be prepared to provide stability and support for the denture.

Partial dentures are often a solution when several teeth are missing.

Removable partial dentures usually consist of replacement teeth attached to pink or gum-colored plastic bases, which are connected by metal framework. Removable partial dentures attach to your natural teeth with metal clasps or devices called precision attachments. Precision attachments are generally more esthetic than metal clasps and are nearly invisible. Crowns on your natural teeth may improve the fit of a removable partial denture and they are usually required with attachments. Partials with precision attachments generally cost more than those with metal clasps.



How are dentures made?



The denture process takes about one month and five appointments: the initial diagnosis is made; an impression and a wax bite are made to determine vertical dimensions and proper jaw position; a "try-in" is placed to assure proper color, shape and fit; and the patient`s final denture is placed, following any minor adjustments.

First, an impression of your jaw is made using special materials. In addition, measurements are made to show how your jaws relate to one another and how much space is between them (bite relationship). The color or shade of your natural teeth will also be determined. The impression, bite and shade are given to the dental laboratory so a denture can be custom-made for your mouth.

The dental laboratory makes a mold or model of your jaw, places the teeth in a wax base, and carves the wax to the exact form wanted in the finished denture. Usually a "wax try-in" of the denture will be done at the dentist`s office so any adjustments can be done before the denture is completed.

The denture is completed at the dental laboratory using the "lost wax" technique. A mold of the wax-up denture is made, the wax is removed and the remaining space is filled with pink plastic in dough form. The mold is then heated to harden the plastic. The denture is then polished and ready for wear.
 

Getting used to your denture



For the first few weeks, a new denture may feel awkward or bulky. However, your mouth will eventually become accustomed to wearing it. Inserting and removing the denture will require some practice. Your denture should easily fit into place. Never force the partial denture into position by biting down. This could bend or break the clasps.

At first, you may be asked to wear your denture all the time. Although this may be temporarily uncomfortable, it is the quickest way to identify those denture parts that may need adjustment. If the denture puts too much pressure on a particular area, that spot will become sore. Your denture can be adjusted to fit more comfortably. After making adjustments, you may need to take the denture out of your mouth before going to bed and replace it in the morning.

Start out by eating soft foods that are cut into small pieces. Chew on both sides of the mouth to keep even pressure on the denture. Avoid sticky or hard foods, including gum.
 

Care of your denture



It's best to stand over a folded towel or a sink of water when handling your denture, just in case you accidentally drop it. Brush the denture (preferably with a denture brush) daily to remove food deposits and plaque, and keep it from becoming permanently stained. Avoid using a brush with hard bristles, which can damage the denture. Look for denture cleansers with the American Dental Association (ADA) Seal of Acceptance. Pay special attention to cleaning teeth that fit under the denture`s metal clasps. Plaque that becomes trapped under the clasps will increase the risk of tooth decay.

Hand soap or mild dishwashing liquid to clean dentures is also acceptable. Other types of household cleaners and many toothpastes are too abrasive and should not be used for cleaning dentures. A denture could lose its proper shape if it is not kept moist. At night, the denture should be placed in soaking solution or water. However, if the appliance has metal attachments, they could be tarnished if placed in soaking solution.

Even with full dentures, you still need to take good care of your mouth. Every morning, brush your gums, tongue and palate with a soft-bristled brush before you put in your dentures. This removes plaque and stimulates circulation in the mouth. Selecting a balanced diet for proper nutrition is also important for maintaining a healthy mouth.
 

Adjustments



Over time, adjusting the denture may be necessary. As you age, your mouth naturally changes, which can affect the fit of the denture. Your bone and gum ridges can recede or shrink, resulting in a loose-fitting denture. Loose dentures can cause various problems, including sores or infections. Dentures that do not fit properly can be adjusted. Avoid using a do-it-yourself kit to adjust your dentures, as this can damage the appliance beyond repair. Glues sold over the counter often contain harmful chemicals and should not be used on a denture.

If your denture no longer fits properly, if it breaks, cracks or chips, or if one of the teeth becomes loose, see your dentist immediately. In many cases, dentists can make necessary adjustments or repairs, often on the same day. Complicated repairs may require that the denture be sent to a special dental laboratory.

Over time, dentures will need to be relined, re-based, or re-made due to normal wear. To reline or re-base a denture, the dentist uses the existing denture teeth and refits the denture base or makes a new denture base. Dentures may need to be replaced if they become loose and the teeth show signs of significant wear.
 

Common concerns



Eating will take a little practice. Start with soft foods cut into small pieces. Chew slowly using both sides of your mouth at the same time to prevent the dentures from tipping. As you become accustomed to chewing, add other foods until you return to your normal diet.

Continue to chew food using both sides of the mouth at the same time. Be cautious with hot or hard foods and sharp-edged bones or shells.

Some people worry about how dentures will affect their speech. Consider how your speech is affected when you have a number of your natural teeth missing.

Pronouncing certain words may require practice. Reading out loud and repeating troublesome words will help. If your dentures "click" while you`re talking, speak more slowly. You may find that your dentures occasionally slip when you laugh, cough or smile. Reposition the dentures by gently biting down and swallowing. If a speaking problem persists, consult your dentist.
 

Denture adhesives



Denture adhesives can provide additional retention for well-fitting dentures. Denture adhesives are not the solution for old, ill-fitting dentures. A poorly fitting denture, which causes constant irritation over a long period, may contribute to the development of sores. These dentures may need a reline or need to be replaced. If your dentures begin to feel loose, or cause pronounced discomfort, consult with your dentist immediately.