I’m missing a bunch of teeth! What should I do?
Depending on how many teeth are missing, there are a variety of options available to replace them. If all of your teeth are missing from one or both arches, or jaws, all the uppers and/or all of the lowers, then one option might be a complete denture. It is called complete because it replaces ALL of the teeth in that arch. This was decent middle of last century dentistry. They work, but they stay in place mainly by suction. For an upper denture, suction can generally be obtained and fairly decent retention can generally be achieved. That is not so for a lower denture. Typically, the ridge, the bone remaining when the teeth are removed, is small and narrow. Not good for creating suction. Lower dentures move around. A lot. Too many times denture stickum becomes your best friend. The movement in the denture makes eating and talking more difficult. Sore spots are common with dentures.
Another disadvantage to a complete denture is the amount of “stuff” in your mouth. An upper denture needs to cover the roof of your mouth for it to get suction to stay in place. Well, this requires a thickness of plastic that affects your taste and your talking. If you are one of those people with a touchy gag reflex, then getting used to all of this “stuff” in your mouth can be a challenge, to say the least. A lower denture fits part way under your tongue along the inside of your mouth. As you move your tongue while eating and talking, the denture likely will move around. Complete dentures work, but they are marginal at best.
How can we deal with this? Implants with special attachments can be placed in the jaw. Corresponding attachments can be placed in the dentures which will allow the denture to snap into place. This way, the denture will stay in place better. These snap-type of attachments are an easy solution for a loose fitting denture. They aren’t perfect, but they are a big improvement. Over time, parts wear out and the denture may become loose. When this occurs, new parts can quickly and easily be swapped out to regain the lost retention. Typically, this is done in the office while you wait.
I’m missing a few teeth in one or both of my jaws. What can I do?
To remedy this situation, there are two basic options available to you. Replacements can be made that are either removable and come out at night or are not removable and do not come out. The removable option involves making what is called a Removable Partial Denture: a partial. It is to be taken out at night. Like a complete denture, this is an older, last century, solution for missing teeth.
With a removable partial denture, you will have material across the roof of your mouth or material under your tongue, next to the remaining lower teeth. Typically, springy, flexible metal wires wrap around the teeth adjacent to the missing teeth to provide the retention to hold the device in place. These are also designed to be taken out at night. The fit of a partial can be anywhere from fairly tight to relatively loose, depending on the number and the position of the teeth being replaced. If there are no teeth in the back to which your partial will connect, there will be up and down movement, especially when you eat something relatively sticky. In many instances this can be overcome by placing implants in the jaw and then making attachments between the partial denture and the implants. In this manner, the partial can still be removed at night but it should fit more snugly.
I am uncomfortable with taking my teeth out at night. What else can I do?
Welcome to the 21st century! These days there are a myriad of solutions available so you do not have to have removable teeth. Implants, artificial tooth roots, can be placed in the jaw to provide “things” to which we can connect replacement teeth. You may have seen ads in the paper or on TV about “All-on -Four” or “Teeth-in-a-Day”. These are just two of the solutions available so you do not have to have a complete denture, a “plate”, or a removable partial denture. Dental implants allow us the ability to screw or cement replacement teeth in your mouth. Implant-retained devices are not as bulky as dentures or partials, nor do they cover a large part of your mouth. They can feel more natural allowing you to eat and talk more comfortably. They can allow you to have a very nice smile, as well.
Q: Why did the cell phone come to see Dr. Hollander?
A: It was having trouble with its Bluetooth!