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Prosthodontist - Denture and Prosthodontic Questions

Q. What is a prosthodontist?

A. A prosthodontist is a specialist in the restoration and replacement of broken and missing teeth. Their training lasts an additional three years after four years of dental school. During that time, a prosthodontist is taught in greater detail about both removable and fixed prosthodontics.

Removable prosthodontics includes replacing missing teeth with appliances that the patients themselves can take in and out of their mouth, such as dentures and partial dentures.

Fixed prosthodontics includes replacing missing and/or broken teeth with restorations that the patient cannot take in and out, such as veneers, crowns, bridges, and implants.

Q. What are dentures?

A. Dentures are removable prosthetic devices designed to replace missing teeth.

Q. What are complete dentures?

A. Complete dentures are dentures that replace a complete set of missing teeth.

Q. What is the difference between conventional dentures and immediate dentures?

A. Conventional dentures are dentures that are made and placed after the remaining teeth are removed and the tissues have healed. Immediate dentures are dentures that are placed immediately after the removal of the remaining teeth.

Q. What is an over-denture?

A. An over-denture is a denture that fits over a small number of remaining natural teeth or implants.

Q. What do dentures feel like?

A. For a few weeks, new dentures will feel awkward until you become accustomed to them. They might feel loose until the cheek and tongue muscles learn to hold them in position. It is not unusual to feel minor irritation or soreness. The patient needs to see his or her dentist or prosthodontist for regular fit adjustments to relieve any sore areas.

Q. Are you able to eat with dentures?

A. Eating with dentures will take a little practice. You should start with soft foods that are cut into small pieces. As you become used to chewing, you can return to your normal diet.

Q. Are there foods you should avoid if you wear dentures?

A. There are only a few eating restrictions for denture wearers. Avoid biting down directly on crunchy or hard foods, like whole apples, hard pretzels, crusty bread, or large sandwiches. They can break because of the angle where the denture comes into contact with the hard surface.

Biting is limited only by the stability of the dentures themselves. Insufficient bone structure (shrunken bone ridges covered by gum tissue), old or worn dentures, and a dry mouth decrease stability.

Q. If you wear dentures, are dental adhesives necessary?

A. Today's dentures have been significantly improved through advances in both dental and materials technologies. As a result, dentures that fit properly usually do not require adhesives to secure the dentures. When you are just getting used to dentures, adhesives may be advised, but otherwise should not be necessary.

A loose denture is a sign that it doesn't fit your mouth correctly. When first getting used to dentures, you may notice them slipping when you laugh, smile, or cough, which is caused by air getting under the base and moving it. The more you wear dentures, the better you will be able to control their movements in these situations.

If your mouth has insufficient bone structure, dentures will be more difficult to retain. Your dentist or prosthodontist may advise the placement of implants. These are placed in the bone and retain the denture with small, precision attachments.

+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.

Dry Mouth And The Denture Patient - Xerostomia

Xerostomia (Dry Mouth) and Wearing Dentures

To a great extent, dentures stay in place comfortably and in a stabilized manner by development of an intimate interface between denture surfaces and the soft tissues they rest upon. Presence of adequate amounts of saliva within this denture/tissue interface is essential. Without enough saliva, a denture will inadequately adhere to tissues, partly through loss of suction. In addition, tissues contacting a denture will become chafed and irritated without the lubricating effects of saliva.

Some Common Causes of Dry Mouth

• Medications: There are approximately 500 commonly prescribed medications that have xerostomia as a possible side effect, and this is a frequent cause of dryness.
• Aging: The amount of saliva produced by salivary glands lessens as a person ages.
li>Illnesses: Xerostomia is sometimes associated with certain illnesses or conditions such as chronic diarrhea, liver dysfunction, or Sjogren's syndrome.
• Radiation therapy: Radiotherapy that is used to treat some cancers may have reduced salivary gland function as a side effect.
• Habits: Chronic mouth breathing and inadequate fluid consumption often will cause dry mouth.

Approaches to Managing Dry Mouth

Before managing a persistent dry mouth, it is essential to first become aware of the problem, and then attempt to determine causation for the xerostomia. Sometimes the cause is easily eliminated, but in many instances, that is not possible, and the condition is persistent and often progressive. There are several approaches to managing dry mouth.

• Modify medications: If a certain medication is suspected of causing xerostomia, consultation with a person's physician may make it possible to use a different, but equally effective, drug that no longer causes dry mouth or causes it to a lesser degree. However, there often are not suitable alternatives for a particular person's individual problem. Under no circumstances should someone discontinue or attempt to change a medication without the explicit knowledge and approval of their physician -- to do otherwise may result in serious illness or death.
• Sialagogues: These are substances that stimulate the production of saliva. There are two important types of sialagogues. 1) Gustatory sialagogues such as sugar-free hard candies frequently will cause some increase in salivation, and citrus flavors such as lemon are sometimes more effective than others. While sugar-free, low-sticking gum has been suggested, the process of chewing gum could more easily irritate already poorly lubricated tissues by increasing denture movement. 2) Pharmaceutical sialagogues (called parasympathomimetic agents) sometimes improve salivation and must be prescribed by a person's physician if their health status allows such a consideration.
• Salivary substitutes: Salivary substitutes are commercially available solutions that help keep the mouth moist and more lubricated. These compounds usually must be applied frequently and they generally necessitate having a container of the substance nearby.
li>Water: Water is a salivary substitute and often is used in place of commercial salivary substitutes. Regularly moistening the mouth, and drinking increased amounts of water may both hydrate tissues and facilitate some increase in production of saliva in certain individuals. While increased intake of water is generally healthful, persons with certain medical conditions such as, but not limited to, congestive heart failure should first check with their physicians before significantly increasing their routine consumption of fluids.

Alternative Denture Therapy for Patients Suffering From Dry Mouth

Those patients who are not able to comfortably wear conventional dentures due to severe xerostomia might consider implant-supported dentures. If this course of treatment is pursued, intense oral hygiene practices are necessary to maintain healthy implants and avoid periodontal disease in the presence of reduced salivary production. A person should always consult with their dentist to determine which treatment is best for them.

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.