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!
Thursday, December 1, 2011
Tuesday, November 22, 2011
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.
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.
Monday, November 21, 2011
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?"
"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.
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.
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.
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.
Sunday, November 20, 2011
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.
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.
Friday, November 18, 2011
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:
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.
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.
Thursday, November 17, 2011
New Year...New Smile
Well, here we are, at the beginning of a new year. Many look at this as an opportunity to make resolutions they never intend to keep. Most of those resolutions are for our own well being but the kids (or grandkids, or dogs, or whatever) get in the way of taking care of ourselves. There is always next year, we say, to lose the weight, get in shape, take care of those teeth that have outlived their usefulness, or get the new dentures you've been promising yourself for years (The ones that will give you your lip back, look more like you before life with dentures, or let you eat again).
How soon you have forgotten that the holiday meals were miserable, only able to eat the mashed potatoes and pumpkin pie, longing for the cookies and other goodies but not able to eat them. How many of you thought to yourself, "I'll call and make a dental appointment as soon as the hustle and bustle of the holidays are over?" You promised yourself at that moment that you would not go through another holiday season like this one again.
What you didn't recognize was that your daughter, sitting next to you, noticed the lack of enthusiasm at the dinner table. Moreover, your wife noticed that you didn't eat more than one rum ball when you winced with pain after tasting the first sweet bite. Then there may be the neighbor, who brings you peanut brittle every year, noticed that it was still on the dish at the New Year's party. Who doesn't love to see the satisfied look on your face only a bite of delicious Christmas fudge can bring? Your family does! Your family and friends have seen your smile fading over the years and it makes them sad for you. Think of it as giving. You give your smile to people all day long. Your kids, grandkids, the grocery clerk... it can go on and on.
So, this simple promise you made to yourself, the promise to get your smile healthy, might not be the selfish resolution you thought. Are you willing to resolve to do something for yourself and those who care about you? The beginning of a new healthy smile is only a phone call away.
How soon you have forgotten that the holiday meals were miserable, only able to eat the mashed potatoes and pumpkin pie, longing for the cookies and other goodies but not able to eat them. How many of you thought to yourself, "I'll call and make a dental appointment as soon as the hustle and bustle of the holidays are over?" You promised yourself at that moment that you would not go through another holiday season like this one again.
What you didn't recognize was that your daughter, sitting next to you, noticed the lack of enthusiasm at the dinner table. Moreover, your wife noticed that you didn't eat more than one rum ball when you winced with pain after tasting the first sweet bite. Then there may be the neighbor, who brings you peanut brittle every year, noticed that it was still on the dish at the New Year's party. Who doesn't love to see the satisfied look on your face only a bite of delicious Christmas fudge can bring? Your family does! Your family and friends have seen your smile fading over the years and it makes them sad for you. Think of it as giving. You give your smile to people all day long. Your kids, grandkids, the grocery clerk... it can go on and on.
So, this simple promise you made to yourself, the promise to get your smile healthy, might not be the selfish resolution you thought. Are you willing to resolve to do something for yourself and those who care about you? The beginning of a new healthy smile is only a phone call away.
Wednesday, November 16, 2011
Fear Factor: The Dentist vs. The Cardiologist
In dental school, the semester had not yet started until the students complained about being required to study the entire human body, when "in real life" all they need to treat are teeth. While the mind of a dental student makes this clear black and white distinction, the experienced dental practitioner knows that the lines between dentistry and medicine are continually getting more blurred.
The merging of dentistry and medicine could not have been more obvious when I met a patient with severe gum disease, who had recently suffered a stroke. Due to the advanced infection in her mouth, she had to have her remaining teeth removed and replaced with dentures. Treatment went beautifully and without incident.
By the very next week she told me that before she got her new dentures, she used to feel chronically tired and her head always "felt funny". She struggled for a way to describe this feeling, but finally realized that she walked around with a sensation that she was about to have another stroke any minute. I couldn't imagine how terrifying it would be to live under the constant fear of a second stroke.
