Tooth and Bone Loss
The jaws are comprised of two types of bone; basal bone, and alveolar bone that supports the roots of the teeth. Once a tooth is lost through disease or trauma there will be an empty socket. Without intervention, this alveolar bone will resorb away with 90% being lost within a year. When all teeth are lost, all of the alveolar bone will be lost. The upper jaw gets smaller and narrower and the lower smaller and weaker but effectively wider. The face gets shorter, the lips become flat and narrow. The edentulous face looks 10 to 15 years older and more wrinkled. Various extraction socket preservation materials are now available that are demonstrating differing levels of success. Surgical skill, careful case planning and denture design remain the most important aspects of treatment to minimize alveolar bone resorption.
A prosthodontist has acquired the extensive knowledge and the clinical skills necessary to fabricate dentures that not only improve masticatory function but also improve facial appearance to help wind back the clock a few years. A prosthodontist is trained to perform all of the procedures in the laboratory as well as the clinical stages in making complete and partial dentures. This allows the prosthodontist to make changes at the appointment and have greater control over the laboratory work and fabrication of the final prostheses. Dr. Wright is a Denture Specialist Redding.
All dentures are not the same nor are they created equally. If a patient saw several dentures side-by-side on a table, they would immediately see the difference in quality for themselves. Most people can tell if a person is wearing poor or classic “store-bought” looking dentures. The perception is usually based on troubling childhood memories of a relative who had dentures and difficulties with them or saw those dentures sitting in a glass of water in the bathroom and avowed never to lose his or her teeth. A prosthodontist is capable of making dentures for patients, which most people would never guess were dentures. Those dentures will make the patient look and feel good, inspiring confidence and vitality.
The quality of the teeth can vary greatly affecting the wear rate and resistance to abrasion and staining. Denture teeth are made out of acrylic (plastic), layered acrylic, reinforced acrylic, resin composite or porcelain. Porcelain teeth last and look the best but porcelain teeth amount for about only 1% of denture teeth made today. The reason for this is simple: it requires a lot more time and skill on the part of the dentist and dental technician to make dentures with porcelain teeth. Dr. Wright prefers to make dentures using porcelain teeth, but not the first set for the patient.
The colour, shading and characterization of the denture base are equally important to attaining an aesthetic result. You would not want to be offered a choice of a “medical insurance plan” glass eye that only came in two solid shades (blue or brown). Most “dental insurance plan fee” dentures are usually made in a bubble gum pink plastic base giving them the “Dollar-Store” Fake Teeth appearance. The time and skill that goes into creating a realistic denture base is never noticed in a patient’s mouth and that is the way it should be. No one really wants to receive the “compliment” – Wow, I do like your new dentures! They would rather hear the vague and unspecified compliment - You are looking good! Have you been on holiday?
Dr. Wright goes to great lengths and takes care to ensure the optimum fit, function, comfort and appearance of dentures for his patients and respects their dignity.
Poorly made dentures will accelerate bone loss and result in fibrous tissue change where the gums become rubbery and move under the dentures. In some cases a combination of porcelain and composite teeth are used for opposing posterior teeth on dentures. Wearing a poorly made, ill-fitting set of complete dentures will cause unnecessary, irreversible damages to the jaws and leave the patient with denture problems for life. Accelerated bone loss can preclude the patient from ever having dental implants. Ill-fitting dentures are a common cause of oral cancer with the tumour frequently growing on the side of the tongue.
The Problem with Dentures
Most dentists will agree that fabricating complete dentures is the most difficult and unrewarding task they perform. Many simply give up in frustration. The lower denture is the most difficult because the bone loss is greater; the lower jaw moves during function and flexes and the tongue tends to displace the denture during speech and swallowing. Dentures must function and permit clarity of speech. They must look “real”. This is a challenge and, as such, requires additional clinical and laboratory time.
Treatment for the Edentulous Patient in Redding
Prosthodontists undergo extensive training in the fabrication of dentures. However good the result, traditional complete dentures are still are a compromise. Dental implants offer the best solution to this problem. Even just two dental implants placed in the lower jaw of an edentulous patient can greatly assist in stabilizing a denture. In order to make a good implant denture, the dentist must first be able to make good conventional dentures. Being a prosthesis dentures fall within the domain of prosthodontics.
Weddings and Dentistry in Redding
Weddings are a frequent reason for getting a new complete or partial denture. This can extend beyond the bride and groom to include the parents and members of the wedding party. Everyone wants to have attractive white teeth for the wedding photographs. Granny’s Gummy Grin can sure ruin the photograph of the wedding party! Plan early as this is a very busy time during the six-month lead up to the happy event.
Dentures for Wind-Instrument Musicians and Singers
Dr. Wright is periodically called upon to make dentures for singers and musicians who play wind instruments like a saxophone, trumpet, flute, trombone, clarinet etc. where a space has to be made between the teeth to accommodate the instrument while not destabilizing the dentures. Often it is best to have a separate denture for singing and musical performances.
