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Do I Go to a Dentist or Oral Surgeon for Dentures?

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I haven’t been to the dentist in years. As a result, my teeth are in horrific shape. I need to get dentures, but don’t know whether or not to go to a dentist or oral surgeon first. Is there a standard procedure for this?

Evan

Dear Evan,

An image showing before and after facial collapse

 

When it comes to pre-denture surgery, it is fine to go to a general dentist. It is a simple enough procedure that most dentists can do it. I would recommend calling the office and asking what they typically do. Don’t talk them into doing it if that’s not their normal.

However, before you settle on getting completely removable dentures I want to make sure that you are aware of the side effects. From the beginning they will have some inconveniences. No matter how well fitting, you will lose a minimum of 50% of your chewing capacity. Then, the longer you are in them, the more severe the consequences get.

The moment your teeth are removed your body recognizes you no longer have any teeth roots and will not need the surrounding bone to keep them in, so it begins to resorb the minerals in your jawbone to use elsewhere in your body. You didn’t say how old you are, but in about ten or so years, you will lose enough bone structure that it will be difficult to keep your dentures in. Eventually, it will become impossible to keep them in. This is known as facial collapse.

The way to prevent this is by getting implant supported dentures. The dental implants signal to your body that you still have teeth which need support and because of that, it leaves your jawbone intact. However, not every dentist can do these. They are an advanced procedure, which requires post-doctoral training.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

My Dentures are Making Me Gag

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I have removable dentures and the upper dentures have been making me gag. It has been almost impossible to use them. My dentist’s attitude has basically been, “Well, you didn’t take care of your teeth so this is what you’re stuck with.” Is there any solution for this?

Brent

Dear Brent,

I’m sorry about the attitude of your dentist. Let’s say for argument’s sake that you didn’t take care of your teeth. That does not mean you don’t deserve compassion and the best treatment possible with your options. I see two options for your situation.

Implant overdentures

Implant Overdentures


A lot of patients have issues with dentures, so don’t feel alone on this. First, the absolute best thing you could do for both the situation with the gagging and the long term health of your body is to get implant supported dentures.

These place four to six dental implants in your jaw and then anchor your dentures to them. Because of that, there will be no need for the upper denture plate that is messing with you now and causing you to gag.

Another important function dental implants serve in is preserving your jawbone. When your teeth were removed, your body immediately began to resorb the minerals in your jawbone in order to use them elsewhere in your body. It does this in an effort to be as efficient with your body’s resources as possible. Because you no longer have teeth roots to support it figures that those resources would be better used elsewhere.

The downside to this is that your jawbone slowly shrinks. While your upper denture is held in by suction, from that denture plate you hate, the lower dentures rests on the ridge of that jawbone to stay in place. Eventually, in about ten years or so, you would no longer have enough of your jawbone to keep in your lower dentures. This is known in dental circles as facial collapse. That would limit you to a soft diet only and severely impact your nutrition.

By placing the dental implants there, it signals to your body that you still have teeth, which means your jawbone is necessary to keep those teeth roots in place. This prevents facial collapse.

The only real downside to this is the cost. It is more expensive than just getting dentures. If you can only afford it for one arch, get it on your lower arch to protect your jawbone. Implants are not as necessary on the upper arch because those those are held in by suction.

However, it is obviously the suction that is giving you the gagging problem. Here is where the second option could help you with the upper dentures without implants.

Altered denture to help with gagging

Altered denture to help with gagging

There is a new procedure that has been helpful for some people developed by a prosthodontist in Lancashire, England, Dr. Finlay Sutton. If you look at the two denture images above, the top one shows the denture extending all the way to the vibrating line. There is a way to cut this back a bit that has prevented some patients with a strong gag reflex from struggling, such as in the lower image. It cannot be cut too far or the denture will lose its suction.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Should I Save My Two Upper Teeth?

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I have most of my bottom teeth. My upper arch, however, is a completely different story. I will soon only have my two front teeth left. Currently I have two partial dentures, both of which will need to be replaced when I lose the teeth that are coming out in a couple of weeks. What I am trying to decide is whether or not I should keep the last two upper teeth or not. I am thoroughly unhappy with the partial dentures. I spoke to my dentist about it and he seems to be of the opinion it doesn’t matter either way what I do, which wasn’t exactly helpful. I usually don’t wear the two partials unless I am going somewhere. I can eat pretty much everything without them, except things that have to be ground a bit more, such as steak or hard things. Would a full denture look and work better than the partials? I’m on a budget of around $5,000.

