Drop Dead Gorgeous Dentures by Sequim Advanced Dental

Sequim Advanced Dental Arts is located in Sequim, Washington. The owner of Sequim Advanced Dental Arts is L. Scott Brooksby, D.D.S., D.I.C.O.I. He is trained in the advanced techniques of creating Drop Dead Gorgeous Dentures.

Dentures are replacements for missing teeth. Often when teeth start to break off or hurt most people belief their only choice is to extract the teeth and get dentures. Sometimes the denture is made before the teeth are extracted. This is called an immediate denture. There are alternatives that are much more comfortable, but lets look at what is involved in getting replacement dentures.

Replacement Dentures

When I used to teach in dental school, and even when I was in dental school we were taught to make an impression of the upper arch and the lower arch. This impression normally felt like it was a mouthful of mush which pushed the muscles of the mouth out of the way. We were then taught to make a tray that only fit that specific mouth. We made it and adjusted it in the mouth so that it did not push on the muscles at all. We would then mold a special compound on to the tray and mold the muscles in normal function so that the denture would fit better. We then would make another impression of the mouth with the muscles in function. The provided a much better fitting denture. Unfortunately this process took about 5 hours to do.

When most dentists got out of school they soon learned to skip the second impression because it took so much time.

Unfortunately with the muscles pushed out of the way in the first impression, the dentures that were made were too big for the mouth and they popped loose when you tried to use them. Denture adhesives were developed to try and overcome this problem.

Often people would get tired of the adhesives and looseness of the dentures and would spend a lot of money to get dental implants to hold the teeth in place. If you needed dental implants you would need to be healthy, have enough bone, it took time for the implant to properly bond to the bone and it was a lot more expensive.

Overdentures

An overdenture is a denture that is made to fit over the top of teeth or dental implants. They can be all tooth supported or all implant supported or even a mixture of both.

Tooth supported overdenture

If a patient is considering extractions, they may consider cutting the teeth down and using them as though they were dental implants.

When teeth start to break down or even hurt most would either extract the tooth or do a root canal to save the tooth. If the root canal was done to remove the infection from inside of the tooth the tooth could last for a long time. If necessary you could even cut the crown off of the tooth in the future if you were going to transition to an overdenture. Obviously you should try and save the teeth, but if you have gotten to the point where things are going down hill this still allows you to cut off the crown and make a denture or partial denture that fit over the roots of the teeth. You are in essence making the root of the tooth act as though it were a dental implant.

The advantage of keeping your own roots to support an overdenture is that it is already in your mouth. It is already bonded to your bone and you can use it immediately. We normally make the overdenture before the teeth are cut down. This then acts as a training denture which you can use to learn how to use the denture. If you have already had a root canal done on that tooth it will still be useable for supporting the denture. If you cut the crown off of the tooth and you do not hit the nerve then you may not even need extra treatment to use it. If the tooth is sensitive or when the crown is cut off and you hit the nerve, you will need to do a vital pulpotomy. You must be numb when we do this procedure. If we start to cut the crown and you feel it then we will numb the tooth. We usually put a special rubber mask around the tooth to keep it sterile and to keep things from getting into your mouth. The vital pulpotomy is a procedure where after cutting the crown off and exposing the nerve you remove the top 5 millimeters or 1/8 of an inch of the nerve. You then allow the nerve tissue to clot and then sterilize the top of the nerve tissue so that there is no bacterial contamination. There are a number of solutions that will sterilize this area, but we use ozone because it is a very powerful sterilizing agent that only uses oxygen. We sterilize the nerve tissue for about two minutes and then place a special material over the nerve that allows the nerve to heal thereby preserving healthy nerve tissue. We then put a filling over the medicament to seal the tooth. This technique only cost about $100-200 more than the cost of extracting the tooth.

Once the teeth are cut down and the denture modified to fit over the teeth we then add acrylic to the modified denture that flows around the roots of the tooth. As the acrylic sets it starts to become rubbery and eventually hardens just like the denture. While in the rubbery stage we tease the denture on and off of the teeth so that the denture does not lock onto the roots of the teeth. We want to be able to get it off and on so that the roots can be cleaned. Once the acrylic sets the denture will then snap on and off of the teeth so that the teeth act just like dental implants with snaps.

There are often adjustments necessary to make sure the teeth do not hurt while you use them. You must use fluoride gel placed inside the dentures around all of the teeth to help prevent decay. This is done three times a day. If the teeth are already decayed, the fluoride can reverse the decay.

Once the patient has learned to use the training denture we then make a stronger denture with a metal substructure to keep the denture from breaking. Often, if there are enough roots left to support the denture you may be able to make the second metal supported denture with out a palate so that you can taste your food again. You can keep the training denture as a spare just in case you lose or break the other one.