Have You Seen the Recluse?

The Brown Recluse is a name that strikes fear into hearts.  We hope we might never encounter this eight-legged arachnid.  Less familiar but equally terrifying, is the Denture Recluse, the person who slowly reorients their lifestyle around an poor-fitting denture and withdraws from society.  While a Recluse spider is deadly to us, a Denture Recluse is deadly to themselves.  The question is, What does one look like?

My father’s aunt is a lovely lady.  She lives far enough up north that I don’t see her often, but when I did, she was always the one to host our family reunions.  In a small mountain town called Paradise, we'd gather to walk through the towering pines, catch up on each other’s lives, and....EAT.  There was always serious eating to be done at these gatherings, just like Thanksgiving and Christmas also involve seriously good food.  This last time we saw Auntie, she quietly let us go out to dinner without her, saying dismissively, “Getting older is hell.” 

I learned Auntie had new dentures that were uncomfortable for chewing.  She found it embarrassing to be seen in public eating so slowly and painfully.  She would rather sit at home, alone in complete isolation than go out with the family that she only sees once a year.  It was evident she was suffering from depression and wasting self-esteem.  While the rest of the family celebrated being together, she became a Recluse.  

Such isolation is terrible.  This is not a condition limited to one woman in a Northern mountain town.  I see people like this in my practice every day, and it breaks my heart.  

There is an antidote for the poison of the deadly Denture Recluse.  It comes in the form of a new smile.  Particularly with the holidays coming up, I find it is important to let people find their confidence again with a custom, well-fitting, beautiful dentures so they don’t have to miss one more event or excuse themselves from one more gathering. 

The greatest reward is to hear things like, “I feel like I have my life back,” or “I went to church on Sunday for the first time after an entire year.”  How can I not love my work?  Don't be left out of this year's family celebrations.  Call today to learn how we can help return you to life!

Have A Plan?

The lesson universally taught in Dental Universities is that decay, infection, tumors, cysts and other serious problems must be addressed first before any other concerns. This applies, for instance, where a patient would like elective veneers to straighten a smile, but refuses to have the fillings required to stop the decay in the molars. I once had a patient who only wanted to have cosmetic dentistry, and insisted that I ignore the greater evil of decay and periodontal disease. In spite of my description of the inevitable root canals and tooth loss, the patient remained unmoved. Faced with this dilemma, I chose not to treat this kind of patient at all. It is unethical to treat elective issues in the presence of disease.

Last week, a patient came to me for a second opinion after visiting a clinic whose ads promised to make an upper denture for $275. She was looking to replace her upper denture because it was loose. Surprisingly, the clinic had quoted $6,000 dollars to place implants in her upper jaw under her existing upper denture, rather than replace it. When she came to my office for standard x-rays, we discovered that this clinic had not diagnosed the abscesses and decaying crowns in her lower jaw. I asked if they had talked about fixing her natural teeth, and she said they had never mentioned it.

Think a moment on this proposed treatment. First, my patient has a denture nearly a decade old. It is worn out, loose and needs replacing. These implants are unnecessary if they would make her a new, reliable, custom-fitting denture. 

Secondly, by the time she has suffered an abscess and her lower teeth have decayed out, her only option will be to get all her teeth pulled. She will have to go back to this clinic for more implants, costing several thousand dollars more, in addition to a new set of complete dentures. The money this clinic would receive for these implants is more than if she were to get her natural teeth cleaned and filled, and a new upper denture made to chew against them. 

This clinic was failing to offer treatment for her most basic needs. She was being given a poor and arguably unethical dentistry solution that will almost certainly guarantee having to return again for more expensive treatment. She felt like she had been completely taken in by the promise of cheap dentures. 

Be involved in your dental care. When going to a dentist, it is imperative that you consider all of the following issues. 

• Make sure your dentist always has updated x-rays when giving a diagnosis. Decay, bone tumors, cysts, abscesses, and other hidden problems are easily seen and diagnosed with x-rays.
• Ask for a complete oral exam and cancer screening. Early detection of cancer and periodontal disease is essential for maximum treatment.
• Always make sure that the dentist presents a comprehensive treatment plan that includes the entire mouth. Dentistry should be done in planned phases, not one tooth at a time.
• Be suspicious of a treatment plan where the only work to be done is implants. Like this patient, it is a fast way to lose your money and get nowhere.

No More Dentists???

"Wouldn't it be easier to take out all my teeth and have dentures?"
"I won't ever have to go to the dentist again, will I?"
"What are dentures anyway?"