Charles

Dear Charles,

An image of complete removable dentures

In most cases, saving your natural teeth would be recommended at all costs. But, this case is a bit different. You have only those two teeth and I would not expect them to last long because of the pressure being place on them when you eat

The ideal solution in your case would be implant supported dentures, sometimes called implant overdentures. These are dentures that are secured to dental implants. However, this would completely blow your budget.

If you were talking about your bottom arch, I would encourage you to do everything you can to get implant overdentures. This is because for the lower arch, your dentures rest on the jawbone. Unfortunately, once your teeth are removed, your body recognizes that you no longer have any tooth roots. As a result, it begins resorbing the minerals in your jawbone in order to utilize them elsewhere in your body. It’s a model of efficiency. The only problem with that is your jawbone begins to shrink as a result. After ten or so years, you do not have enough jawbone left to retain your dentures.

The good news for you is that upper dentures are held in by suction so the jawbone is not as much of an issue. My recommendation is that you go ahead and get the dentures. I think you’ll be happier if you have a complete set rather than two partials. If they are well made, they will be more comfortable than your current set up.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Will Medical Insurance Pay for My Dental Implants?

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I have had massive problems with my teeth and my dentist suggested that I have all my upper teeth removed and get dentures. I have tried, but I just cannot eat with these. The plate that goes across my palate completely gags me. Then food sometimes gets under it. I’ve also tried eating without it but you can imagine how that went. I have lost twelve pounds in just a few weeks. This is unsustainable. I’m told implant overdentures do not need that plate. Is there a way my medical insurance will cover this because it is having an impact on my health?

Carla R.

Dear Carla,

Implant overdentures

Implant Overdentures

You are not the only patient to struggle with dentures. Not only is the plate hard for people with a strong gag reflex to deal with, but even the best fitting dentures will reduce your chewing capacity by 50%.

Having implant supported dentures is a great way to solve the problem you are facing. There will be no plate to gag on. There will be no shifting or moving of the dentures. There will be no problems eating. Unfortunately, I sincerely doubt that your medical insurance will pay for it. While it is affecting your health, which is obvious from the weight loss, medical insurance plans have dental exclusion clauses. If they didn’t, then technically patients could call a cavity an infection and demand they pay for that as well.

The best you can get is maybe some coverage from dental insurance. Don’t expect them to cover the whole thing. You may get a percentage of it covered.

You can generally pay for this in two stages. The first stage is the implant stage. Then, there will be a period of healing and time for the bone to integrate with the dental implants. This stage of osseointegration is essential so that the dental implants have the support they need.

The second stage will be the dentures stage. Once the implants are secure, you can pay the second half and your dentist will anchor the dentures to the implants. They are definitely worth saving up for.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Is there a Soft Denture?

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I have a denture and it is driving me bananas. I have a strong gag reflex and the hard plate is making it hard for me to get through my day with teeth in. I am hoping there is such a thing as a soft denture that will make it easier for me to handle this.

Judy

Dear Judy,

dentures

 

There is not such a thing as a soft denture, but there is something like a soft lining. These can be used to line the inside of the denture and are helpful for patients who have bony ridges. This protects the ridge of their jawbone from getting sores. They help the lower denture to become more comfortable. They are more expensive and do not last very long so they will have to be replaced.

Unfortunately, this will not help with your upper denture. The plate is necessary to create a stable framework. There is not anything pliable that will work in that case.

The best solution for you would be to get fixed implant dentures. This entails having some dental implants surgically placed, then your dentures can be anchored to them. This will prevent you from needing that plate at all because the implants retain the dentures for you. They will be completely secure.

An even bigger benefit is it will prevent facial collapse. When your teeth were first removed, your body recognized that and began to resorb the minerals in your jawbone. It does this because it realizes that you no longer need to support the teeth and it wasn’t to be as efficient with the resources in your body as possible. After about ten or so years, you will no longer have enough minerals in your jawbone to retain your dentures. This is known as facial collapse.

The dental implants placed in your body, serve as prosthetic tooth roots. This signals to your body that you still have tooth roots, which means it will preserve your jawbone in order to keep your teeth in place.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

What If You Are Allergic to Your Denture?

