It’s a common problem for denture wearers: after years of a comfortable fit, your dentures now seem to be uncomfortably loose. The reason, though, may have more to do with bone loss than the dentures.
Bone is a living tissue with a life cycle — it forms, it ages, and it eventually dies and dissolves (resorbs). It’s replaced with new bone and the cycle repeats. Additionally, the forces generated when we bite or chew are transmitted from the teeth to the jaw, which helps stimulate new bone growth. When the natural teeth are missing, however, the bone no longer receives this stimulus. Resorbed bone isn’t replaced at a healthy rate, which leads over time to bone loss.
Denture construction can also contribute to bone loss. The denture palate rests for support on the bony ridges that once held the teeth. Over time the compressive forces of the dentures apply damages and reduces the volume of gum tissue and eventually does the same to the bone. Combining all these factors, the reduced gum and bone volume will eventually alter the denture fit.
There are a few alternatives for correcting loose dentures. One is to reline them with new plastic, as either a temporary fix performed during an office visit or a more permanent relining that requires sending your dentures to a dental lab. Depending on the rate of bone loss, a patient could go through several denture relinings to accommodate ongoing changes in the jaw. At some point, though, it may be necessary to create a new set of dentures.
A third alternative that’s becoming increasingly useful is to incorporate dental implants into the denture design. Implants can of course be used to replace individual teeth, but a few strategically placed implants (usually of smaller dimension) can serve as a support platform for a removable denture. This relieves some of the compression force of a traditionally worn denture and can slow bone loss.
If you’re having problems with your denture fit, call us for an appointment. We’ll help you decide on the best alternative to improving the fit and making your dentures more comfortable and secure.
If you would like more information on refitting loose dentures, please contact us today to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Loose Dentures.”
On the big screen, Australian-born actress Margot Robbie may be best known for playing devil-may-care anti-heroes—like Suicide Squad member Harley Quinn and notorious figure skater Tonya Harding. But recently, a discussion of her role in Peter Rabbit proved that in real life, she’s making healthier choices. When asked whether it was hard to voice a character with a speech impediment, she revealed that she wears retainers in her mouth at night, which gives her a noticeable lisp.
“I actually have two retainers,” she explained, “one for my bottom teeth which is for grinding my teeth, and one for my top teeth which is just so my teeth don't move.”
Clearly Robbie is serious about protecting her dazzling smile. And she has good reasons for wearing both of those retainers. So first, let’s talk about retainers for teeth grinding.
Also called bruxism, teeth grinding affects around 10 percent of adults at one time or another, and is often associated with stress. If you wake up with headaches, sore teeth or irritated gums, or your sleeping partner complains of grinding noises at night, you may be suffering from nighttime teeth grinding without even being aware of it.
A type of retainer called an occlusal guard is frequently recommended to alleviate the symptoms of bruxism. Typically made of plastic, this appliance fits comfortably over your teeth and prevents them from being damaged when they rub against each other. In combination with stress reduction techniques and other conservative treatments, it’s often the best way to manage teeth grinding.
Orthodontic retainers are also well-established treatment devices. While appliances like braces or aligners cause teeth to move into better positions, retainers are designed to keep teeth from moving—helping them to stay in those positions. After active orthodontic treatment, a period of retention is needed to allow the bite to stabilize. Otherwise, the teeth can drift right back to their old locations, undoing the time and effort of orthodontic treatment.
So Robbie has the right idea there too. However, for those who don’t relish the idea of wearing a plastic appliance, it’s often possible to bond a wire retainer to the back surfaces of the teeth, where it’s invisible. No matter which kind you choose, wearing a retainer can help keep your smile looking great for many years to come.
If you have questions about teeth grinding or orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “The Importance of Orthodontic Retainers.”
Placing a dental implant within the jawbone requires a surgical procedure. For most people it’s a relatively minor affair, but for some with certain health conditions it might be otherwise. Because of their condition they might have an increased risk for a bacterial infection afterward that could interfere with the implant’s integration with the bone and lead to possible failure.
To lower this risk, dentists for many years have routinely prescribed an antibiotic for patients considered at high-risk for infection to take before their implant surgery. But there’s been a lively debate among health practitioners about the true necessity for this practice and whether it’s worth the possible side effects that can accompany taking antibiotics.
While the practice still continues, current guidelines now recommend it for fewer health conditions. The American Dental Association (ADA) together with the American Heart Association (AHA) now recommend antibiotics only for surgical patients who have prosthetic heart valves, a history of infective endocarditis, a heart transplant or certain congenital heart conditions.