My patient continued by telling me that after her she got her dentures, her symptoms went away almost immediately. She regretted not having treatment done sooner. Not only did her smile look pretty again, but she felt healthier and more energetic. I asked her why she waited so long to get the dental care she so desperately needed. Her answer was one I hear all too often: "I have always been afraid of the dentist."
My question to her and to anyone with the same answer: Aren't you terrified of the rehab hospital? The physician? The cardiologist? Untreated periodontal (gum) disease can very easily lead to heart disease and/or stroke. Let me tell you how...
Most people know all about "CPR". Cardiopulmonary resuscitation is the manual pumping of oxygen-rich blood to the brain and non-beating heart for a better chance of surviving a cardiac arrest. CPR can save your life, but less people know about "CRP," a killer that can take it. C-Reactive Protein (CRP) is a plasma protein produced by the liver while the body is fighting off inflammation from an infection. Scientists believe it plays an important role in immunity as an early defense system against bacteria. Research is ongoing to prove that people with elevated levels of CRP are at a higher risk for cardiovascular disease, diabetes, hypertension, and stroke. Those that have severe periodontal disease are proven to have higher levels of CRP, and therefore are at risk for more than just dentures. Now that's really scary!
If you look at your mouth as a space, it does not seem so big. However, the bacteria and pus wraps around each tooth, making a large surface area. If you take the infection from around 28 teeth and stretch it out across your leg, it would be a huge infection. You would not dream of ignoring it. Controlling the infection, which could be anywhere from a consistent professional/home hygiene regime to full mouth extractions, is critical to your whole body's health.
I cannot definitively say that my patient would not have had her first stroke had she not been afraid of the dentist. I can say since having proper treatment, her risk of having another stroke has dramatically decreased.
Don't let fear be a factor for you! If you think you might fit the patient profile I have described, please call our office and take advantage of the free evaluation to help you get on track to a healthier, more energetic you.
Tuesday, November 15, 2011
Let Them Eat Cake???
THE STORY
Last week my patient was overjoyed about a cucumber and tomato salad. It was the first one she had eaten in several years. As a diabetic, she had been struggling to lose weight and eat in a healthier manner for a long time. Unfortunately, desire was not enough. Her old dentures were preventing her from eating healthy foods. She had described a terrible pain in her face when she wore the old dentures. Because of the pain, eating good food like raw carrots, cauliflower, cucumbers, almonds, oranges and apples were completely out of the question. The soft foods that she could eat were often sweets, like cakes, Twinkies, and donuts. These were exactly what she was trying to avoid.
She has been wearing her new dentures for only a couple of weeks. What made the pain stop?
THE EXPLANATION
The truth is that there are many factors as to why this lady could not eat a cucumber salad with her old dentures. However, her most pronounced problem was the height. The technical term for this is “closed vertical dimension,” which basically means that her dentures were too short for her mouth.
Often a denture is at the correct vertical dimension when it is newly made and inserted. Over the years, the bone naturally erodes away, but the dentures stay the same. The dentures are no longer tall enough to make up for the missing bone. One of the common symptoms of short dentures is a concave profile, where the chin and the nose are coming closer together. Some describe this as the “witch look.” Another symptom is an under-bite, where the lower teeth jut out in front of the upper teeth. This is sometimes described as the "bulldog look."
My patient had both these problems, but also one much more medically serious. She felt excruciating pain radiating from her jaw joint, called the Temporomandibular Joint (TMJ). When touching her teeth together, she had to close her jaws a lot farther than nature had intended her to do originally. This put strain on her TMJ, creating pain not only in the joint, but in the attached muscles needed for chewing. This can be felt all the way up into the temples and beyond the hair line. It is also felt the ear, cheek, and inside and outside of the lower jaw. Hearing can be impaired. The pain can be debilitating.
THE FIX
In an hour long appointment, I set up a laboratory within the treatment room. I created a denture template for my patient with precise measurements and accurate construction. Among other things, I determined the proper lip support, tooth length, shape of her face, and the height of her back teeth, all of which cured her concave profile and corrected her vertical dimension. She was on her way to an extreme bruise-free facelift and pain-free chewing. A few days later, my patient was fitted with dentures meeting her needs, and most particularly her “height requirement.”
