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Prosthodontist - Denture and Prosthodontic Questions

Q. What is a prosthodontist?

A. A prosthodontist is a specialist in the restoration and replacement of broken and missing teeth. Their training lasts an additional three years after four years of dental school. During that time, a prosthodontist is taught in greater detail about both removable and fixed prosthodontics.

Removable prosthodontics includes replacing missing teeth with appliances that the patients themselves can take in and out of their mouth, such as dentures and partial dentures.

Fixed prosthodontics includes replacing missing and/or broken teeth with restorations that the patient cannot take in and out, such as veneers, crowns, bridges, and implants.

Q. What are dentures?

A. Dentures are removable prosthetic devices designed to replace missing teeth.

Q. What are complete dentures?

A. Complete dentures are dentures that replace a complete set of missing teeth.

Q. What is the difference between conventional dentures and immediate dentures?

A. Conventional dentures are dentures that are made and placed after the remaining teeth are removed and the tissues have healed. Immediate dentures are dentures that are placed immediately after the removal of the remaining teeth.

Q. What is an over-denture?

A. An over-denture is a denture that fits over a small number of remaining natural teeth or implants.

Q. What do dentures feel like?

A. For a few weeks, new dentures will feel awkward until you become accustomed to them. They might feel loose until the cheek and tongue muscles learn to hold them in position. It is not unusual to feel minor irritation or soreness. The patient needs to see his or her dentist or prosthodontist for regular fit adjustments to relieve any sore areas.

Q. Are you able to eat with dentures?

A. Eating with dentures will take a little practice. You should start with soft foods that are cut into small pieces. As you become used to chewing, you can return to your normal diet.

Q. Are there foods you should avoid if you wear dentures?

A. There are only a few eating restrictions for denture wearers. Avoid biting down directly on crunchy or hard foods, like whole apples, hard pretzels, crusty bread, or large sandwiches. They can break because of the angle where the denture comes into contact with the hard surface.

Biting is limited only by the stability of the dentures themselves. Insufficient bone structure (shrunken bone ridges covered by gum tissue), old or worn dentures, and a dry mouth decrease stability.

Q. If you wear dentures, are dental adhesives necessary?

A. Today's dentures have been significantly improved through advances in both dental and materials technologies. As a result, dentures that fit properly usually do not require adhesives to secure the dentures. When you are just getting used to dentures, adhesives may be advised, but otherwise should not be necessary.

A loose denture is a sign that it doesn't fit your mouth correctly. When first getting used to dentures, you may notice them slipping when you laugh, smile, or cough, which is caused by air getting under the base and moving it. The more you wear dentures, the better you will be able to control their movements in these situations.

If your mouth has insufficient bone structure, dentures will be more difficult to retain. Your dentist or prosthodontist may advise the placement of implants. These are placed in the bone and retain the denture with small, precision attachments.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

What To Expect From Immediate Dentures

Immediate dentures are placed in the mouth directly after the remaining teeth are extracted. This approach is utilized when a person does not want to be without any teeth for several months while extraction tooth sockets heal and a denture is fabricated.

Immediate Dentures Involve a Two-Step Denture Process

Optimally, immediate dentures are the first denture of a two-denture process and should be considered as a temporary interim prosthesis until a second refined and esthetically enhanced denture may be constructed after healing.

First Stage

• Usually, most or all of the back teeth are removed and extraction sites are allowed to heal for a minimum of six weeks or more, depending upon an individual's healing rate.
• After adequate healing, the immediate dentures unit is fabricated.
• The remaining teeth are extracted and the immediate dentures are placed in the mouth. Wearing immediate dentures right away over extractions normally is no more uncomfortable than the extractions alone.
• Discomfort is managed with proper anesthesia and pain medication. Immediate dentures act like a Band Aid bandage, holding tissues together and protecting them during healing.
• Generally, the dentist does not remove immediate dentures until the day after surgery. Surgery is checked and denture adjustments are made as necessary.
• Immediate dentures will gradually become loose because of bone shrinkage as the jaw continues to heal. Provisional liners are placed in the loosening denture to help hold it in place during healing.
• Adhesives also maintain the denture in place as it becomes looser. If immediate dentures become too loose during this healing period of several months, it may be necessary to reline multiple times.

Second Stage

• After adequate healing has occurred, a second refined denture is fabricated. This denture allows the dentist to artistically position teeth in an optimal and enhanced esthetic relationship, which was not possible with immediate dentures. It also is now possible to establish better functional relationships of the jaws.
• Approximately six months after the second denture is delivered, it will most likely need to be relined to compensate for continuing jaw shrinkage. After this reline, a patient usually needs annual relines to accommodate a continually shrinking jaw.
• The frequency of relines is an individual matter unique to each patient and is best determined by a licensed dentist after a thorough periodic examination that should occur at six-month intervals.

Modified Approaches to Immediate Dentures

• It is possible to extract all the back and front teeth at one time and insert immediate dentures. However, such an approach is problematic and generally is discouraged unless the patient has no other alternatives.
• All teeth may be extracted with no interim denture while the jaws heal and a denture is fabricated. This is generally a more economical approach, but an individual would be without teeth for several months.

Advantages of Immediate Dentures

• A person is not without teeth for any extended period of time.
• Immediate dentures act as a bandage while bony tooth sockets are healing after tooth extractions.

Disadvantages of Immediate Dentures

• A second refined and esthetically enhanced denture is necessary soon after the immediate dentures.
• While the cost of immediate dentures is generally about the same as a conventional denture, the second denture needs to be fabricated soon after the immediate denture. Therefore, a person would be experiencing the additional cost of the second denture sooner.

by Joseph J. Massad, D.D.S.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.