Let’s get to the root of the problem. Why people loose their teeth?

The most common causes of tooth loss include cavities (dental caries) and gum disease (periodontitis).

In the case of the tooth cavities, tooth structure is irreversibly lost as a result of oral bacteria producing acid on the surfaces of the teeth. As the cavity progresses in size the weakened tooth breaks and chips away. As the cavity process spreads deeper into the internal part of the tooth, bacteria and bacterial products can cause root canal infections and spread outside of the tooth into the surrounding bone.

In case of gum disease, the attachment between the tooth and the supporting gums and bone is destroyed as a result of inflammatory process that is triggered by the oral bacteria living on the tooth surfaces. As gum disease progresses the teeth become loose and mobile. Bacteria can also spread into the adjacent bone and soft tissue causing abscesses.

In most of the cases, dental caries and gum disease can be successfully treated and arrested using standard treatment protocols. However severe forms may not be amenable to the treatment thus requiring removal of the teeth.

Other less common causes of tooth loss include traumatic injuries, severe forms of tooth wear, tooth resorption, and tooth cracking as a result of chewing and grinding.

You are faced with the prospect of loosing your teeth and would like to do something about it. Your dentist may offer you several potential treatment options, with a removable denture being one of them. So what is a denture?

A denture is an artificial prosthesis, which replaces missing teeth and gums in one or both jaws. The denture can be removed by the denture wearer and dentist for cleaning and servicing. When the denture replaces teeth in the top jaw it is called a top, upper, or maxillary denture. When the denture replaces teeth in the bottom jaw it is called bottom, lower or mandibular denture. There are several different types of dentures.

Full denture is fabricated for the replacement of all teeth in one jaw. When the denture replaces one or more but not all teeth in one jaw it is called a Partial denture.

Immediate denture is placed immediately following removal of the teeth. This type of denture allows immediate restoration of smile and function so the patient does not have to go without teeth for even one day.

Implant denture represents yet another type of denture treatment. In some situations gums or teeth do not anchor prosthesis well, thus making the denture wearer feel uncomfortable during chewing, speech, and swallowing. In such situations dental implants are used to anchor the denture.

Denture prosthesis is made of several different parts. Artificial denture teeth that are made of plastic or ceramic materials are used as a replacement of the natural teeth. The denture base is used for the replacement of the gums and usually made of plastic materials. When the denture is anchored to the teeth or implants additional anchoring metal or plastic parts are incorporated into the denture. It is also quite common to incorporate an additional strengthening element, usually made out of metal alloys, in order to reinforce the denture and prevent undesirable fractures.

Besides the denture, are there other options for the replacement of the teeth? What are the advantages and disadvantages of these options?

Two common options in the replacement of missing teeth include (1) fixed bridges and crowns and (2) removable dentures.

(1). Bridges and crowns can be supported by the natural teeth and dental implants. The most important characteristic of the bridge or crown is the fact that it is fixed and very stable during chewing and other oral functions.

Stability is the most important advantage of this type of tooth replacement. Performance of the fixed crowns and bridges is similar to the patient’s own natural teeth, and it is well appreciated by the patients. The disadvantage of the fixed crowns and bridges is a higher treatment cost, especially in situations where there is a need to replace several or all teeth. Treatment with fixed options may also add additional complexity and treatment time.

(2). Removable dentures are also used for the replacement of the missing teeth. Removable dentures can either be partial or full. Partial dentures are used for the replacement of one or several teeth in a jaw. The partial denture is designed in such a manner that it gets its stability from the remaining teeth and gums. Full dentures are used for replacement of all missing teeth in a jaw. Full denture gets its stability from the underlying gums of the jawbone. The main advantage of the denture treatment includes reduced cost. Denture treatment can also be less time consuming and less complex in comparison to the fixed treatment.

