Tag Archives: Dentures

Sedation Dentist

Dealing with a High Resistance to Novocaine

I am 27 years old and have horrible teeth. Dental work is almost impossible for me because I have a high resistance to Novocain which makes it almost impossible to get numb. I’m thinking my only option is to remove my teeth and get dentures. I want to move up in my career and feel my smile is really holding me back. I am assuming that I can get the teeth removed with anesthesia, right?

Amelia

Dear Amelia,

Woman with beautiful smile

Before you do anything drastic, like remove all your teeth, I want togive you a solution that will allow you to keep your natural teeth, have a beautiful smile, and not get tortured at the dentist because of your high resistance to Novocain.

There is a huge connection between the inability to get numb and dental anxiety. Given your traumatizing experiences with dental care, I would not be surprised if you had a very high anxiety level.

This anxiety amps up your metabolism, which burns off the numbing medication before it can do anything. I recommend you see a sedation dentist who offers oral conscious sedation.

This is administered by a pill which will completely relax you. In fact, it is so strong that it has been dubbed sleep dentistry because most patients just snooze through their entire procedure. You will need someone to drive you to and from your appointment as well as stay with you for a few hours until you are lucid and steady on your feet again. But, this will change your life and you’ll be able to get that work done on your teeth without pain or anxiety.

Why You Don’t Want Dentures

images of before and after facial collapse
The result of facial collapse

When your teeth are removed,  your body recognizes that and immediately begins to resorb the minerals in your jawbone to use elsewhere in your body. In about ten or so years, you will no longer have enough of your jawbone left to retain your dentures. Dentists call this facial collapse. You are only 27 years old, this is NOT what you want.

While there is a way to prevent this, it is expensive. You could have dental implants placed that your dentures would anchor to. The implants are like prosthetic tooth roots, so your body recognizes that you have teeth there and leaves your jawbone intact.

Before you go this route, I think trying dental sedation will truly solve your issue.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Dental Implants

How Far Back Should Dentures Go?

I’m new to this whole dentures thing. In all honestly, I never thought I’d be without teeth at my age (42). I need to know how far back they are supposed to go. The problem I am facing is that my lower dentures do not cover the area where my wisdom teeth were and I’m chewing on gums. It’s uncomfortable. I spoke to my dentist and he told me he put them back as far as they go. How do people with dentures deal with the wisdom tooth area?

Todd

Dear Todd,

Man holding his jaw in pain

Dentures have problems. Even the best fitting dentures will reduce your chewing capacity by 50%. While you may never be completely thrilled with your dentures, there are some things your dentist can do to make this as pleasant as possible for you. Fixing this issue is one of them.

Your dentures should go past the wisdom tooth area and into the beginnning of the retromolar pad. Covering the retromolar pad completely is a bad idea because you will end up with interferance with your upper dentures, but going onto the beginning of it is fine and preferred.

So if your dentures can cover your wisdom teeth, why is your dentist acting like it can’t? While I cannot read your dentist’s mind, my suspicion is that he does not want to admit it can be fixed because fixing it means re-doing the denture completely.

If you have already paid for these, you won’t really have any leverage. You could show him this blog post and appeal to his integrity. If that does not work then you can threaten to share your experience on the review sites. This will impact  his business and he’ll know that.

An Additional Problem with Dentures

Before and after facial collapse
An Example of Facial Collapse

I am concerned that you have dentures at such a young age. Hopefully, your dentist warned you about the danger of facial collapse when you wear dentures for years.

When your teeth were first extracted, your body immediately began resorbing the minerals in your jawbone. It does this in order to be as efficient as possible with your body’s resources. Unfortunately, after about ten or so years you will no longer have enough jawbone left to support your denture. This is known in dental circles as facial collapse. The good news is there is a way to prevent it.

