Conventional Full Denture & Immediate Denture

Post by: Gerarda on 12 Nov 2019

Today´s blog, part 2 of a 5-part series.

Conventional Full Denture 
If you are edentulous (completely without teeth) then you would be a candidate for a conventional full denture. Once the teeth have been removed and the gums have healed, typically between 2-4 months, a conventional denture can be made.

Your dentist will begin the process of a conventional denture by taking a series of impressions of the oral tissue that will support the denture. The dental lab will make models of the patient´s mouth based on the impressions. Between the dental lab and the dentist they will slowly build a denture or a set of dentures that will fit your mouth and your mouth only. All of the impressions will go toward building a set of dentures that have a perfect fit. They will be sized to fit the shape of your face and mouth and the color will be in keeping with your complexion and age. A good bite will be established to ensure they are not only esthetically pleasing, but also functional.

This process usually takes about 5 weeks from start to finish and begins after all the healing has taken place and the tissue and bone has been remodeled. Once the patient starts to wear the denture and get used to them, they will most likely notice that further tweaking is needed to make them more comfortable as the gums can be sore in places. That is something that can be done chairside. Remember adjustments to the denture are an important part of the process and it is important to do those adjustments sooner rather than later as otherwise it will continue to irritate the oral tissue.

I can´t be without teeth. What do I do?
While you are waiting for the bone to remodel and gums to heal you would receive an immediate denture so that you have something to wear the same day the teeth are extracted. This type of denture is made before the teeth are extracted and fitted immediately after.

It won´t fit the bone and gum tissue as well as a conventional denture as the tissue is continually healing, therefore, it will require adjustments throughout the healing process.

It is important to remember that an immediate denture is a temporary appliance until the conventional denture can be made. That is made after all the healing and remodeling of the gum and bone has taken place.

When a person is missing teeth, s/he can experience a range of issues from the obvious ones of having difficulty eating and speaking to feelings of insecurity and ill-confidence because the face does not retain its shape. Without the support of teeth the mouth collapses and the lower portion of the face shrinks. A denture suddenly fills out the face as it provides your jaw the height to bring your face back to its normal shape.

Everything is new and can take some time to get used to. If you are new to dentures you may need to learn how to put the denture in and take it out. You may also need to learn how to speak, eat and drink. This too is part of the process.

Having an immediate denture solves two problems;  it helps restore a person’s appearance and gives the patient oral function at the same time. Hence its name, immediate denture.

Dentures

Post by: Gerarda on 21 Oct 2019

This 5-part series will explore dentures, from what dentures are to what is the alternative to them. Today´s blog will focus on what they are and what types of dentures are available.

Dentures are referred to as a plate or a dental appliance. They are associated with visiting your grandparents and seeing them sitting in a glass by their bedside. Thankfully dentistry has advanced.

There are many types of dentures available and depending on your oral circumstances your dentist, in consultation with you, will decide which denture best suits your needs. Along with many types of dentures there are also many kinds of material used to make them. Whichever type of denture you ultimately receive, it is important to replace your missing teeth as they are an essential component to retaining the shape of your face. Without the support of your teeth the mouth collapses and the lower portion of the face shrinks. A denture suddenly fills out the face as it provides your jaw the height to bring your face back to its normal position.

What are dentures?
Dentures are an appliance used if a patient is missing one, some or all of their teeth. They are usually made of an acrylic base that is colored to make them look like natural gums along with a set of acrylic or porcelain teeth. Metals such as steel and chrome can also be used in the base of dentures, particularly in the upper jaw, but if you want something that is flexible, the material Valplast is used. It is a translucent resin that blends with natural gum color.

Dentures can be taken out of your mouth and put back in. They are commonly referred to as a plate and if you are a first-time wearer it can take some getting used to. While they will not feel like your original teeth, with advancements in dentistry they have come to look perfectly natural and feel very comfortable.

What types of dentures are available?
There are many different types of dentures, conventional full denture, immediate full denture, partial denture, denture on implants and flexible dentures to name just a few. Depending on a number of factors there is a whole range available.

Those factors include:

• The number of missing teeth
• The materials being used
• If the denture will be fixed or removable
• If the denture will be supported by the gum or by implants

Dentures made from acrylic while they are strong, are less durable than some of the alternatives. They can break easily if dropped or if too much pressure is applied while biting. Acrylic is the most affordable type of denture as the material is easier to work with and is less expensive.

