Q: What is a prosthodontist?
A: A prosthodontist is a dentist who specializes in restorative and reconstructive dentistry. Prosthodontists have received an additional 3 years of training after dental school focusing on dental implants, crown and bridge, complete dentures, partial dentures, and cosmetic dentistry. In addition to training in the aforementioned dental treatments, prosthodontists have further education in dental biomaterials, metallurgy, ceramics, and understanding of color and how it affects aesthetics. They are experts in diagnosing and planning complex and difficult cases where coordination of other dental specialties are utilized to create an aesthetic and functional outcome.
Q: When/why should I see a prosthodontist?
A: Most people see a general dentist for the majority of their dental needs. General dentists often will refer a patient to a specialist if they feel the patient would benefit from the specialist’s expertise in their field. Prosthodontists are often called upon when a patient has certain dental needs that may be beyond what the referring dentist feels comfortable with treating. For example, it may be a case that requires extra attention in achieving the ideal aesthetics, or it may be where treatment is particularly difficult due to certain conditions the patient has. Sometimes it may be that the patient wishes to have a particular restoration that is complicated and requires the skills of a specialist.
Q: I am new to wearing dentures. What should I expect and how should I care for them?
A: First of all, it is important to remember that dentures are not a substitute for teeth – they are the alternative for not having any teeth. Compared to natural teeth, dentures will have a reduced chewing efficiency, requiring more effort and chewing strokes to break down the same amount of food. If this is your first set of dentures, it may take a while for your mouth to adjust to them. You may immediately notice your mouth salivating a lot more than normal with the dentures in. You may also have some difficulty in pronouncing certain words or sounds. Both of these issues will usually improve as you adjust to your new dentures.
Sore spots are fairly common with new dentures, be it your very first time wearing them, or if you have had older sets of dentures. Do not try to adjust your dentures yourself as irreparable damage may be done inadvertently. It is best to contact your dentist and have them adjust your dentures for you. Sometimes it may take a week or two to fully get a new set of dentures completely adjusted and fitting comfortably. Even then a sore spot or two may come up every once in a while and need adjusting.
Adhesives are frequently used by denture wearers and can be a good way to provide a little bit more retention and stability to a denture that may be slightly loose. It is best to consult your dentist regarding what kind of denture adhesive is recommended and how to use it most effectively.
Although dentures are not the same as natural teeth, it is very important to keep them clean of food debris and plaque. Doing so can extend the life of your dentures, making them more comfortable fitting, improve chewing efficiency, and maintaining better oral health. Your dentist may recommend certain cleaning protocols, but in general, it is recommended to brush your dentures clean of all debris and plaque at the end of the day using either a specialized denture brush or a regular toothbrush. Toothpaste may be used, but it is not necessary. Soaking the dentures for an hour in a cleaning solution like Efferdent or Polident can help keep them from developing an odor or taste. Generally, you always want to keep the dentures wet – either they are in your mouth or they are soaking in a cleaning solution or plain water. The denture acrylics are designed to be moist and may suffer damage if allowed to completely dry out.
Just because you wear dentures does not mean you no longer need to see your dentist! It is a good idea to see your dentist at least once a year so that your dentures can be inspected and professionally cleaned. Your dentist will also evaluate your oral tissues and inspect for any problems that need addressing.
Q: What are veneers and how do they compare to crowns?
A: Veneers are a cosmetic restoration often done to provide improved aesthetics to the front upper and sometimes lower teeth. They are thin pieces of porcelain often no thicker than a half millimeter that are bonded in place to the surface of the teeth facing the lips. For best results, the teeth to be veneered should be prepared, that is, they should have a thin layer of the enamel removed to make room for the porcelain. That way, the overall size and shape of the teeth are not drastically altered compared to what is naturally present. Veneers are best used in very specific situations determined by your dentist, and are not for everyone. Existing fillings, cavities, and other dental issues usually preclude the use of veneers, but a crown may be a suitable restoration instead.
Crowns are different from veneers in that they cover the tooth entirely and are much thicker and stronger. A crown is often used if a tooth is fractured, cracked, or just broken down from numerous fillings. Because of the total coverage, a crown is like putting a helmet over a tooth, holding it together and strengthening it, while a veneer is more akin to a press-on fingernail for aesthetics purposes. Your dentist can help you determine what is the best restoration to suit your needs.
Q: What are dental implants and can I get them?
A: A dental implant is a surgical device placed within the bone of the jaw and is used to support a dental restoration to replace missing teeth. Dental implants have been actively used in dentistry for over 30 years and have revolutionized modern dentistry. Before implants, our treatment options for missing teeth were limited to using adjacent natural teeth to support a bridge or a removable partial denture. If the patient lacked any teeth, complete dentures were used. Implants have allowed us to perform simple procedures like replacing one tooth, or complex procedures such as supporting a complete dentures to replace all missing teeth.