Dentures in comparison to the fixed bridges and crowns are usually less stable during normal functions such as chewing, speech and swallowing. The degree to which a denture moves in the mouth is extremely variable and depends on number factors. In many instances denture mobility can be a minor issue to the patient. However there are also many situations where a loose denture presents a considerable problem to the patient. The most common solution for loose dentures includes placement of dental implants that act as anchors.

This is the most common question we hear from our patients who are faced with the prospect of loosing their teeth.

Most of the time dentures can be placed immediately after removal of the teeth. This type of dentures is called “immediate dentures”. The biggest advantage of immediate dentures includes immediate restoration of smile and function so the patient does not have to go without teeth for even one day. Immediate dentures also help with the healing process by sealing the surgical wound which is present after tooth removal. Immediate dentures are made before the removal of the teeth. Measurements and impressions of the jaws are made in the dental office and sent to the dental laboratory where dentures are made.

Immediate dentures require additional servicing procedures. Bone and gums are always shrinking in the area of the removed teeth. The highest degree of bone shrinkage occurs in the first several months after the removal of the teeth. Upon gum shrinkage the immediate denture does not fit well anymore. In order to improve the fit of the denture, it is adjusted and relined as necessary. The number of reline and adjustment appointments depends on the clinical condition of the patient. It is common to have at least several adjustments and reline procedures done on the denture. Upon completion of the healing process the immediate denture is usually replaced with a new permanent denture.

It takes some practice, patience, and time to get used to your first dentures. On the other hand, adaptation to the new denture for patients with previous denture experience is usually a relatively straightforward task.

Patients who receive dentures for the first time may feel awkward or uncomfortable for the first several weeks. Dentures may feel loose, while the muscles of your cheeks and tongue learn to hold them in place. Salivary flow may also temporarily increase. Soft tissue irritation and soreness is not unusual especially when there is removal of the teeth and their replacement with an immediate denture. These problems disappear as your mouth becomes accustomed to the new dentures and your dentist makes necessary adjustments to the dentures.

For patients with immediate dentures we recommend soft diet for the first several weeks after removal of the teeth. Chewing slowly and using both sides of your mouth at the same time will prevent the dentures from moving out of place. Other types of foods can gradually be introduced until you resume your normal diet.

It is not advisable to wear dentures round the clock because gum tissues that are constantly covered with denture can become irritated. Patients are usually instructed to remove their dentures before bedtime. However for patients who receive immediate dentures, it is advisable to sleep with their dentures for first several nights after removal of the teeth.

Your existing denture does not fit well anymore. What can be done to improve its fit?

Changes in the denture fit most commonly occur as a result of the shrinkage in the bone and gums that support the denture. The degree to which bone and gums shrink depends on a number of factors as well as patient’s individual characteristics. When shrinkage of the supporting tissues reaches certain levels, the patient’s denture may not fit well anymore. Typically the patient will notice denture looseness, rocking, and denture sores. Potential solutions to this problem may include denture reline, denture rebase or fabrication of a new denture. Denture reline involves addition of a new material to the underside of the denture. In denture rebase, a new base is made and artificial teeth are added from the old denture.

Another common change that occurs with the denture over time is wear of the denture teeth. When tooth wear is significant, patient complaints may include unsatisfactory appearance, bite, and comfort. One potential solution to this problem may involve replacement of the old teeth with a new set. When denture presents with several problems such as poor fit and worn teeth it is best to replace the old denture with a new one.

Dental implants are the most advanced solution in the replacement of missing teeth and stabilization of removable dentures.

Dental implants are small titanium screws or cylinders. They are made of titanium and this material integrates well with the human body. Dental implants are placed into the jaw and after appropriate healing time they become permanently attached to it. Dental implants can be used to anchor a single tooth, multiple teeth or full dentures and partial dentures.

Dental implants have been used for several decades. Research indicates that dental implants have a very high success rate. Missing teeth that are replaced with implants can look and feel like natural teeth and allow patient to chew food comfortably. Another advantage of the dental implants is their ability to prevent further bone shrinkage.

