Dentures are prosthetic devices designed to help patients with missing teeth perform daily activities that would otherwise be difficult. Patients who have lost their natural teeth due to decay, periodontal disease, or injury may suffer from further decay, difficulty eating and speaking. The absence of teeth can also lead to a sunken, collapsed appearance in the mouth area. By restoring the physical presence of teeth, this malformation is corrected and the patient can maintain their normal appearance and function.
Types of Dentures
There are three types of dentures:
Where and how many teeth you are missing dictates what method is usually used to replace them.
Fixed partial dentures (bridges) can act just like natural teeth. As the name implies, they are not removable. They are very aesthetic and can be completed in a short amount of time, usually two visits. They are usually made of a porcelain fused to metal, all porcelain, or gold. Other than the gold bridges, they can be hidden well and typically do not show any metal. They work best when only one or very few teeth are missing in one arch. The only downside is asking some teeth to do the job of many, which can increase the possibility of fracture of the appliance or the abutment teeth. In some cases, the fixed version is not possible for patients due to complicating factors. See "crowns and bridges" for more details on the procedure.
Removable partial dentures are an excellent and cost effective way of restoring multiple missing teeth in the same arch (upper or lower). Teeth are usually prepared in order to get the partials to fit tightly to the teeth and provide retention. No anesthetic is required. An impression is taken of the prepared teeth, a metal framework is constructed at a dental laboratory, and then tried in to ensure fit. A bite is taken to capture how the teeth fit together. The teeth are set in wax and tried in the mouth and then processed by the lab. The whole procedure can take roughly six weeks and up to three visits before the appliance is delivered. Care is taken in order to get an excellent fit and function. Sometimes adjustments are needed at later appointments. Removable appliances take some adaptation. Some people are unable to adapt to removable partial dentures because of the bulky nature and some minor movement of the appliances. There is more maintenance with partial dentures and your dental team will explain these to you.
Full or complete dentures are necessary when all the teeth in an arch are lost due to multiple factors. One thing to keep in mind is the best denture can typically create only 30% chewing ability when compared to natural teeth. Dentures are not anchored in bone like natural teeth and act like glorified suction cups. Maxillary (top jaw) dentures tend to fit and perform better than lower dentures. Upper dentures perform well and are usually very stable because they can achieve good suction. Mandibular (bottom jaw) dentures can be difficult to get used to and are much more effective if stabilized. This can be accomplished with natural teeth root anchors (overdenture) or implants (implant retained denture). The lower denture has cheek and tongue musculature to work around and is sitting on top of a "pond." There is less surface area on a lower denture to get suction and stability compared to an upper denture. Most dentures take approximately four visits and six weeks before they are delivered and usually require multiple adjustment appointments. The denture learning curve can be difficult, but with proper construction can be very beautiful and functional.
A tooth is primarily a mineral shell that encloses a small amount of nerve and blood vessels. This is referred to as the pulp. Through a small opening in the tooth, we clean the inside of the root to remove the damaged nerve or pulp. It is then disinfected, dried, and sealed with a filler to prevent bacterial growth. Depending on the anatomy of the tooth, and the extent of inflammation, this may take more than one appointment. The internal part of the tooth is now free of nerve, but the tooth is still nourished by surrounding nerve and tissues. This makes it possible to still "feel" the tooth. Depending on the extent of tooth structure lost, a crown (cap) may or may not be needed. A root canal makes it possible to keep a tooth in your mouth that would otherwise need to be removed. If you consider the cost of bridgework, implant, or partial denture to replace a missing tooth, a root canal can be a cost effective way of keeping teeth in your mouth. There is nothing that outperforms your own teeth.
Most people hear the phrase "root canal" and instantly cringe. They have most likely had or heard of a bad experience. Root canals do not need to be painful. When a tooth needs a root canal, it is infected or is in the process of becoming infected. This can happen with deep cavities, broken teeth, or trauma. A tooth that is not infected can easily be sedated under local anesthesia and the procedure can be done painlessly. If the tooth is infected and hurts to the touch an antibiotic needs to be taken before the start of a root canal; in order to make it possible to sedate or put the tooth to sleep.
A tooth extraction, or "pulling of a tooth", is one of the most common procedures performed at a dentist's office. The extraction of a tooth may be recommended for the following reasons:
- Advanced decay
- Broken teeth that cannot be restored
- Impacted wisdom teeth
- Loose teeth that have lost bony support
- In preparation for braces
The tooth extraction procedure may require removal of soft or hard tissue, depending on whether the tooth is fully erupted. The extraction is performed under local anesthetic. After the extraction, stitches may be necessary. Antibiotics before or after an extraction may be prescribed if there is an infection present. Patients taking blood thinners may have to stop taking these in order to have the extraction. This will have to be discussed with the dentist and your doctor before any action is taken.