Palatine, IL Denture Information Near You

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.

Are Lower Dentures Always A Problem?

While dentures are marginally adequate substitutes for missing natural teeth, the lower denture can be troublesome for many individuals.

Inherent Lower Denture Problems

• A lower denture interfaces with more movable mouth surfaces than an upper denture.
• The lower denture has less stabilizing surface to rest upon. For example, there is no broad palatal surface (roof of the mouth) as in an upper denture.
• Loss of jawbone over time brings a lower denture into closer contact with tissue extensions called frenum attachments, which create dislodging forces.

While these problems are inherent to lower dentures, every person is different and not affected in the same way. There are ways to approach these problems.

Some Considerations for Improving Lower Denture Stability

A thin band-like tissue extension (called a frenum) may attach between a jaw ridge (called an alveolar ridge) and the inside of the cheek. This strip of tissue may become active while eating or speaking and can lift a denture from its alveolar ridge. This frenum attachment may be surgically moved (this is called a frenectomy).

Alveolar ridge bone profile lessens or literally comes closer to the floor of the mouth as jawbone is lost over time. The bone loss is called resorption. This reduces the vestibule or space between the lip and alveolar ridge. Surgical extension of this vestibule (called vestibuloplasty) provides more alveolar ridge exposure for a denture to rest upon and reduces muscle pull due to a high frenum attachment.

As an alveolar ridge loses bone, it often may be built-up by surgically placing various substances beneath the gum tissue to increase both bulk and height of the ridge. This is called alveolar ridge augmentation.

As a person eats and speaks, the lips and cheeks exert forces towards the inside of the mouth while the tongue exerts an outward counter force. There is a space between the tongue and lips and cheeks, called the neutral zone, where there are balanced forces during function. These opposing forces can help maintain a denture in place, with surprising power, if the denture is fabricated so that its bulk and teeth rest within this space.

Inserting metal implants into the jawbone and fabricating a lower denture to receive and connect with these implants in various ways will help stabilize a lower denture, while still allowing for comfortable and easy removal of the prosthesis for cleaning.

Ensuring that upper and lower teeth contact optimally during function (called balanced occlusion) is a basic means of stabilizing a lower denture. If one tooth strikes on one side only, the denture will rock. Even contact or biting is a necessity. Fabrication of a denture that completely avoids contact with all potentially dislodging structures and has a metal base for strength and some weight often will facilitate stability.

What's the Best Approach?

Frequently, several approaches are combined, and not all may be suitable for a particular patient. After a thorough examination, a licensed dentist can best advise an individual as to the best means of helping stabilize a lower denture in their unique situation.

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.