Preventing Facial Collapse

Implant Overdentures
Fixed implant bridge

If you place dental implants into your jawbone and then anchor your denture to them, which is a fixed implant bridge, not only will your dentures be completely secure but it will also prevent facial collapse. The implants serve as prosthetic tooth roots and signal to your body that your minerals are needed so that your jawbone can retain your teeth.

This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimmesch.

Dental Implants

How Can I Keep My Face From Collapsing with Dentures

I am only 32-years-old and have recently been diagnosed with a severe calcium deficiency. My dentist said this is why my teeth are always falling apart. He wants to extract the rest of my teeth and give me dentures. I have heard that getting dentures can make your face collapse, which makes you look like a grandmother. I still have two toddlers. I want to look like their mother, NOT their grandmother. Is there anything I can do which will help prevent this from happening? I am getting treatment for my calcium deficiency, but my dentist says it is too late for what is going on with my teeth.

Avery

Dear Avery,

images of before and after facial collapse

For those who are unaware, facial collapse is something that happens when you get dentures. As a result of no longer having teeth, your body immediately begins resorbing the minerals in your jawbone to use elsewhere, as a means of being efficient with your body’s resources. After all, you don’t have teeth to support any longer so you no longer need that bone.

The problem with that is after ten or so years, you no longer have enough jawbone left to support your dentures and end up looking like the woman on the left side of the picture above. This woman now looks decades older than she really is.

While there is a way to prevent this that I will go over, I don’t think you will need to have your teeth extracted. Certainly not all of them. I have no idea why your dentist is blaming your calcium deficiency for your teeth issues. That has zero impact on what is going on with your teeth now.

Your teeth are fully formed so developing a calcium deficiency in adulthood will not impact the health of your teeth. It can cause cramps, nerve damage, and osteoporosis. So why is your dentist saying this? I’m only guessing here, but dentists have different levels of willingness to fight to save teeth. Yours seems to be on the low end and all he wants to do is extract them and be done.

In your place, I would look for a dentist who is willing to put in the work to save your teeth. Don’t get anything done until you get a second opinion. See another dentist for a cleaning and check up and get their unbiased opinion. Do not tell them what your other dentist said. Just let them examine you and give their recommendations.

Preventing Facial Collapse

Implant overdentures illustation

For those who do have to have all their teeth extracted, there is a way to prevent facial collapse. If you have dental implants placed, it signals to your brain that there are still roots of your teeth there and therefore it will not resorb any of the minerals from your bone, thereby leaving it completely intact.

Once the implants are placed and integrated with your bone, then your dentist can anchor a set of dentures to them. These are known as implant overdentures and will be completely secure, unlike removable dentures.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Sedation Dentist

Can’t Get Numb At Dentist

I have always had a hard time getting numb at the dentist. My last appointment was no different. In fact, I would call it torture. I’m about to give up and just extract all my teeth and get dentures. Before I do that, though, I just wanted to check and see if you have ever encountered this with other patients. If so, did you find a solution for them?

Jason

Dear Jason,

Man in pain in need of an emergency dentist

Please don’t extract all of your teeth. Dentures cause more problems than they solve. I do have a solution for you. Many dentists are not aware of the connection between dental anxiety and numbing medication. The higher the anxiety, the less effective the medication. There is something that happens to your metabolism with fear that kicks in and tends to burn off the numbing medication before it has a chance to really work for you.

The key is to make certain the patient is completely relaxed before administering the Novocaine so that it has a chance to really kick in. What you need is a sedation dentist. These dentists are used to working with anxious patients and have medication that can help you relax.

In your case, I am going to suggest you use oral conscious sedation. This is administered by a pill. However, it will relax you so much that you could sleep through your entire procedure.

Patients who’ve used oral conscious sedation have their lives changed and their ability to get their dental care done in a pain-free manner restored. Additionally, because you can sleep, your dentist can get more work done at each sitting.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Dental Implants

Should My Husband Get All-On-Four Dental Implants?

