Denture Replacement - in Your Local Area

Root Caries: An Epidemic of Age

People are living longer and keeping their natural teeth more than ever before. The advances in tooth retention, the desire to look one's best, and higher expectations about oral health have raised dental awareness among older adults.

With the significant increase in the older portion of society, with even greater increases expected, more older adults will have more teeth that are susceptible to root caries. Root caries may emerge as one of the most significant dental problems among older adults during the next decade. A recent study conducted by the National Institute for Dental and Craniofacial Research (NIDCR) showed that over half of older adults have decayed or filled root surfaces. The frequency of root caries is strongly age-dependent and will continue to be a major dental problem among the elderly.

Root caries lesions can be caused by new or primary root caries, caries around existing dental fillings or recurrent caries, and abrasion or erosion of the root surfaces. Root caries progress quickly due to the relatively soft nature of the root surface, as well as the risk factors associated with the incidence of root caries.

Risk factors associated with the high prevalence of root caries among older adults include decrease salivary flow or xerostomia, exposure of root surfaces due to periodontal (gum) disease, chronic medical conditions, radiation treatment for head and neck cancer, physical limitations, and diminished manual dexterity due to stroke, arthritis, or Parkinson's disease, cognitive deficits due to mental illness, depression, Alzheimer's disease or dementia, Sjögren's syndrome (an autoimmune disease), diabetes, poor oral hygiene, multiple medication use, and changes in dietary habits. One or more of these risk factors or life changes, which are more common among older adults, can increase root caries in an individual who has not had dental caries for many years.

Root caries can be a challenge for the dentist to treat depending on the size and the type of root caries lesion, the extent and rate of caries activity for that person, the physical and mental condition of the individual, and where the root caries are located in the mouth. Many root lesions have limited accessibility and visibility, are often more complicated by pre-existing extensive dental work, and are difficult to isolate from oral fluids during the restoration process. Also, many people who have widespread root lesions have limited tolerance for dental treatment because of medical conditions, illness, and mental health problems.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

Metal Based Denture vs Plastic - Which is Best for You?

A metal-based denture is one in which a portion of the denture body is made of a substantial metal casting rather than all plastic (acrylic resin). This procedure is usually done on the lower denture.

There are two types of metal-based dentures.

Standard metal-based denture

The metal base portion of the denture is in direct contact with underlying supporting tissues.

The base is fabricated from a special medical grade alloy that is hypoallergenic and very biocompatible with tissues. Generally, tissues in contact with this type of material are very healthy in appearance.

Modified metal-based denture

The metal base portion of the denture is not in direct contact with underlying supporting tissues. A soft or hard plastic liner may be interposed between the metal and supporting tissues.

A soft liner is generally preferred to hard plastic since it is more comfortable to wear; however, the soft liner usually should be replaced on an annual basis.

The Rationale for a Metal-Based Denture

Facilitates the avoidance of disruptive forces

Sometimes it is necessary to construct a very narrow denture in order to avoid any structures that would loosen the prosthesis, such as muscles flexing, and so forth. In addition, necessary surgical procedures to reposition a muscle attachment (called a frenum) can sometimes be avoided with these narrow type dentures.

However, such narrow dentures are weak and tend to break quite easily when fabricated just from plastic. A metal base provides the needed strength to design a very narrow denture in order to follow the confines of a patient's lower resorbed alveolar ridge (the remaining bony ridge). In addition, the metal base provides long-term dimensional stability and strength that is not enjoyed with an all-plastic denture base.

Provides a more natural feeling

The added weight of the metal base provides a more natural perception for many patients. Many patients prefer the additional weight on the lower jaw.

A private study measured the actual weight of cadaver jaw ridges and teeth that would normally be lost after the extraction of teeth and associated natural shrinkage of the jawbones. It was found that the weight of these tissues closely approximated the weight of a metal base. Therefore, it is likely that the more natural feeling perceived by persons wearing metal-based dentures is probably real rather than imagined.

The additional weight of a metal base also contributes to lower denture stability by causing the denture to settle down onto a jaw ridge.

Advantages of Metal-Based Dentures

• Very biocompatible and hypoallergenic with healthy-appearing supporting tissues
• May include a soft liner
• Can be relined easily
• Provides added strength for easily broken narrow dentures
• Facilitates fabrication of stable narrow-based dentures that are designed to avoid contact with disrupting muscle forces
• Sometimes facilitates the avoidance of surgical procedures to reposition frenum
• Patients perceive a more natural feeling from the added weight
• Weight may contribute to additional denture stability
• Dimensionally very stable when compared to all-plastic-based dentures during fabrication and over time

Disadvantages of Metal-Based Dentures

• Generally difficult to reline standard metal-based dentures; modified metal-based dentures (described earlier above) are easier to reline
• More costly to fabricate

by Joseph J. Massad, D.D.S.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.