But patients with prosthetic joint replacements, who were once included in the recommendation for pre-surgical antibiotics, are no longer in that category. Even so, some orthopedic surgeons continue to recommend it for their joint replacement patients out of concern that a post-surgical infection could adversely affect their replaced joints.
But while these areas of disagreement about pre-surgical antibiotics still continue, a consensus may be emerging about a possible “sweet spot” in administering the therapy. Evidence from recent studies indicates just a small dose of antibiotics administered an hour before surgery may be sufficient to reduce the risk of infection-related implant failure with only minimal risk of side effects from the drug.
Because pre-surgical antibiotic therapy can be a complicated matter, it’s best that you discuss with both the physician caring for your health condition and your dentist about whether you should undergo this option to reduce the infection risk with your own implant surgery. Still, if all the factors surrounding your health indicate it, this antibiotic therapy might help you avoid losing an implant to infection.
If you would like more information on antibiotics before implant surgery, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Implants & Antibiotics: Lowering Risk of Implant Failure.”
With its life-like color and texture, dental porcelain can restore a smile marred by decayed or damaged teeth. This durable ceramic material not only matches the varieties of individual tooth colors and hues, its translucence mimics the appearance of natural teeth. But perhaps its greatest benefit is its adaptability for use in a number of different applications, particularly veneers and crowns.
Veneers are thin layers of dental porcelain laminated together and permanently bonded to cover the visible outer side of a tooth to improve its appearance. Crowns, on the other hand, are “caps” of dental porcelain designed to completely cover a defective tooth.
Veneers and crowns share a number of similarities. Both can alter the color and shape of teeth, although crowns are used when more extensive tooth structure has been damaged. They’re also “irreversible,” meaning the tooth must be altered in such a way that it will always require a veneer or crown, though on some occasions a veneer can require no removal of tooth structure and can be reversible.
They do, however, have some differences as to the type of situation they address. Veneers are generally used where the affected teeth have a poor appearance (chipped, malformed or stained, for example) but are still structurally healthy. And although they do generally require some removal of tooth enamel to accommodate them (to minimize a “bulky” appearance), the reduction is much less than for a crown.
Crowns, on the other hand, restore teeth that have lost significant structure from disease, injury, stress-related grinding habits or the wearing effects of aging. Since they must contain enough mass to stand up to the normal biting forces a tooth must endure, a significant amount of the original tooth structure must be removed to accommodate them.
Which application we use will depend upon a thorough examination of your teeth. Once we’ve determined their condition and what you need, we can then recommend the best application for your situation. But regardless of whether we install a veneer or crown, using dental porcelain can help achieve an end result that’s truly life-changing — a new, younger-looking smile.
If you would like more information on dental porcelain restorations, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Porcelain Crowns & Veneers.”
Long-term dental health is built on a foundation of good hygiene habits instilled at an early age. Consistent, daily hygiene not only makes for healthy teeth and gums but an attractive smile too.
Here are 4 tips for encouraging your child to develop effective oral hygiene habits.
Begin teaching them to brush and floss on their own around age 6. Brushing and flossing are the primary ways to remove bacterial plaque from teeth, the main cause for dental disease. You should begin brushing your child’s teeth when they first appear; around age 6 you can begin encouraging them to brush for themselves and learn to floss.
Promote healthy eating and snacking habits. A nutritious diet is also important for maintaining healthy teeth and gums. Make sure your child is eating a varied, balanced diet of whole foods in appropriate portions. You should limit sugar and other carbohydrates (which accelerate growth of decay-causing bacteria) to mealtimes; offer limited, non-sugary snacks between meals.
Warn older children and teens about practices that are unhealthy for the mouth. As children enter their teen years, they’re under increased pressure from peers to try unhealthy practices. Oral piercings like tongue and lip bolts can increase tooth damage — chipping and wear — and gum recession, infection and bone loss. Tobacco use, both smoke and smokeless, can also cause tooth staining, increase the risk of decay, gum disease and oral cancer. Begin stressing the dangers these practices pose to their general and oral health before they reach puberty.
Practice what you teach. Â Modeling healthy behavior you want your child to learn is just as important as instructing them how to do it. When they’re very young, brushing teeth should be a family affair — allow them to see how you brush your teeth as you help them brush theirs. And, if you’re not sure if your hygiene techniques are worthy of emulation, we’ll be glad to help you improve your effectiveness to pass on to the next generation.
If you would like more information on developing life-long dental habits with your child, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How to Help Your Child Develop the Best Habits for Oral Health.”
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