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I was fitted for a complete denture. Both the upper and lower fit beautifully and I am quite happy with them. Unfortunately, I think I am allergic to them and am hoping there is a solution. The first day, I had swelling around my eyes and an itchy throat. Second day, the swelling grew worse around my eyes, my throat swelled and my glands swelled. I took a day off of wearing them and took some benadryl for the allergy symptoms. I got some relief then. I tried putting them in again the next day and the symptoms returned. Is there any way I can figure out how to prevent these allergy symptoms? I can’t go without teeth.

Brianna

Dear Brianna,

A complete set of removable dentures with a pink acrylic base and white teeth.

It definitely sounds like there is an allergy here. You do not want to mess with this. Your throat could swell so much that you cannot breathe. This can happen suddenly and unless you have someone with you who notices, you will not get help on time.

Your first step will be to not wear them until you have an answer to what you are allergic to. You need to see an allergist and get a patch test done, making sure it includes the materials in your denture. My guess is that you are allergic to the unreacted monomer.

The denture’s base is made of acrylic. When it is first processed that acrylic is in its liquid state, which is a monomer. A chemical reaction is started that changes the acrylic to a polymer, which is a solid form. In many chemical reactions, there are leftover materials. The same is true in this case. There will be some leftover monomer that did not react. If it turns out that it is the monomer you have an allergy to, one thing your dental office can try is to immerse the denture in very hot water for several hours in an attempt to get the remainder of the monomer to react. Here is some research on this that you can show to your dentist.

You’ll have to find out what you are allergic to before any definitive steps can be taken.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

What If I’m Can’t Afford Dental Implants?

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I feel absolutely helpless at the moment. I feel like my teeth can’t be saved and trying to has almost bankrupted me. I had seven children and vomited almost daily during my pregnancies, which did a number on my teeth. Then, as soon as I was done having children, when I thought I’d get to take a break and take care of myself for a change, I was diagnosed with cancer. The radiation and chemo have also done a number on my teeth. They are literally crumbling. My dentist said I need to get dental implants but there is no way I can afford them. What if the only thing I can do is afford dentures? Will it be as horrible as my dentist is hinting?

Kristin

Dear Kristin,

An image showing before and after facial collapseI am so sorry for all you have been through. Let’s see if we can figure out some helpful solutions for you. First, understand the reason your dentist is pushing you toward dental implants.

When your teeth are removed, your body recognizes there are no roots of your teeth to support. In order to be as efficient as possible with your body’s resources, it will then start to resorb the minerals in your jawbone in order to use them where they are more needed. This has the unfortunate side effect of shrinking your jawbone. After about ten to twenty years, you will no longer have enough jawbone left to even keep your dentures in. This is known as facial collapse.

Having dental implants placed signals to your brain that you still have teeth that need to be supported. As a result, it leaves the minerals of your jawbone in place. This is the ideal solution. Rarely, however, is life ideal.

One thing you can do is only get implants on your lower arch. This is the most important when it comes to facial collapse because the dentures actually rest on the ridge of your jawbone. Your upper arch is held in by suction so you are safer to leave those with dentures.

If you can’t afford to do full implant overdentures on your lower arch, then maybe see if snap on dentures are a possiblity for you. This can use as few as two dental implants and will at least preserve some of your jaw.

I hope this helps and that the remainder of your treatment goes well.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

How Far Back Should My Dentures Go?

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I had to get lower dentures. I still have my wisdom teeth. on my top arch. Because of that, I am literally chewing on my lower wisdom teeth gums. My dentist does not seem to understand why this is a problem. Shouldn’t the denture go back to where the wisdom teeth are?

Kevin

Dear Kevin,

A complete set of removable dentures with a pink acrylic base and white teeth.

While getting removable dentures is never really completely comfortable, your dentist is allowing unnecessary pain in this situation. I suspect he just doesn’t want to fix it because it would mean starting over for him.

Your denture actually should have covered the wisdom teeth to begin with, as well as go a little past that area to what is called the retromolar pad. While they can’t cover the entire retromolar pad or it will interfere with an upper denture, they can cover a bunch of it and, as I said, it can cover the entire wisdom tooth area.

If you have already paid for the denture, you may not have leverage. However, you can tell him that you spoke to another dentist and learned that he should have covered that area. If he still doesn’t make this right, then tell him you are going to be sharing a review that he doesn’t make his products correctly and then refuses to fix them.

