DENTAL CARE

Jeffrey Gross, DDS, FAGD

Q: What Can I Do To Make My Teeth Last Longer?

A: I know. You probably think that this column is about brushing and flossing. Well that’s not what we are talking about today. Of course, I will mention the old adage. When asked the question, “which teeth should I brush and floss?”, the usual dentist answer is “only those that you want to keep”! We all know how important oral home care and cleanliness is to the health of our teeth. However, today I want to talk about limiting stress on teeth. More specifically, I want to focus on the patient who is already missing teeth and wears a partial denture or bridge that comes in and out. These are essentially the same things, but different people use different terms to describe them.

The partial denture that serves the best is one that only replaces a minimal number of teeth. By doing this, it is more stable in the mouth as it hugs onto the rest of the teeth in the mouth. It will wear away with time, but the fit should be relatively stable. Wear of the replacement teeth makes them less efficient. As more teeth are lost and the partial denture gets bigger, the level of stability goes down. The partial now uses the gum tissue for support as well as the teeth. There is movement of the partial and we often hear that food catches under it. If we move forward in time for this patient, they present themselves with even less teeth. The loss of teeth has occurred due to decay or gum disease. Depending upon the position of the remaining teeth, the possibility of making a partial denture that will function decreases. In fact it can go so far, that it gets to the point, that the patient is told that the only fix is a complete denture. That’s right. Remove the remaining teeth and make a denture. I can’t begin to tell you how many people plead with me and tell me that this is not the direction that they would like to go. I listen to my patients and came up with a solution. In both of these latter cases that I just mentioned, the problem comes from too little teeth and too much gum. Since the partial denture wraps around the teeth, less teeth means a partial denture that is really inefficient, at best, and not usable in the worst case scenario. Wearing a partial in this situation puts an undue amount of stress on the teeth resulting in their demise and ultimate removal.

To avoid traveling down this road, the teeth have to become protected from this type of stress. So how do I reduce the stress? The answer is simply more anchors for the partial denture. They are needed to reduce the tugging and pulling on the remaining teeth. When I lecture other doctors and discuss this concept they are amazed at how simple the fix to this horrible problem can be. How do we obtain more anchors for the partial? The answer is simply to add a dental implant or two to improve the situation. In fact an implant is actually better than having a tooth in that position. The reason for is because the implant, used in this situation, is able to handle more stress than a natural tooth. Because of this, all of the wear and tear is removed from the few remaining natural teeth. They last longer and the partial denture last longer. As we get older we are less resilient to change. Let me share a story with you.

I just saw a patient, who is over 90 years old. She was not at a point in her life where she wanted to learn how to wear a full denture. One single implant made all the difference for her. She now has a great smile and chews food well. To add to this good news, many times I can retrofit an implant to an existing partial denture. This patient went from” I know that you will have to pull the rest of my teeth” to “I’m so happy that you told me about this treatment”!

If you have a situation in your mouth that you have been “putting up with”, please feel free to call and discuss it with me. I can be reached at 440.951.7856 I look forward to hearing from you.