THE CONCLUSION
The instant the new dentures were delivered to my patient, she looked shocked. “The pain stopped.”
Her face looks younger, healthier and happier for having properly fitted dentures. She is healthier and happier without the pain. Best of all, she is happiest that she ate her cucumber and tomato salad after craving it for so many years, and she is well on her way to living a healthy lifestyle.
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!
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!
Monday, November 14, 2011
Myth of the Perfect Reline
The Story
Last month I got a desperate visit from a desperate lady. My patient had driven all the way from Oregon to see me. Eight years ago, she had new dentures made in this practice, and moved shortly thereafter to Oregon. Lately, she found that her lower denture was not fitting like it once did when she had left Bakersfield. She told me that her dentures had been getting old and she thought a reline would stretch out a couple more years of use.
A dentist had told her that he could make it perfect with a reline. Ironically, she was more miserable after the reline, and her mouth hurt when she wore her dentures. Eating now was nearly impossible. She was willing to drive as many times from Oregon as it took to get a new set made again in Bakersfield. What happened?
The Explanation
Relines are intended to help the denture re-form to the changing shape of the jaw bones. This is a good solution for people who have osteoporosis and the shape of their jaws change quickly. For those who have dentures that are more than 6-8 years old, there may be another factor to consider.
When a dentist makes a set of dentures, he or she carefully calibrates the way the teeth bite together. This is critical to a denture's success. Bone loss occurs as a natural result of getting older, which causes the bite to be thrown off. When the wearer eats, the denture is knocked around. This causes it to rock, break loose, and hurt. Instead of meshing beautifully, the teeth wreak havoc on the mouth.
Relines do not help the way the teeth bite together. Regardless of the fit, as soon as the teeth touch, disaster strikes. This is what my patient was experiencing.
The Fix
Here is a simple test to tell whether the denture or the bite is causing discomfort. Holding the teeth together, rub the lower jaw forward and backward, and then side to side. If sliding the teeth together dislodges the denture, the dentist may need to correct the bite by selectively grinding specific teeth. If a reline is done without correcting the bite, it will either be of no help at all, or the problem will return within weeks. If it is too far out of line or too old, then making a new set of dentures with an accurate bite is the right answer.
The Conclusion
My patient realized that her discomfort was a warning of having worn an old set of teeth too long. She learned that the myth of the perfect reline can be deceiving. Making a brand new set of dentures relieved her distress and turned her desperation into much needed comfort.
Sunday, November 13, 2011
Stroke Scare
Stroke Scare
THE STORY
Recently a favorite patient came in to see me very scared and very depressed. Of all the hard knocks life had dealt this sweet-natured lady, this seemed to be the straw to break the camel's back. Having fought a number of ailments, disabilities, and pain with great courage and strength, she was horrified to discover a recurring numbness on one side of her face. She had no doubt that she must have had a stroke.
She had noticed that the numbness was connected to eating. After a meal, the lower half of her face on one side would feel numb. A few hours later, the sensation would wear off, only to be triggered again by another meal. Wondering how her mouth could be connected to this problem, she came in to ask advice.
THE EXPLANATION
This patient is not alone in her fear. Two other patients with similar stories came to see me in the same week. Many have come before, and several since. The symptoms include electrical shocks, numbness, and tingling sensations throughout one side of the jaw bone, or mandible.
Fortunately, the explanation is simple.
The nerve going to the lower lip, chin, and part of the cheek is called the Mental Nerve. The Mental nerve exits the mandible in an area about an inch behind the lower canines, down where the gums meet the cheek.
In all denture wearers, the lower ridge resorbs and gets shorter year after year. This causes the denture to settle further down the mandible. As this occurs, the outside flange of the denture begins to rub on where the Mental Nerve exits the mandible.
All goes well until it is necessary to bite a little extra hard on something. The shocking result is similar to what happens when the crazy bone is bumped on the elbow. Instead of the hand feeling numb, the sensation spreads in the face.
THE FIX
The fix is simple. No need to waste energy by panicking. It may be that just a straightforward adjustment is needed on the denture. Or perhaps, if the dentures have been worn for many years, it may indicate that it is time for new dentures. Either option is a whole lot better than discovering a serious stroke!
