Dentures and Quality
As we suffer through this cold snap, my mind sometimes drifts back to days past where the weather was a bit nicer. Last spring, I was fortunate enough to attend a performance windsurfing clinic in Florida. One of the best sailors in our class was a fellow from New York who invented toys for a living. He was unfortunate to have lost one of his legs just below the knee.
One day at lunch I mentioned to him that I found it amazing that he could sail so well with a prosthetic limb. He told me that he actually designed and constructed his own attachments for his leg to allow him to utilize the foot straps on the board.
He then mentioned that the most critical part of a prosthetic limb is the interface between the prosthetic and the limb. He had many different prosthetic legs made and was not able to participate in sports. Apparently the fit is so crucial that any errors or distortions create extreme discomfort when extra stress is placed on the prosthesis. Eventually he was able to find someone who could make an interface that worked for him. He had to travel over 300 miles to see this man and the cost of the prosthesis was 5 times that of his previous legs. Before he had experienced the better artificial leg, he was okay with the leg that he had and was adapting; he thought that he would just have to learn to live with the limitations imposed by his disability. Now that he has the new limb, he could never go back to the other.
Now you are saying, “Brian has the cold weather frozen your brain, what has this to do with dentistry?”
I found that in some respects, the situation described above is very similar to the full and partial dentures. There are millions of people who are using dentures as a replacement for their natural teeth. Most of these dental prosthesis, while functional, are not optimal.
Those wearing these appliances may not even know that there could be a substantial improvement in comfort, esthetics and the ability to speak.
The common perception about dentures is that they are equal replacements to natural teeth. This is far from the truth. Teeth are anchored in the gums and jawbones, dentures sit on top of the gums. Dentures are held in place by suction. Of course the upper dentures with six times the surface area suck in better.
For dentures to function at the maximum efficiency, they must be made in a very precise manner. The interface between the denture and the gums must be very carefully constructed. The extensions of the edges of the denture have to be exact to prevent sores yet allow maximum suction with minimal movement. The way the teeth hit in function (occlusion) has to be made in a way that maximizes the chewing ability yet minimizes the dislodgment of the dentures. Of course, the teeth must look good and be set up to allow for proper speech.
Since the bone that supported the teeth is no longer required for teeth, it slowly disappears. This means that the fit of a denture is constantly degrading. It is important that dentures be relined every two years.
The best way to minimize the problems associated with dentures is to have dental implants placed. This moves the load bearing responsibility from the gums back to the bone where it belongs. Implant supported dentures are the ultimate in dental prosthetics.
If you have dentures and feel that you are not ready to have implant-supported teeth, you should get the best dentures that you can. A high quality set of dentures may cost you 2-3 times as much as a bargain denture, but you will appreciate the difference.
If you have any questions about dentures and the options available to you ask Dr. Saby.
Tags: Comprehensive Dentistry, Cosmetic Dentistry, crowns, dentistry, Dr. Saby, implant, restorative dentistry, Saby
March 29th, 2009 at 1:47 am
Dr. Saby,
I have a question and I am confident that you will know the answer. I am 52 yrs old and got upper and lower dentures. The lower are supported with implants and work wonderfully. The upper denture was made with “suction ” and is horrible. The dentist does not do implant for the upper denture because the placement of the implant is too close to the sinus cavity. I was wanting the implants for both dentures. The Dentist sold me on the new suction denture and it does not work. The full palate is still there and after trying three times it is still not working.
I am looking to talk to others that have had this done. I need to know if this procedure has worked for anyone else. I do not expect you to put down dental procedures or another Dentist. I am very unhappy and was expecting something that would work better than this.
I know people that have upper dentures without the suction and never have to wear paste. I would have gone another route if I had known that this suction did not work. Now I have too much money invested to do anything differently. I do not have dental insurance.
Thank you for taking this letter. I would like to know you thoughts on the the suction.
Sorry I wrote so much. You are the first person I have been able to vent my problem.
Sincerely,
Iris Cox
March 29th, 2009 at 10:37 am
Iris:
It is interesting that in some situations, an adequate upper denture feels loose once the lower denture has been fixed in place. Usually the lower denture is more mobile than the upper, so the upper feels good relatively. Once the lower is not moving, the upper movement becomes evident.
If you are having problems retaining your upper denture, dental implants would be the answer for you. You could have implants placed, even though your sinus cavity is large. A procedure called a sinus lift is available. In that instance, the floor of the sinus is lifted and a bone graft is placed, this will give you sufficient bone to allow for the implants. This is a fairly straight forward procedure that would be done in the dental chair. Depending on how many implants you have placed, the upper denture could be replaced with a fixed restoration, or you could have an implant retained denture that clips onto the implants (you would not need the palate covered with either solution).
If finances do not allow for you to have the implant procedure done, you should be able to get adequate suction to maintain your upper denture. You should have the extensions of the denture checked to make sure they are not too long, which would decrease suction. The bite should also be checked to make sure that it is not getting loose due to premature bite contacts. After these have been checked and corrected as possible you could have a procedure called a functional reline. Here you would have a soft pliable material placed in you upper denture and would wear it for a few days. The material would adapt to your gums, giving you the optimal fit. The denture would then be processed to acrylic and should have better retention.