My husband needs to replace his bottom teeth. His upper teeth have been gone for a while and he has dentures there. We were told that you shouldn’t do dentures on bottom teeth because they won’t stay in the way the top ones do. Our dentist said he needs to get all-on-4 dental implants. I just want to explore if there are other options before we make a decision?

Pricilla

Dear Pricilla,

All-on-4 Dental Implants

I am curious why that is the only option he gave your husband. A dentist is ethically obligated to give his or her patients all of their options. He is correct that dentures are a bad idea on bottom teeth. While it is true that dentures will struggle to stay in on the lower arch, that does not happen right away. This is an issue because of bone resorption.

When his teeth are removed, his body recognizes that and begins to resorb the minerals in his jawbone in an effort to be as efficient as possible with his body’s resources. The big problem with that is after ten or so years, he will no longer have enough jawbone left to retain his dentures. This is known as facial collapse.

This bone structure is important no matter what tooth replacement option he chooses.

All-on-4 Dental implants (pictured above) are what dentists will sometimes offer to patients who have lost some jawbone structure but still want dental implants. However, there are other options.

Implant-supported denture

The first thing to find out is whether or not he has lost bone structure. If he hasn’t, then his best option is to get an implant overdenture. This uses between for and six dental implants and then anchors a denture to them.

If he is missing bone, depending on the amount, he has two choices. First, he can have the all-on-4 procedure his dentist suggested, as long as he hasn’t lost too much bone. The one downside to this procedure, however, is that if one implant fails, the entire unit has to be redone. A second option, no matter how much bone he’s lost, is to have a bone grafting procedure done to build it back up. Then, he can do implant overdentures if he wants. He could get a denture too, but bear in mind he will end up with facial collapse. Having dental implants in the jaw bone, prevents that from happening.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Dental Implants

Dentist Said I Have to Get Dentures

I have dental insurance for the first time and just started going to the dentist. My teeth are pretty bad and some of them have started coming out. My dentist said I have advanced gum disease and will need to extract my teeth and get dentures. Is it at all possible that I could get dental implants instead?

Susan A.

Dear Susan,

Implant Overdentures
Implant Overdentures

You are in a tough position. At some point, dental implants will be possible, but you are going to have to get that periodontal (gum) disease under control first. That will be imperative. After that, I would make sure your dentist does adequate diagnostics. That would need to include a CT for two reasons. First, you want to make sure you have enough bone structure left to retain your dental implants. Second, dental implants are a 3D procedure and you need 3-Dimensional images in order to ensure proper placement.

If you don’t have enough bone structure, you will need to have a bone grafting procedure done first. Then, after a time of healing, it will be okay for you to go forward with your dental implants.

What you will want to get is called implant overdentures or implant supported dentures. With this, you will have between four to eight dental implants placed and then, after a period necessary for osseointegration (meaning bone integrating with the implants), have a denture anchored to them.

This blog is brought to you by Lafayette, LA Dentists Drs. Foremen and Thimmesch.

Dental Implants

Should I Keep My Last Two Teeth?

I am about to have another tooth extracted. This will leave me with only my two front teeth on my upper arch. They are fairly healthy and should last a good while. Most of my lower teeth are still there. I am wearing a partial denture right now to accommodate the upper partial. It’s really uncomfortable and makes it difficult to talk. Because I can eat everything but meat with it, I rarely put it on, unless I am going somewhere to socialize. Some people are telling me that I would probably be happier with a complete upper denture instead of my partial. There aren’t really people I know who have been in this situation where I can ask them if they thought removing those last two teeth was worth it. Have you an opinion on this issue? I’m kind of torn and having a hard time making my mind up. It’s not like I can change my mind after extracting those last two teeth.

Brent

Dear Brent,

Implant Overdentures

I am going to start with a tiny disclaimer that I can only give you general principles here. I don’t have your x-rays and haven’t examined you, so I am strictly going off the information you have provided me with.