The Big Danger with Completely Removable Dentures

Implant overdentures

Implant Overdentures

I don’t know if your dentist warned you about this, but it is important so I am going to mention it here. Once your teeth are removed, your body senses this. As a result, it will begin redistributing the minerals in your jawbone to use elsewhere in your body. It does this in an effort to be as efficient as possible with your body’s resources. Unfortunately, it does have the nasty side effect of slowly shrinking your jawbone. After ten or so years, you will not have enough jawbone left to keep your denture in. This is known as facial collapse and why you often see denture wearers with skwunched up faces and their dentures falling out all the time.

The way to prevent this is to have implant overdentures placed instead of completely removable dentures. The implants serve as prosthetic tooth roots, which signals to your body that you still have teeth there. As a result, it leaves your jawbone alone thereby preventing facial collapse.

Additionally, it also takes care of all the other negative issues that come up with dentures. You’ll find your quality of life goes up exponentially with implant overdentures than it would with removable dentures, including your ability to eat. With dental implant support, you can eat anything you want. Even the best fitting removable dentures will reduce your chewing capacity by 50%.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Help! My Dentures Won’t Stay In?

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Can you tell me if there is a solution to a problem I’m having? I’ve been in dentures for 20 years. Recently, I can’t even keep them in with those adhesives. I went to see a dentist and they told me I didn’t have a ridge anymore and that was part of having dentures. Is there any way to fix this?

Laura

Dear Laura,

An image showing before and after facial collapse

What you are dealing with is known as facial collapse and while your dentist is right that it is part of dentures, he left out the solution. This occurs because when your teeth are removed, your body immediately recognizes that. In an effort to be as efficent with your body’s resources, it begins to resorb the minerals in your jawbone in order to use them elsewhere in your body. The problem with that for you is that your jawbone begins to shrink. After ten or so years, you no longer have enough jawbone left to retain your dentures because the ridge is no longer there to hold them in place.

That being said, there is a solution. I am not sure why your dentist didn’t tell you about it unless he doesn’t know how to do the procedures necessary. However, he could have referred you to someone who does.

Fixing Facial Collapse

The first thing that needs to happen is the building up of the bone. This can be done with a bone grafting procedure. Once that is healed, you have a couple of choices. You now have your ridge back. You can just get new dentures. However, the whole cycle of facial collapse will start over again.

If you want to permanently keep that bone in place, I recommend you get dental implants placed. Then, your dentist can anchor the dentures onto them. This is known is implant overdentures. Not only, will you never have to worry about facial collapse, but your dentures will never move again. They will be completely secure. You’ll find your quality of life goes up tremendously.

I hope this helps.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Should My Dentist Refund Me for Not Finishing My Denture On Time?

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I needed my overdenture replaced. However, I knew I would be relocating soon for a new job. I asked my dentist how long it would take to make a new one for me. He told me it would take three weeks. I didn’t actually receive it until a little after nine weeks. However, even after it did come in, the dentist had a devil of a time getting it attached. He had to force it on. After I got home, I could not even eat a bowl of pasta. I was in so much pain. Eventually, I was able to get it off. Unfortunately, when I tried to put it back in, I found that impossible. I called them and scheduled an emergency appointment. My dentist wasn’t in, but I saw one of his partners. He told me that the denture was not properly made. Not only was it at a slant, but the holes were not drilled out properly. Then, I got a call a WEEK later, saying they’d just ordered the new gaskets. I don’t have any time left. I have to move. Is it unreasonable for me to ask for a refund and have this fixed with whatever dentist I end up with in my new location?

Kevin

Dear Kevin,

Implant overdentures

Implant Overdentures

You should definitely get a refund from this dentist. He made a legal agreement with you by telling you that they would have your dentures ready in three weeks. He missed the agreed time by a significant amount. Then, when he finally did get them to you, they did not meet the minimum standard of care with the results. Though you should not have trouble getting a refund if this dentist has integrity, I have found that sometimes dentists who do shoddy work are the most reluctant to give a refund, no matter how well deserved. If that happens to you, there are ways for you to gain some leverage.

First, tell him you will leave a review telling him about the horrendous service you received. Believe it or not, these reviews have a large impact on their business. You could also tell him that you would be willing to write a positive review about his integrity and his willingness to make things right.

If that does not work, your second piece of leverage is to threaten to go to the dental board. Dentists do not like dealing with the dental board, so this carries more weight than you might think.

Finally, you could do a malpractice lawsuit, but the truth is I don’t think this would do you much good. You wouldn’t get enough to justify the cost, not to mention the hassle and time, of the suit.

Hopefully, he’ll step up and do the right thing.
This blog is brought to you by Dr. David Marion, who tries to be one of the best dentists in Duluth, GA.