Immediate Dentures
There comes a time or situation in the lives of many patients when the clinical status of his or her dentition that the teeth in one or both jaws need to be extracted. Dental implants may not be a practical or financially option for all patients. Most patients would prefer to have dentures made ahead of the surgical appointment so that an immediate replacement denture is inserted on completion of the surgery. This is often the best treatment.
Fabrication and delivery of immediate dentures following careful dental extraction is one of the most important professional services a dentist can provide for his or her patient. Dr. Wright believes that it is essential that the same clinician should extract the teeth and deliver the denture and look after post-operative treatment.
Careful consideration must be given to planning and sequencing the case. Dr. Wright insists on preparing the casts of his patient’s dentition, designing the denture and performing the surgical removal of teeth. He will also set the teeth on the casts for optimum aesthetics, function and phonetics.
A number of post-operative appointments are required in the first month as the jaws heal. Dr. Wright personally takes care of all the laboratory procedures. The quality of care spent in the first six months of denture wear will determine the success for denture wear throughout life and the feasibility of subsequent implant placement for the patient.
An immediate denture is not intended to last more than one year. It is a transitional denture that will be replaced once the majority of bone loss has occurred.
“Affordable”, “Budget” or “Discount” Dentures are a false economy that can cause rapid bone loss in six months totally compromising the prognosis for the success of future dentures and potential for dental implants. Once the bone is gone, it’s gone.
It is not uncommon for patients being unable to wear “affordable” dentures and simply giving up. If an edentulous person (without any teeth) does not wear his or her dentures then the tongue being a powerful muscle will grow and spread towards the cheeks. It will then usually not be possible to make dentures for this patient as there is no room for them. The quality of speech will be impaired. No one looks good without dentures. Such people tend to give up and let themselves go.
Society generally has a poor opinion of people without teeth and dentures and they find it difficult to get employment, find a partner or be taken seriously. A person without teeth and dentures is unable to eat anything other than soft foods and soups. The diet suffers and so does the person’s health and they often become fat.
General dentists usually refer such patients to a prosthodontist who has specialized knowledge and skills that enable him or her to treat some but not all of those patients. Like with most problems, the sooner they are addressed the better the chances of a successful outcome. This is one area of health care and dentistry where it is best to get it right first time around. Be wise and follow Dr. Wright’s motto:
Do it Once, Do it Well, Do it Wright!
Art & Digital Dental Technology: CAD/CAM Dentures
A significant amount of a prosthodontist’s training is spent learning dental technology. This involves physically making the crowns, veneers, bridges, implant restorations, TMD splints, complete and partial dentures for his or her patient. In the last ten years there have been major advances in the development of digital technology in prosthodontics. There are now CAD/CAM systems available for the manufacture of digital dentures. The computer does not design the denture; it is the person operating the computer who designs the dentures. More than ever this calls for a greater understanding and hands-on skill in dental prosthetics. The prosthodontist is known as the bio-engineer of the dental profession.
A major benefit for the patient is that the prosthodontist can fabricate and repair many provisional, interim and permanent restorations and prostheses in the practice rather that having to send it back to the dental laboratory and a rescheduled appointment. Great skill is required to achieve an aesthetic, durable and functional result.
Medical Billing for Dentistry
Patients with medical insurance requiring a TMJ Treatment may be eligible for benefits payable by their medical insurance for a portion of the treatment provided that it is a PPO or AARP Medicare Advantage (HMO)
Bone Preservation Materials and Grafting Techniques
When teeth are extracted, the residual empty sockets will lose most all of the bone within 6 to 12 months often precluding the possibility of placing future dental implants. By grafting the sockets with certain bone grafting materials, we can minimize the amount bone lost and stimulate new bone production. In certain situations, dental implants can be placed at the same time as the extraction. Each situation requires careful individual diagnosis and treatment planning.
We only use synthetic bone grafting materials (ALLOPLASTS). The mineral Beta Tri-Calcium Phosphate we choose to use is FDA approved for human grafting. This material is turned over and replaced with the patient’s own bone within 3-6 months. We do not use human cadaver bone or collagen (ALLOGRAFTS) nor do we use cow, pig or horse bone or collagen derived from animals (XENOGRAFTS). We use TEFLON (PTFE) membranes to temporarily retain the bone grafting material for about a month then they are removed.
Bone preservation materials and grafting techniques are also particularly important when delivering immediate dentures, placing dental implants and dealing with acute trauma cases.
Dr. Wright provides specialist prosthodontics services for Redding, Shasta, and the neighbouring counties of Tehama; Siskiyou, Trinity; Modoc; Lassen; Plumas and Glenn.
Learn about Dental Implants »
Ask the Doctor
Dr. Wright provides specialist prosthodontics services for Redding, Shasta, and the neighbouring counties of Tehama; Siskiyou, Trinity; Modoc; Lassen; Plumas and Glenn
Should you have a question about prosthodontic treatment for yourself or family member, feel free to send Dr. Wright an email. He will be happy to respond within 48 hours.