In almost all cases it is better to preserve as many natural teeth as possible. That being said, your situation is unique. Yes, those two front teeth are healthy, but they are all you are eating with most of the time and the stresses on them will be tremendous. I don’t think they will last as long as you are hoping. In your case, I am going to suggest that you remove those last two upper teeth and replace the entire arch.

Tooth Replacement Options

The ideal would be for you to replace those teeth with implant overdentures. That would mean getting four to six dental implants and then anchoring a complete dentures to them. It is the most secure replacement possible. The only real downside to them is their expense.

Facial Collapse

The effects of facial collapse.

If these were your bottom teeth, I would tell you to do everything possible to ensure you get the implant supported dentures. This is because when your teeth are removed, your body immediately begins to resorb the minerals in your jawbone to redistribute them elsewhere in your body. With your bottom teeth, this is devastating. Not only does it age your appearance by decades, but your bottom denture simply rests upon your jawbone for its base. After ten or so years, you will not have enough bone left to retain your dentures. This is known as facial collapse.

Because you are dealing with your upper teeth, you are at a slight advantage. These are h eld in by suction and not your jawbone, so you will have more security and retention. Getting complete dentures in this case will be okay if you cannot afford the implant overdentures.

This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimmesch.

Dental Implants

Dental Implants After Ten Years in Dentures

I have been in dentures for a little over ten years. To be honest, I have hated them the entire time. I knew fairly quickly after getting them that I would need to switch to dental implants, but just didn’t have the budget for it yet. I’ve finally saved up enough. Is it too late for me? My dentist retired and the new one said I’ve been in dentures for too long to switch.

Avery

Dear Avery,

Implant overdentures

Technically, it is never too late to get dental implants. That being said, there could be the possibility of needing one procedure to get your mouth in the right condition for dental implants to have a chance to succeed. If that is the case, why did your dentist tell you it is too late?

During Dental School, students are taught that it is important patients are confident in them. Because of that, many dentists do not want to admit when there is a procedure they are not comfortable doing. Instead of risking the patient’s respect by admitting they can’t do something, some dentists will simply steer their patient’s to another procedure they are more comfortable with.

It is never a good idea to pressure a dentist to do a procedure that is out of their comfort zone. The results are usually disastrous. This is especially true with dental implants, which is a very advanced procedure. The training required to do this well has to be done in a post-doctoral setting. Not many dentists invest in enough of it, which is probably why it is one of the procedures that tops the malpractice suit list. I’m going to recommend, you find a different dentist to do your porcedure.

Dental Implants and Facial Collapse

The consequences of years in dentures.

When your teeth were first removed for your dentures, your body recognized you no longer had tooth roots and, therefore, didn’t need any of your jawbone to help keep them in place. Our bodies are always striving to be as efficient as possible with its resources. To help with that goal, it will resorb the minerals in your jawbone to use elsewhere in your body.

While remarkable, this will have the unfortunate side-effect of slowly shrinking your jawbone. Eventually, there will no longer be enough jawbone to even support your dentures. This is known as facial collpase (pictured directly above).

For dental implants to be retained, they need the surrounding bone to integrate with it and keep it secure. If you don’t have enough bone to start with, that is impossible. You have been in dentures for ten years, which is enough time for significant bone loss.

The good news is there is a fairly simple solution. You can have a procedure done, known as bone grafting. It will build back up the bone in your jawbone. Once you have healed from that, you can have your dental implants placed and then anchor your new denture to them–a procedure known as implant overdentures.

You will have the secure smile you’ve always wanted with none of the problems and consequences that come with removable dentures.

This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimmesch.

Dental Implants

Can I Get Dental Implants after 30 years in Dentures?

I’ve had dentures for around 30 years. I’ve never been crazy about them and always wanted to switch to dental implants. Now, I’m having trouble even keeping them in. I think this may be a perfect time to switch, but I don’t know if I waited too long. Is it still possible? If not, how do I get my dentures to stay in? Not even those nasty adhesives are working.