THE CONCLUSION
In two minutes my patient's problem was solved by an anatomically accurate denture adjustment. She could bite and chew as she pleased without any twinges of pain or numbness. We were both relieved, and laughed at what a terrible stroke scare one little nerve can cause.
Saturday, November 12, 2011
A Bone to Pick
Very few people understand how their own bones work. Most leave that job to a physician. Denture patients, however, have a long list of problems that are related to bone, but most don’t understand it. Turning to the internet, it didn’t take long to see why more people aren’t informed, particularly about the bones in their mouths. All the information is geared towards doctors. The big fifty-cent words are so confusing that it would take hours of researching to get the meaning of the research. Therefore, I’m saving you the misery and decoding the Latin for you, in hopes that you might more thoroughly “know thyself.”
First of all, your bone is alive. There are canals running through the bone for the blood supply to keep it nourished. There is a common misconception that bone is dead like hair and fingernails. In truth, it is more like your skin, where dead cells are brushed off and new ones continually replace them. Bone is constantly changing, keeping the balance between new bone cells building up where old bone cells are tearing down. This is called “remodeling.”
When the teeth are taken out, the tear down process is faster than the rebuilding. This is called “resorption.” Resorption of the bone is the greatest within the first six month of extractions. After this, studies have shown that bone loss averages about 6/10 millimeter per year. This adds up to 3 mm in 5 years, and 6 mm in 10 years.
While 6 millimeters seem miniscule to the average person, it is easier to think of it as the width of a pencil. A denture wearer knows that a pencil width makes all the difference in the world for lip support, facial contour, the ability to eat comfortably, and most particularly self image. Resorption in the lower jaw is four times greater than in the upper jaw, which explains why most denture wearers experience problems with the lower denture first.
There are some factors that speed up bone loss. Some can’t be controlled, like age, gender, bone quality and how long teeth have been missing. Other factors are worth discussing with a physician, like Calcium deficiency, Calcium/Phosphorous imbalance, hormone disorders, use of medications and osteoporosis.
A common cause of bone loss is the uneven bite load from the denture teeth to the bone ridge. Denture quality, oral hygiene, denture wearing habits, and trauma from chewing can affect how fast the bone wears away. Studies show that people who wear their dentures to sleep at night have more bone loss compared to those who only wear them during their awake hours.
For the denture wearer, bone loss means denture edges that dig into the gums, food that gets under it, loss of control, instability, and sometimes a tingling, numb sensation from traumatized nerve bundles. In addition, there are TMJ disorders, or pain in the jaw joints. As the bone shrinks, the denture no longer adequately replaces the tissue that is missing. The jaw has to travel further to make the teeth meet, placing undue stress on the joints, and making the chin and nose come closer together. The shape of the face changes, but worse, can result in hearing loss, headaches and neuromuscular issues. These are only some of the problems I encounter in my practice each day.
It is easier for me to treat some of these bone loss challenges than it is to write about all of them. Quality, customized, and ergonomic dentures solve some of these problems, while others are life-long handicaps for the patient. With this in mind, realize that a denture wearer’s most precious resource is bone and will need it the rest of their lives. Call us and find out what we can do together to protect your greatest resource.
First of all, your bone is alive. There are canals running through the bone for the blood supply to keep it nourished. There is a common misconception that bone is dead like hair and fingernails. In truth, it is more like your skin, where dead cells are brushed off and new ones continually replace them. Bone is constantly changing, keeping the balance between new bone cells building up where old bone cells are tearing down. This is called “remodeling.”
When the teeth are taken out, the tear down process is faster than the rebuilding. This is called “resorption.” Resorption of the bone is the greatest within the first six month of extractions. After this, studies have shown that bone loss averages about 6/10 millimeter per year. This adds up to 3 mm in 5 years, and 6 mm in 10 years.
While 6 millimeters seem miniscule to the average person, it is easier to think of it as the width of a pencil. A denture wearer knows that a pencil width makes all the difference in the world for lip support, facial contour, the ability to eat comfortably, and most particularly self image. Resorption in the lower jaw is four times greater than in the upper jaw, which explains why most denture wearers experience problems with the lower denture first.