Not everyone is a candidate for dental implants. Compared to traditional crown and bridge, dental implants are a little more complicated and have a surgical component that can result in taking longer to achieve the desired outcome, as well as costing more. Your dentist can explain the requirements needed for placing dental implants and what kind of restoration may be recommended to best suit your needs.
Q: I heard you can get implants and dentures done in a day, how is that possible?
A: Not everyone is a candidate for having implants and dentures done in a day. For such a complex procedure, certain criteria must be met first before such a treatment can be considered. Criteria such as systemic health, current dental condition, bone levels of the jaws, patient’s desired outcome, financial consideration, etc. are factors in determining if a patient is a good candidate for this procedure.
The “implants and dentures in a day” line is correct, albeit somewhat misleading. It can be misconstrued to mean a person can walk into a dental clinic without teeth and walk out that same day with a full set of teeth, but in fact, that is in reference to the actual procedure date and not the initial visit. With any complex treatment, careful planning is required and multiple visits may be needed to allow the dentist to gather the necessary data to plan out and execute the treatment.
Q: I was told I need bone grafts if I want implants. What is that and why do I need it?
A: If you have been told bone grafting is needed, then it is due to the fact that the location where your dentist needs to place an implant lacks the sufficient amount of bone. An implant is dependent upon the surrounding bone in which it is placed for its support and positioning. If there is insufficient quantity of bone, then more may be gained by way of bone grafting. Grafting is a surgical procedure in which bone material is placed at the site where dental implants are desired. The material is placed in intimate contact with your natural bone under the gum tissue and a healing period of around 4-6 months may be needed for the graft to be ready for implantation.
Q: My denture is broken. Are you able to fix it?
A: In most cases, yes. Whether a denture is repairable or not depends on the age, where it broke, and how severe the damage is. At Prosthodontic Associates, we have an in-house lab capable of repairing the vast majority of breaks – from complete breaks down the middle to small fractures and broken off teeth. It is important to note that while most breaks can be repaired, the repaired area will not be as strong as the original whole denture. Also, depending on the age, denture acrylic can discolor or stain, and the new repair acrylic may not match the original.
If your denture is broken, please do not attempt to repair it with Super Glue or any other adhesive. Often times, this results in a poorly repaired denture where the broken parts no longer fit together precisely and will complicate the repair procedure. Should your denture break, please give us a call as soon as possible. Most days we will be able to get you in the same day you call.
Q: My tooth does not hurt, but my dentist said I need to either get a root canal or have it extracted. Why?
A: Your dentist can find issues with your teeth that you often may not be aware of. In most cases, the absence of pain is not a reliable indicator of lack of problems. For example, the pulp of a tooth may die and turn into a low-grade localized infection that only your dentist would notice during a routine exam with x-rays. Because the tooth is dead, the nerve is also dead and no pain is felt. By the time you begin to notice something is amiss, it may be far too late to save the affected tooth and perhaps neighboring teeth due to spreading infection and damage.
While our specialty at Prosthodontic Associates is replacing missing teeth, we would prefer to save your existing teeth unless that proves to not be possible. In the event that it is not, we have multiple options for patients to replace the lost tooth or teeth.
Q: What is the difference between a partial denture and a complete denture?
A: A complete denture is a removable appliance that replaces all the missing teeth on an arch. It is usually made of acrylic resin and covers the gums of the supporting arch. Complete dentures rely upon close intimate fit to create a suction for retention and stability. Denture adhesives are sometimes used to improve the suction.
A partial denture is a removable appliance that replaces only some of the missing teeth on an arch. Partial dentures are also made of an acrylic resin, but often have a metal frame to provide support and strength. Partial dentures benefit from being able to derive stability and retention from adjacent natural teeth by way of clasps.
Q: My lower denture keeps lifting up. Can anything be done to hold it in place?
A: Denture wearers usually experience looseness with the lower denture due to the fact that the lower denture offers less surface area than the upper, and the lower jaw has anatomical features that do not contribute to a suction that can be obtained with the upper denture.
The most common way to obtain better retention is to use a denture adhesive. Adhesives come in a variety of forms from creams to powders and even sheets that work like tape. Adhesives work best with dentures that have good fit and can serve to provide a little bit of extra hold, but they do not work well if one has to use a lot on poorly fitting dentures. If dentures do not fit well, it would be advisable to consult your dentist to see if your dentures might need relining or adjustment.
Implants are a great way to markedly improve lower denture retention. Two implants can be placed where the lower canines used to be and a set of snaps can be installed on them and the receptacles placed in the denture. The resulting outcome is a lower denture that is held in place by a mechanical fixture and snaps on and off, virtually eliminating the need for denture adhesive. As with any mechanical device, the snaps on the implants and in the denture will eventually wear out and may require replacing in order to give you the desired level of retention. At Prosthodontic Associates, implant overdentures are our specialty and we would be happy to assist you in servicing existing dentures or creating new ones with implants so that you can get the most out of life.