Got Dentures?
Dr. Smith spent 3 days in July in Chicago at an implant conference on the diagnosis and treatment of patients who need implants. Dr. Misch, who presented the program through his institute, heads the implant department in 2 dental colleges. He is the primary advisor for one of the implant manufactures and presents many lectures around the world for dentists. The week before his presentation to our group, he was placing implants for the King of Qatar.
He began by stating the obvious; even with all our preventive efforts some people over 55 still lose one or more teeth. In fact, 30 million Americans have an upper denture and 20 million have a lower denture. The average person with upper and lower dentures sees a dentist once every 14 years. This is a mistake. In fact, in 2008 Americans spent $150 million on denture adhesive. Denture wearers should at least be seen every 2 years to check for
1. Oral cancer
2. Watch for loss of bone around teeth. When the teeth are lost, the bone will dissolve away. Fosamax and other biophosphonates can reduce bone density.
3. Look for gum problems
4. Evaluate the TM joint
5. Look for tooth wear, chewing ability, etc.
Implants have been the best approach to replacing missing teeth, stabilizing loose appliances, and preventing bone loss since 2004. When you lose your teeth and get dentures, several bad things happen.
1. You lose bone (10 times more the first year after the extraction)
2. Muscles atrophy and the skin in the lower ½ of the face sags.
3. With the loss of the bone supporting the dentures, the nose and chin come closer together, and wrinkle lines develop at the corners of the mouth and the chin sticks out. Someone with teeth can chew with a force of 100 – 150 pounds/square inch. A new complete denture wearer can exert 50 pounds/square inch, but after 15 years it’s only 6.
A reline every 3 – 5 years can stabilize the dentures and compensate for this bone loss to maintain chewing ability, as well as appearance. One study showed that poor-fitting dentures reduced chewing ability enough to stop eating most natural fruits, vegetables, etc., with most denture wearers eating only processed foods – and this reduced life expectancy 10 years.
Not only are implants great to help denture wearers, they have become the accepted best approach to replace one or more missing teeth for people who plan to have their natural teeth all their lives.
Charles C. Smith, DDS