There are some factors that speed up bone loss. Some can’t be controlled, like age, gender, bone quality and how long teeth have been missing. Other factors are worth discussing with a physician, like Calcium deficiency, Calcium/Phosphorous imbalance, hormone disorders, use of medications and osteoporosis.
A common cause of bone loss is the uneven bite load from the denture teeth to the bone ridge. Denture quality, oral hygiene, denture wearing habits, and trauma from chewing can affect how fast the bone wears away. Studies show that people who wear their dentures to sleep at night have more bone loss compared to those who only wear them during their awake hours.
For the denture wearer, bone loss means denture edges that dig into the gums, food that gets under it, loss of control, instability, and sometimes a tingling, numb sensation from traumatized nerve bundles. In addition, there are TMJ disorders, or pain in the jaw joints. As the bone shrinks, the denture no longer adequately replaces the tissue that is missing. The jaw has to travel further to make the teeth meet, placing undue stress on the joints, and making the chin and nose come closer together. The shape of the face changes, but worse, can result in hearing loss, headaches and neuromuscular issues. These are only some of the problems I encounter in my practice each day.
It is easier for me to treat some of these bone loss challenges than it is to write about all of them. Quality, customized, and ergonomic dentures solve some of these problems, while others are life-long handicaps for the patient. With this in mind, realize that a denture wearer’s most precious resource is bone and will need it the rest of their lives. Call us and find out what we can do together to protect your greatest resource.
Thursday, November 10, 2011
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.
Meth and the Smile the Bride Deserves...Can the two become one?
I have been noticing an unusual trend in my office. My practice is primarily dentures and partials, so it breaks my heart that a growing number of young patients have shocking tooth decay. Though they are young, they have little choice but to have their teeth removed and replaced with dentures.
My heart was heavy when a girl began treatment with me five months after her wedding. Her wedding album was full of closed-mouth grins instead of the radiant smiles of a bride. Though starting a new life with a new man, a new direction, and a new hope, she was hiding the shame of the personal neglect that came with her life's choices. Her tattered smile was the last remaining shackle to her old life in a world of drugs and abuse. Even though she had been clean for a long time, she still couldn't shed the image of an addict every time she opened her mouth to speak. Hiding her teeth, even in her wedding photos, was her way to cope with the shame.
"Meth Mouth" is becoming a common dental term. It describes the extreme decay and deterioration of teeth brought on by the use of Methamphetamines. On the street, the drug 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. Needless to say, 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 her past was starting over with a new smile. My goal was to make her look so natural that people who had never met her before would not even suspect she was wearing a denture. People who do know her well often give compliments on how lovely she looks. She tells me she has never known what it is like to be beautiful. Working hard to give her the smile she deserves, her outward appearance finally matches the beauty of her inward person. When she smiles, she shines.
Soon after, another young girl stepped into my office asking, "Can you take my teeth out and give me a denture before my wedding? It's in eleven days." You can bet we were on it in a flash. Thanks to the extra hard work put in by my team, her wedding album glows with the brilliance and confidence of an extraordinary bride.
Think you’re too young for dentures?
A young patient of our office pleaded with me to write this article. She is one of three patients that we are currently treating under the age of 36, the youngest being 24. Professors told me in school, “Very soon nobody will need dentures because advances have been made in dentistry.” I wonder what the professor would say to the girl wearing dentures who is my age. She wants to know where she fits in and I can’t say I blame her. All the advertising and marketing for denture care is geared to people over 50, not younger people. She does not identify with these silver-haired ladies. She likes low-cut jeans, bright hair colors, and loud music.
Surprisingly, we see a large number of patients under 45 who already have dentures, or just a few unsavable teeth. They have been victims of car accidents, construction accidents, chronic poor health, illness, neglect, recreational drugs, and worst of all, victims of poor and unethical dentistry. There is a whole class of young people living with the disappointment and shame of having lost their teeth. They are afraid friends will find out their secret, but they are clueless as to where to go to find help.