Marilyn

Dear Marilyn,

dental implant diagram

Technically, as long as you are in reasonably good health, you can get dental implants. Though, in cases like yours, an extra step will be needed. As you can see from the image above, your dental implant will need to be surrounded by bone in order to stay in place. This bone is also what holds your teeth in place as well, along with some ligaments. After this length of time with dentures, you are missing that bone.

You’re Dealing with Facial Collapse

When your teeth were removed 30 something years ago, your body immediately began resorbing the minerals in your jawbone to use elsewhere. It does this in an effort to be efficient with your body’s resources. It knows you don’t have teeth anymore and assumes that you won’t need the bones in your jawbone to hold them. True. However, your dentures rest on the ridgeline of your jawbone. As that shrinks, there is less and less of a ridge to hold your dentures in place.

After ten years in dentures, you likely noticed them starting to slip. By thirty years, it is almost impossible to keep them in. This is known as facial collapse. You’ve probably also noticed your jawline shrinking,, which makes you look much older than you really are.

There is a procedure to help with this– Bone grafting. You can have either natural or synthetic bone built back up in the area so that you’ll have enough bone there to integrate with your dental implants and keep them in place.

Implant Overdentures

implant-overdentures
Implant Supported Dentures

Once the bone grafting is complete, then you will be able to get the dental implants you hope for. You won’t want to do a one-to-one replacement for your teeth. That is way too expensive. Instead, you’ll get implant overdentures. With these, you’ll have four to six dental implants placed in each arch and then have a new set of dentures anchored to them.

Your dentures will be completely secure and will protect you from facial collapse in the future.

This blog is brought to you by Lafayette, LA Dentists Drs. Forman and Thimmesch.

Uncategorized

Is it necessary for my son to get all of his teeth pulled?

My son is 23 years old. He is a drug addict who is in recovery, and his teeth are completely ruined. The dentist at the clinic says he should just have all of them pulled and replace them with dentures.

Right now, I recognize that this is the only avenue open to us. The teeth have to come out. He is only able to chew with a couple of teeth towards the front of his mouth.

My question is whether or not all of this can be done in one visit. It seems like a lot–he has 26 teeth that need to come out. Would they be able to fit dentures when they’ve just removed all those teeth? It doesn’t seem like they could do that until after his gums heal

Any advice you can offer would be appreciated. This has been a long, hard road.

Serena in Overton

Dear Serena,

This treatment plan is too extreme. It may seem like the easiest solution to the dentist, but it means a lifetime of dental trouble for your son. He is much too young to have all of his teeth removed.

As soon as all his teeth are removed, your son’s jawbones will start to shrink. When a tooth is lost, the body reabsorbs the bone of the jaw at the location of the missing tooth. When ALL the teeth are removed, eventually that person will experience “facial collapse”. You have probably seen pictures of people whose faces look as if they have collapsed inward. This happens when the jawbones deteriorate to the point that the patient cannot wear any kind of denture at all.

If he is in his early 20s now, this could happen by the time he is 40. He will be unable to eat normal foods, and at that point the repairs are much more complicated and expensive.

If at all possible, the goal should be to retain as many of his natural teeth as possible. They may not be in perfect condition, but every tooth that can be saved represents a more stable jawbone. Those remaining teeth could be used to anchor partial dentures or dental bridges.

If in fact none of his teeth can be saved, dental implants will work just like natural teeth to preserve the structure of his jawbone. The least expensive option would be mini-dental implants, where two implants per arch are placed and used to anchor dentures. Having ALL the extractions done in one sitting is too much. The amount of Novocain required to numb the upper jaw for a full set of extractions is significant, and poses a correspondingly significant risk.

It is time to get a second opinion. We recommend looking for a dentist that really makes you feel like he cares about your son, and your situation. Your son is on the road to recovery, and needs compassion to get the care he needs.

This blog is posted courtesy of Lafayette Louisiana cosmetic dentist Dr. Mike Malone.