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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.

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.

Can I Stop My Face From Collapsing with Dentures?

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I have just been diagnosed with a severe calcium deficiency. My dentist is suggesting I just go ahead and extract my teeth now and get dentures so I don’t spend a fortune trying to keep them. I have been reading about dentures and came across an article that said my face will eventually collapse?? How do I stop that? Can I stop that? I’ve been crying since seeing my dentist. I’m only 42 and my teeth aren’t perfect, but they are all my own.

Abigail

Dear Abigail,

An image of a woman before and after facial collapse.

The results of facial collapse

I’m going to start with the concept of facial collapse. This is a term given to the result of long term denture wear. When your teeth are removed, your brain notes there are no longer teeth roots in your jawbone that need support. In an effort to be as efficient with your body’s resources as possible, it will begin resorbing the minerals in your jawbone to use elsewhere in your body. This has the effect of shrinking your jawbone as it loses more and more of those minerals. Eventually, you will no longer have enough bone left to retain your dentures.

There is a way to prevent this. You would need dental implants placed in your jaw. These are prosthetic tooth roots and it will cause your body to leave the minerals alone, preserving your jawbone as a result. Then, you can anchor your denture to that in a variety of ways from fixed implant dentures (as the best option), all the way down to snap-on dentures.

Before you do that, however, I take issue with your dentist’s assertion that a calcium deficiency means you’re going to have problems with your teeth. Your teeth have been fully formed for years. A calcium deficiency developed in adulthood will have no impact on your teeth. What you will have to deal with are nerve problems, muscle cramps, and osteoporosis. Those are serious, so don’t minimize this diagnosis.

It sounds more like you have one of those dentists who would rather pull teeth than work on them. This is not the best dentist for people who prefer to preserve as much natural tooth structure as possible.

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.

Can I Get Gold Teeth Placed in My Dentures?

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I am 45 and have very bad teeth. I’m about to get rid of them and get dentures. I am excited about the idea of getting to plan how my teeth look and was hoping to get one gold tooth put there. My dentist acted like I was crazy. Is this a possibility or am I asking for too much?

Dina

Dear Dina,

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

Yes, it is possible to get a gold tooth placed in a denture. It sounds like this was more not to your dentist’s taste. If he or she is basing your treatment on how they like the appearance, they might not be the best dentist for you. Especially when it comes to the aesthetics of a smile, it is the patient who should have the final word.

You won’t be the first person to have a gold tooth placed in their dentures and you certainly won’t be the last. Some people want the entire tooth gold; some just want it outlined in gold; some want something completely different. In order to be certain you get what you want, it would be safer to bring your dentist an image of what you want the result to look like.

Dentures and Facial Collapse

The results of facial collapse

One thing your dentist should have mentioned is what happens when your teeth are removed. You are only 45 years old and the long-term consequences of dentures can be rather severe. When your teeth are removed, your body recognizes that. As a means of being as efficient with your body’s resources as possible, it takes the minerals that were in your jawbone to help keep the tooth roots in place and resorbs them to use in other places where it perceives the minerals will be more useful. This has the unfortunate effect of slowly shrinking your jawbone. After about ten or so years, you will no longer have enough jawbone left to retain your dentures.

The good news is that there is a way to prevent this. Instead of getting completely removable dentures, you can get implant overdentures. With this procedure, you will place between four to six dental implants in the arch. Then a set of dentures is anchored to the implants. Your body interprets the implant prosthetics as tooth roots and will preserve your bone structure as a result. There are other benefits too. For instance, no matter how well fitting removable dentures are, your chewing capacity will be reduced by 50%. With implant supported dentures, they are completely secure and you can eat whatever you want without anything moving around.

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

Can I Get Dental Implants After 30 Years in Dentures?

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I have been wearing dentures for close to thirty years. Because of that, I have not had a pretty smile in many years. Plus, my dentures don’t even stay in anymore. I think they have stretched out over the years. A friend of mine has dental implants and her smile is beautiful. Is it too late for me to get a beautiful smile with dental implants?

Laurie

Dear Laurie,

Implant overdentures

Implant Overdentures

Technically, you can get dental implants at any time. However, the length of time that you have been in dentures means you are dealing with facial collapse. I don’t know if your dentist warned you when you first received your dentures, but this is one of the downsides to dentures. When your teeth were removed, your body recognized that and began resorbing the minerals in your jawbone to use elsewhere. While this is a remarkably efficient way of preserving your body’s resources, it does have the unfortunate side effect of slowly shrinking your jawbone. At this point, you probably have very little jawbone left. This is actually the reason why your dentures are not staying in.

Before you get the implants, you will need to build back up that bone structure again. This can be done with a bone grafting procedure. Once that is completed, you will need some healing time. From there, it will be time to get your dental implant procedure going. Because you were in full dentures, you will get implant overdentures, which is much more affordable than trying to replace each and every tooth with a dental implant.

Getting a Pretty Smile

Getting a beautiful smile has very little to do with whether you have dentures or dental implants. Instead, it is based on the skill of your dentist in cosmetic procedures. Dentures can be made to look stunning and dental implants can look fake. It all depends on the skill of the dentist. I would ask whatever dentist you choose to work with to see his smile gallery. This is a brag book of sorts that shows before and after pictures of cases he’s worked on. You’ll want a dentist who gets beautiful results. If they do not have a smile gallery, that means they do not do enough cosmetic work and likely cannot give you the beautiful smile you have been hoping for.

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

Losing Teeth Like Crazy

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I have pretty advanced gum disease and have already lost seven teeth. Is it possible for me to get dental implants to replace my teeth or will I be stuck with dentures?

Joe

Dear Joe,

Implant overdentures

Implant Overdentures

Dental implants are a great solution when you’ve lost your teeth. Anyone in good general health can usually get them. However, your gum disease will be an issue that will have to be addressed in order for this to be a successful option for you. In order to retain your dental implants, you need to have enough bone to integrate with the implants. Gum disease eats away at your bone structure, which is why you’ve been losing your teeth.

Here is my suggestion to give you the best outcome possible. Get serious about your gum disease treatment. Once that is handled, you will need to build back up the bone structure. There is an outpatient procedure known as bone grafting which can do that. Once you’ve healed from that, it will be time for your implants.

I know you’re probably thinking that is a lot of trouble to go through to get those implants. Maybe it would be easier to just get dentures? While it may seem easier at first, you will not feel that way with your quality of life. Even the best fitting dentures reduce your chewing capacity by 50%. Then, because there are no roots of your teeth any longer, your body will begin to resorb the minerals in your jawbone. This shrinks your jawbone to the point where you will no longer be able to keep your dentures in. The implants are worth it. They are like having healthy, natural teeth once again.

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