We have heard people say that the day they got their first denture, they looked 10 years older and went home and cried. Others talk about avoiding social situations where there is food involved because they are embarrassed by how badly they eat with their dentures. They have lost both their youth and their social life, an appalling consequence of a bad set of dentures.
Dentures must be disguised to protect the privacy of the wearer. It takes an artist to create a "young look." Young smiles have character and brilliance that cannot be accomplished with a straight, square, mechanical row of denture teeth. In our office, we take extreme care in the details to obtain this goal, including an extra hour and a half appointment to design a unique look with personality.
Disguising a denture considers how the person looks while both smiling and eating. Comfort and function are just as important in public situations as the appearance. We set aside extra time for a special technique that creates an ergonomic lower denture that is comfortable when the patient eats. People find that within about 6 months of practice and persistence they can learn to eat sandwiches, buffalo wings, and ribs with the rest of their friends.
There is a large group of young and vibrant people desperately needing the proper denture care to allow them to live their lives to the fullest. This segment of our population has largely been ignored and cries out for understanding and a viable solution to this ever present need for proper dentures.
So where does our young patient fit in? She belongs securely within her loving family and friends, eating comfortably during holiday parties, smiling often, and living a fun, inspiring life, unhindered by poor self-esteem, pain and embarrassment. With a little time, a lot of work and close attention to details, she will have all of this at her command. She deserves nothing less.
We invite you to call our office with your questions and take advantage of our free evaluation to help you with your denture needs.
Second Smile Denture Care
3301 19th Street
Bakersfield, CA 93301
Tel: 661-325-1263
Just Because it Doesn’t Hurt...
A 96 year old man named Harold came into the office needing help with his full upper denture and lower partial. He had just a few teeth left in the front part of his lower jaw, and the partial denture hung very precariously onto faltering teeth. He had the obvious problems that he could tell me about, like a broken tooth, a badly fitting denture and denture teeth that do not meet up correctly in the back. Looking in his mouth, I could see a bigger problem that he did not know about. He only knew about the tip of the iceberg.
The chewing teeth on the part of the partial that rests on the soft tissue were significantly shorter than the natural teeth in front, attesting to severe bone loss in back since his molars were extracted. This situation had been aggravated by the natural teeth growing taller as the partial tipped further and further down. Since the back teeth could not meet up anymore, Harold had been using his front teeth to chew like a rabbit. The front part of the upper denture was overloaded, beating the upper gums up until the bone went away. The tissue that used to be a solid, firm footing to hold a denture in place had become spongy and jello- like, making the front teeth appear to bounce when he chewed. His chin and nose were closing in on each other. Meanwhile, the bony tissue in the back of his palate had grown unnaturally downward. Between the sunken front and the elongated back, his upper denture looked like it was frowning, the back teeth showing more than the front. This gave Harold a permanent scowl, even when he was in a good mood. Yes, the dentures did not fit, but as you can see, that was the least of his problems.
This cocktail of symptoms mixes into the classical condition called Combination Syndrome, first described in an article in 1972 by Dr. Ellsworth Kelly, a UCSF professor. Dr. Kelly used the term “Combination” because the lower partial is supported half on the teeth and half on the tissue. When the tissue support is lost, the symptoms show up. Since I started writing this article, I have seen at least one case as extreme as Harold’s per week. (You know who you are because I have told you that I am writing this article for you.)
Harold will always have problems. There is no surgery adequate to replace the destroyed bone so that he can wear a denture without problems. 60% of all the bone grafted in surgery will dissolve away within the first year. Sometimes the surgeon will cut off the flabby tissue, but that can reduce any suction the denture might have otherwise had. With so little bone, even implants would require extensive reconstructive surgery and still have a high failure rate. There is no miracle cure for the damage already done. Denture wearers who only go to the dentist when it hurts are most subject to this kind of irreversible damage. The only way to totally avoid this dilemma is to have never allowed this situation in the first place. This means, protect your most precious resource, your bone!