The questions above are only a few asked by patients each week. In my practice, we see a variety of patients in many stages of tooth loss. Here are my answers to some commonly asked questions to help clarify the issues and dispel some rumors.

There are two common types of designs for removable dentures. Partials are generally made with a metal framework and acrylic, replacing teeth in the areas where the patient is missing them. In contrast, a full denture is what most people picture when they talk about "false teeth". Made of pink acrylic and porcelain or plastic teeth, they are designed to give the patient with no teeth the ability to look good and eat well. 

I have heard people say that the easiest solution to their dental problems would be to have all their teeth removed and replaced with full dentures. Veteran denture wearers are shaking their heads and wondering how anyone could think that way. I tell patients that dentures are not a replacement for teeth. They are a replacement for no teeth at all. If there is still hope for your natural teeth, by all means, do what you can to save them. Don't take the decision to get dentures lightly. If your dental situation has left you in a desperate position, dentures are a great option to restore your smile and your confidence. That is something I can do to help you.

Some think dentures are a one-time fix, where once they have dentures they never need to visit the dentist again. This cannot be further from the truth. Bone shrinks and tissue changes constantly. They need to be replaced every 6-10 years. Very often, a dentist can see early stages of osteoporosis before the physician diagnoses it. Current x-rays are important to check the degree of bone loss and screen for bone diseases. Denture wearers need a yearly check-up. The dentist will assure the denture is fitting correctly and perform an oral cancer screening. Yearly check-ups and maintenance can extend the life of a denture.

If you are interested in finding out how my office can help you, feel free to call for a consultation at no charge.

An attractive smile - or an attractive denture?

Every patient is anxious to see what their new denture looks like, and for good reason. But how can you judge if it's really going to be grand?

Coco Chanel, the world-renowned fashion designer, once said that if you notice a lady's clothes, she is poorly dressed; if you notice the lady instead, she's impeccably dressed. That same philosophy can help denture patients to assess for themselves what looks right. During the wax try-in appointment- when we're "fine-tuning" a new denture- some people are apt to peer at the denture while they hold it in their hands, or evaluate what they see in the mirror through bifocals. While this "view" will give you an idea of the construction of your new denture, it's not how other people will see it.
What goes into a good denture?

The dentist can create a rugged or delicate, masculine or feminine, assertive or passive, youthful or mature look. Youthfulness can be achieved by a curved smile line, showing the two front teeth more than those on each side, and having a darker translucent edge on those front teeth. Teeth can be brought down where they are more visible and placed further forward to plump out a thin upper lip. If teeth are arranged evenly in a flat line, it makes a person look older. Any of these qualities can be realized in a new denture, but they won't show while the denture is in your hand. A good dentist invests time and all his skill to make your denture look best- in your mouth, where it belongs.

“How Come No One Told Me That Before”

It is easy for me to forget that not everyone grew up in a family where dentures were the main topic of conversation at the dinner table every night. Working for my dad in this practice since I was 13 has made me take for granted some of the basics of denture care. After explaining some fundamental rules for cleaning and caring for dentures, I’ve heard several patients exclaim, “How come no one told me that before?” It made me wonder how many more people out there have never heard it either, and if putting into print would help
Denture Care 101

1. Always clean your dentures over a towel on the counter. If your denture slips out of your hands, it will be less likely to break on a towel than the tile sink.
2. You can use water or a product like Efferdent Denture Cleaner to clean your dentures. Just be sure to follow the instructions on the package.
3. Brush your dentures after they have soaked overnight. In the office we use a bar of Ivory soap, but most patients prefer the minty flavor of denture paste. Do not use regular toothpaste on your denture, because it is too abrasive and can wear the plastic right off. Dentu-Creme and Complete are two examples of denture pastes that will not harm the denture. 
4. For removal of tartar and calcium deposits, you may soak your dentures in a 1:3 vinegar solution for 3-4 hours once a week, or less often as needed. Scrub well and rinse. The build-up should come right off.
5. When your dentures are not in your mouth, they should always be in water. This keeps them hydrated and prevents them from warping out of shape. Do not keep a spare set in water because it will mildew. However, if you need to wear your back-up set in an emergency, remember it will take some time to rehydrate before it starts feeling familiar again.
6. I strongly encourage you to take your dentures out at night. This allows the tissue in your mouth time to breathe. It also causes fewer denture sores and trauma to the bone as you are unable to clench or grind in your sleep.
Pop Quiz: What To Do If Your Denture Breaks?