Depending on the type of denture you have, that level of comfort can vary. The flexible denture uses soft material which is gentler on the gums, doesn´t have the rigidity of acrylic and is less bulky. This means they are more comfortable to wear and cause fewer difficulties with speech.

Dentures with a metal framework are stronger and more durable than acrylic. Because it is metal, the denture can be made thinner than acrylic, so are comfortable and lightweight.

Thankfully, today one is “spoiled for choice” when it comes to choosing the best denture for you. No longer do you have to see them sitting in a glass by your bedside as there are options.

Next time this blog will explore full dentures and immediate dentures.

Dental Emergencies

Post by: Gerarda on 09 Sep 2019

Broken front teeth, tooth pain, knocking out a tooth (avulsed tooth), bleeding gums and tooth sensitivity have all been covered in previous blogs. Below are many other types of dental emergencies that patients have.

Realigned your teeth after a fall
Once your permanent teeth grow in your teeth should never be loose. If you fall and hit your mouth and move teeth out of position, they will become loose and need immediate treatment. A trauma so severe as to move teeth needs emergency room treatment at a hospital to determine if you have had a concussion or a broken jaw. Your first stop though should be your dentist as the sooner the teeth are realigned the better chance they will survive the trauma.

Under some conditions it is possible to move teeth back into place. The dentist administers a local anesthetic, repositions the teeth and then uses composite to bond them to the neighboring teeth for support. This keeps them in place until they heal back into the bone. Depending on the extent of the injury the bonding will have to remain in place for up to 3 months. The longer the teeth are left untreated the harder it will be to move them back into position. Teeth that have moved and caused bone damage will most likely need to be extracted.

Root canal treatment will need to be done on the injured teeth as the nerve will die from the trauma and will cause infection; therefore, the canals have to be cleaned, disinfected and medication placed in the canals or the teeth will start to go dark, a sure sign the nerve is dying.

The teeth stand a better chance of long term viability the sooner they are treated. Seek immediate dental treatment.

Infections
Infections can result in varying degrees of pain and sometimes they can have no pain at all, but all have one thing in common. There is something wrong in your mouth and it needs to be treated sooner rather than later. Whether it is a tooth abscess, cavity, injury, prior dental work or poor oral hygiene, left untreated will only become more serious.

Idiopathic ulcers or canker sores
While idiopathic ulcers are not life threatening, they are very painful and make eating and talking difficult. They develop on the soft tissue or at the base of the gum and are small, oval in shape with a red edge. Most go away in a week or so. Their cause is unknown but researchers believe they develop after a mouth injury such as an accidental cheek bite, hard teeth brushing, food sensitivities or stress to name a few. Contact your dentist if it doesn´t heal or it gets progressively worse.

Abscess
There are three types of abscesses, a periapical abscess, a periodontal abscess, and a gingival abscess. Abscesses occur at different regions of the tooth and for different reasons. Essentially, an abscess is a pocket of pus that is caused by a bacterial infection. Either way you slice it, the abscess need to be treated. The abscess has to be drained to get rid of the infection. At times a root canal treatment is required and if that is not possible then the tooth would need to be pulled. Infection causes bone destruction so it is important for it to be treated in a timely manner. It also can result in serious and sometimes life-threatening complications if left untreated.

Swelling
Swelling in the oral cavity is a common dental emergency and depending on the reason for the swelling is one that needs immediate attention. Usually the swelling doesn´t go away on its own. Swelling of any kind is never a good sign and can indicate that you have a serious dental infection.

A swelling has many causes including:
Gum disease
Gum inflammation (gingivitis)
Using a dental device such as braces
Having a sharp or broken tooth
Reaction to certain foods or medication
Biting your tongue or cheek
Cancer treatment such as chemotherapy or radiation
Taking medication for rheumatoid arthritis, epilepsy or antibiotics
Autoimmune diseases such as lupus, Crohn´s disease or Bechet’s disease

It is not pleasant realizing that you have something wrong in your mouth and it is difficult to examine yourself. You are left wondering if this will go away on its own. Can I look after this myself? How long do I wait before calling my dentist? Many times people have favorite home remedies that can help, but at other times you need to call your dentist immediately.