If you have an upper denture against a lower partial, visit your dentist every year to check on the condition of your mouth. Plan to replace your prostheses every 3 to 6 years. That may sound like a lot, but remember, there is no going back. I have seen Combination Syndrome in 40 year olds. How will it look in 20 more years? A 96 year old might overlook the fact that his front teeth bounce up and down when talking, but picture yourself meeting your son’s new fiance, or convincing a potential customer to buy your product. Far worse than any of these is when your 4 year old grandson asks why your teeth move so funny.
There is some good news to be had. I was able to make Harold a new set of dentures that would stop destroying his mouth. Part of the solution was to move all the chewing capacity to the back teeth where the footing was solid. According to an article on treating Combination Syndrome by William S. Jameson, D.D.S. in 2001, the front teeth are to be used only for helping you speak properly and for smiling only. The front teeth should never touch, especially for chewing and biting. Customizing for proper retention will keep his upper denture from falling out, even if the front teeth still wiggles slightly when he touches his teeth together. Harold will get by, but just barely.
Let his story be a wake up call for you. Protect yourself and get checked by a dentist before your symptoms get any worse. Call me with any questions, and see what can be done for you Just Because it Doesn’t Hurt...
The chewing teeth on the part of the partial that rests on the soft tissue were significantly shorter than the natural teeth in front, attesting to severe bone loss in back since his molars were extracted. This situation had been aggravated by the natural teeth growing taller as the partial tipped further and further down. Since the back teeth could not meet up anymore, Harold had been using his front teeth to chew like a rabbit. The front part of the upper denture was overloaded, beating the upper gums up until the bone went away. The tissue that used to be a solid, firm footing to hold a denture in place had become spongy and jello- like, making the front teeth appear to bounce when he chewed. His chin and nose were closing in on each other. Meanwhile, the bony tissue in the back of his palate had grown unnaturally downward. Between the sunken front and the elongated back, his upper denture looked like it was frowning, the back teeth showing more than the front. This gave Harold a permanent scowl, even when he was in a good mood. Yes, the dentures did not fit, but as you can see, that was the least of his problems.
This cocktail of symptoms mixes into the classical condition called Combination Syndrome, first described in an article in 1972 by Dr. Ellsworth Kelly, a UCSF professor. Dr. Kelly used the term “Combination” because the lower partial is supported half on the teeth and half on the tissue. When the tissue support is lost, the symptoms show up. Since I started writing this article, I have seen at least one case as extreme as Harold’s per week. (You know who you are because I have told you that I am writing this article for you.)
Harold will always have problems. There is no surgery adequate to replace the destroyed bone so that he can wear a denture without problems. 60% of all the bone grafted in surgery will dissolve away within the first year. Sometimes the surgeon will cut off the flabby tissue, but that can reduce any suction the denture might have otherwise had. With so little bone, even implants would require extensive reconstructive surgery and still have a high failure rate. There is no miracle cure for the damage already done. Denture wearers who only go to the dentist when it hurts are most subject to this kind of irreversible damage. The only way to totally avoid this dilemma is to have never allowed this situation in the first place. This means, protect your most precious resource, your bone!
If you have an upper denture against a lower partial, visit your dentist every year to check on the condition of your mouth. Plan to replace your prostheses every 3 to 6 years. That may sound like a lot, but remember, there is no going back. I have seen Combination Syndrome in 40 year olds. How will it look in 20 more years? A 96 year old might overlook the fact that his front teeth bounce up and down when talking, but picture yourself meeting your son’s new fiance, or convincing a potential customer to buy your product. Far worse than any of these is when your 4 year old grandson asks why your teeth move so funny.
There is some good news to be had. I was able to make Harold a new set of dentures that would stop destroying his mouth. Part of the solution was to move all the chewing capacity to the back teeth where the footing was solid. According to an article on treating Combination Syndrome by William S. Jameson, D.D.S. in 2001, the front teeth are to be used only for helping you speak properly and for smiling only. The front teeth should never touch, especially for chewing and biting. Customizing for proper retention will keep his upper denture from falling out, even if the front teeth still wiggles slightly when he touches his teeth together. Harold will get by, but just barely.
Let his story be a wake up call for you. Protect yourself and get checked by a dentist before your symptoms get any worse. Call me with any questions, and see what can be done for you Just Because it Doesn’t Hurt...
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