Once a denture breaks, it will be up to your dentist to determine if it is repairable. He or she will weigh up factors, like the age of the denture and if pieces are missing, before telling you whether it can be done. Once broken, the integrity of the denture is compromised. Therefore, if it can be repaired, there is no guarantee to the longevity. So be careful! Otherwise...
1. Call the office first thing and arrange a time to bring in your clean denture.
2. Do not glue the denture back together yourself. It is nearly impossible for a technician to get all the glue out and piece the denture together again correctly. When this happens, the denture may no longer fit properly.
3. Be prepared to accept that if a tooth needs replacing, it may not match perfectly, especially if you take it to an office other than the one that made it. In most cases, the technician can match it so closely that you might not even notice, but this information should be given to you prior to agreeing on the repair.
4. Be prepared for a reasonable fee. Some insurances cover the cost of repairs so be sure to ask the financial coordinator.
While I don’t expect you to talk about denture care over your dinner table, I hope that my family’s meal time chatter will help you take better care of your dental investment. If you have any other questions or anecdotal solutions to common denture issues, feel free to call my office and share.

Breaking From the Past: Meth Recovery and the Dentist

A young man came into my office a year ago with an extreme amount of decay and a story.  Unashamed to share his past with me, he described a long-term love affair with Methamphetamines.  Though he had been clean for six years, the effects of the drug were evident every time he laughed or smiled.  Often, people stared at his mouth while he talked.  He felt as if he lost credibility with people as soon as they noticed the condition of his teeth.  As a result, he hid his smile, the last shackle that kept him tied to an old way of life. God helped him with his addiction; I had to help him with his teeth. 

In a practice where I only do dentures and partials, I have seen a growing number of people in their 30's with massive tooth decay.  Though they are young, they have little choice but to have their teeth removed and replaced with dentures.
 
The drug itself is not the culprit, as many believe, but the habits it creates in the person. On the street, it is called Meth, Speed, Ice, Crank, Glass, and Crystal. It is cheaper and easier to obtain than Cocaine, and the high lasts around 12 hours rather than Cocaine’s one.  It is hardly surprising that Meth is a popular drug.  As the number of users increases, so does the devastation. According to the American Dental Association, Meth rots teeth quickly by causing dry mouth, cravings for soda, tooth grinding, clenching, and long periods of self-neglect. 
 
Part of my patient’s recovery and break from his past was starting over with a new smile.  I made him look so natural that people who had never met him before did not even suspect he was wearing a denture.  People who already know him give compliments on how much younger and more handsome he looks.  Naturally social, he is seen in church laughing easily, smiling and joking.  He doesn’t know it, but I overhear girls in the congregation talking about how good he looks.  I can’t help but smile to myself knowing that for some people, “Mysterious Ways ” just may include a trip to the dentist.

Elements of a Good Denture

I recently got a phone call from a rehab hospital. A daughter called with the concern that her mother's lower denture might need a reline. She explained to me that her mom had been in for a check-up only 6 months before. Suddenly her lower denture was very loose and uncomfortable and she was unable to talk and eat. The daughter was desperate to help her mom, and thought an emergency reline would be a quick and easy solution. In speaking to her a few more minutes, I found out the reason mom is in the hospital was due to a serious stroke. With this information, I explained to her why the reline is not the best answer for this problem.

A stroke is a blood clot lodged in the brain. This in no way changes the shape of a patient's mouth. What does change is the patient's ability to control that denture since their muscles no longer work as they used to. A reline will only change the fit of the denture, so this is a faulty solution to her problem. 

A properly fitting upper denture stays in place with suction. A lower denture, however, stays in place by having:

• a shape that balances with the muscles in all directions when the mouth is at rest,
• a shape that produces no lifting forces during talking, swallowing, or opening the mouth,
• a bite that does not rock the dentures when chewing,
• a tongue that has "learned" to stay in a relaxed position and does not push the denture up when the mouth is open.

The first three elements of a good lower denture are entirely in the skilled hands of the dentist. The fourth element is completely up to the patient. A good dentist, however, can help by teaching a patient some techniques to control his tongue.

The majority of patients who come to see me for the first time have unsuccessful dentures. While most people have one of the above denture design problems, some people just have a tongue that is not doing what it should. Most of these people survive with the help of denture adhesive but with a concerted effort, they can eliminate the problem and the need for the unpleasant glue. Others manage with the assistance of a denture stabilization implant. These are posts placed in the bone and attach with snaps to the denture. In some cases, this can be the best option. For others the surgical process is unnecessary if all that is needed is training and practice. 

My patient has since fully recovered from her stroke and regained muscle control. The reline would have ruined her denture creating the need for a new one.