Dental implants are very helpful for patients with loose dentures. Dental implants anchor the denture and help to eliminate denture sores and allow to chew food just like natural teeth. In today’s dental practice dental implants are routinely used for all types of tooth replacement.

Patients with loose dentures may experience gum discomfort and difficulties chewing food. Dental implants can be the best solution to these problems.

Dental implants are the best invention we have to date for loose and uncomfortable dentures. Usually two or more dental implants are placed in the jaw to help anchor the denture in place. The implants prevent the denture from flopping around thus making it more stable and comfortable. The advantages are many. They allow you to chew better and eat the foods you enjoy, speak more comfortably, smile confidently, enjoy your social life and overall improve the quality of your life. Patients who loose their teeth, experience continuous shrinkage of the jaw bone in the areas of the missing teeth. Another advantage of the dental implants is their ability to prevent further bone shrinkage.

For patients with loose dentures implants can be used in several possible ways. In one approach implants anchor the removable denture. In the other approach implants anchor a fixed bridge that is permanently attached to the implants. During planning stage of treatment, patient’s clinical condition is assessed for the feasibility of different treatment options.

Who is a good candidate for implant treatment? Patients in good general health, healthy gums, and adequate bone are good candidates for implant treatment. Patients who decide to have dental implants must be committed to thorough oral hygiene in order to keep their mouth healthy. In addition implant dentures and bridges require regular maintenance procedures in the dental office.

The mouth and oral tissues are subject to potentially serious deceases and should be examined on a routine basis.

Regular dental check-up and having your teeth, implants, and dentures professionally cleaned are important in order to keep your mouth healthy. Regular visits allow your dentist to check the soft tissues of your mouth, including the tongue and cheeks. These examinations are important so the dentist can spot any infections, mouth conditions or even mouth cancer at the earliest stages. Dentists recommend a dental check-up at least once a year even for patients who have no teeth. Professional dental cleaning intervals vary between the patients and depends on each patient’s condition. Professional cleaning for majority of the patients is usually performed once or twice a year.

Basic care of the dentures include handling, cleaning, and storing.

The materials your denture are made of can well withstand chewing forces. However a denture may easily break if accidentally dropped on a hard surface. Handle your denture with care to prevent any accidental falling. When cleaning your denture, you can hold it over a towel or over a sink filled up with water.

Just like natural teeth, dentures accumulate food deposits, plaque, tartar, and stain. Removing food particles and plaque helps to eliminate undesirable microorganisms which can irritate your gums. Brushing also decreases staining of the denture. We recommend brushing your dentures at least twice a day. It is best to use a cleaning brush specifically designed for dentures, however you can also use a regular soft-bristle toothbrush. Dentures can be soaked in one of the specially developed commercial products. These products are helpful in removing microorganisms from the surface of the denture. We do not recommend household bleach for the soaking of the denture. Bleach can cause undesirable changes in color of the denture. It can also be harmful to the gums if not completely rinsed off the denture.

For denture storage we recommend to use a specially designed plastic storage container. For the overnight storage, a thoroughly clean and dry denture is placed into the storage container. There is no need to store your denture in water or wet environment. Moisture promotes growth of undesirable microorganisms.

A prosthodontist is a dentist who specializes in restoration and replacement of missing teeth.

Prosthodontist is a dentist who receives three years of additional training after dental school in the area of dentistry that is called prosthodontics. Prosthodontists deal with the restoration and replacement of missing teeth and associated oral structures, restoration of smile and restoration of oral functions. Prosthodontics is one of the nine dental specialties recognized by the American Dental Association. Dental specialties are recognized in those areas where advanced knowledge and skills are essential to maintain or restore oral health.

Training for prosthodontists is earned through a hospital or university program accredited by the American Dental Association. Specialty training includes didactic lectures and seminars, laboratory and clinical training in cosmetic dentistry, crowns, bridges, veneers, dental fillings, removable dentures, and dental implants. Upon completion of the training, prosthodontists receive certificate in their specialty and often times, a Master’s degree in dentistry (for research completed in the program).