1. Broken front teeth from diving into a pool or from falling down
Remember while it might be irritating and unattractive, a broken tooth is usually not life-threatening. Depending on how much of your tooth is broken and the angle it is broken at, the treatment could range from doing a composite repair for a chipped tooth to doing a root canal treatment and a crown if the tooth is broken off at the margin of the gum. If the tooth is chipped then schedule an appointment at your convenience; if however, the tooth has broken off or you have pain then see a dentist immediately.

2. Tooth pain
Usually a dental emergency will have a degree of pain attached. It just depends on the level of pain and the kind of pain how your dentist deals with it. If it is sensitive to both cold and hot temperatures, chances are it is a grinding problem. If it is only sensitive to cold, many times, but not always, it could be a nerve problem. It could be that the nerve has been irritated and is crying out for attention. If that is the case you need to call your dentist immediately. It doesn´t get better by itself. If it hurts when you bite down, it could be a broken tooth, it could also mean that you have been grinding your teeth or it could be a sign that you have an abscess. Either way, you need to have it treated by a dentist.

3. You´ve knocked out your tooth
If for whatever reason your tooth gets knocked out, put it back in. Yes put it back in the socket. And hold it there until you see a dentist. Make sure though when you pick it up you only touch the crown of the tooth, the part that is used to chew and not the root. Also important is to put it back in the correct position. If there is any debris on the tooth when you pick it up rinse it in a cup of lukewarm tap water for no more than 10 seconds. Any longer than that can kill the cells on the root surface that help reattach it. If you are looking at your tooth between your fingers then most probably you´re in shock, but if you want to save the tooth then you have to remain calm and think. If you can´t put it back correctly, then put it in a glass of milk. If milk is not an option, then put it in your mouth between the cheek and the gum to keep it moist. Do not swallow it as you only have about 2 hours for it to be reimplanted correctly. The sooner the better, otherwise, the likelihood of success becomes less. You need to make a very quick trip to a dentist.

For most dental emergencies you need to go to a dental clinic not a hospital. Hospitals rarely have a dental department and if they do it is even rarer that there would be someone on call. A doctor in an emergency room can only give you pain medication or antibiotics. In some cases, they will schedule an x-ray or scan depending on the severity of the trauma. They will still suggest you see your dentist.

Tooth Enamel and Erosion

Post by: Gerarda on 08 Aug 2019

What is tooth enamel?
Tooth enamel is that hard, shiny layer of material which protects your teeth against decay. It is the layer of material that you are to brush and floss on a daily basis. To be more precise, it is hydroxyapatite, a translucent calcium phosphate. Suffice it to say enamel is the hardest mineral element in your body, even harder than bone. Don´t be fooled though as it still can be damaged.

What causes enamel to be damaged or eroded?
• Poor oral hygiene
• Acidic food & drinks (lemon juice, limes, grapefruits, grapes, pineapples, pomegranates, blueberries) to name a few
• Soft drinks in excess
• High sugar and starch diet
• Teeth grinding – wears away the enamel and leaves the dentin exposed
• Medications (antihistamines, decongestants, high blood pressure medications (including diuretics & calcium channel blockers), antidepressants, sedatives, pain medications, antacids
• Dry mouth – xerostomia, where the saliva glands don´t make enough saliva to keep the mouth wet. Many times this is a side effect of medication or radiation therapy.
• Acid reflux that occurs more than a couple of times a week
• Gastrointestinal problems – repeated vomiting from GI problems or eating disorders

What does tooth erosion look or feel like?
When your teeth become rough and irregular, or serrated like a saw blade you know the enamel has eroded. Essentially you reshape your teeth. You can experience sever sensitivity to both cold and hot temperatures and to sweets. You can also feel a shooting pain through one or more teeth so much so that it makes your eyes squint.

Can tooth erosion be repaired?
Once tooth enamel is gone, it´s gone. Teeth need to be rebuilt with composite restorations, crowns or veneers. The advantage of composite restorations is that it is a comparatively inexpensive and a conservative way to restore teeth. The result is immediate. More extensively damaged teeth might necessitate a porcelain veneer or porcelain crown.

You only get one set of permanent teeth; therefore, you might as well look after them. They are not meant to bite off thread or to open a bottle cap in a pinch. Your teeth need to be healthy as they not only serve to make us look good, but they also aid in digestion. As your mouth is the beginning of the digestive system it stands to reason that if you have digestive problems then you look to the overall health of your mouth as well as your stomach to determine the problem.

Begin by looking at your teeth and see whether any of the above symptoms are similar to yours. If they are then you know what to do. Call your dentist for a check-up.