Question: I have read recently about special fitting dentures. Can you tell me what makes them special and do you make them?
Great Question. Dentures are plastic prostheses that replace missing teeth. There are 30 million people in the U.S. that have no teeth in one or both arches. Dentures are typically made by a dentist taking impressions of the mouth, trying in acrylic denture bases which are set with denture teeth in wax and then processing or “cooking” the dentures to harden the acrylic. These are then delivered to the patient and the dentist will check how the dentures fit and make adjustments until they are comfortable.At Hampton Dental Associates we often make dentures the way they were made many years ago by the “father of removable dentures” Dr. Earl Pound. We first select teeth by evaluating the patient’s shape and size of their heads. The average tooth is 1/16th the width and height of the face. We use the shapes of teeth – ovoid, tapering , square etc. to help select the most beautiful tooth for that person’s face. That is where the true artistic range of your dentist really counts. We spend two hours setting these teeth with our patients present so this can be customized to every patient’s desires.The use of provisional or learning dentures is an old concept but one still employed by artisan dentists which allows us to make the first set of dentures so that we may work out a patient’s bite properly, evaluate their speech patterns and cosmetics and make sure we will succeed in meeting a patient’s denture needs. While we don’t do this for everybody it truly adds to a beautiful denture experience.
So often times our patients end up with two sets of dentures! Sounds like the dentist is just selling more teeth, but in reality, it allows a patient the dignity of a spare set and it allows the dentist to take a functional impression of their mouth to get the best fitting denture money can buy! Most dentists put a tray of impression material in a patient’s mouth and hold it until it sets creating a mold of a persons’ mouth-this is called a static impression. A functional impression allows the patient to wear their dentures in function while eating, swallowing, talking, etc. all the while capturing details of a persons’ mouth which is used to fabricate an intimate fit of their dentures.
Lastly we use soft silicone liners in our specialty dentures which act as a shock absorber to their jaw bones. When dentures move in speech or chewing the pressure of the dentures resorbs or wears the jaw bone down over time. Soft liners allow us to use porcelain denture teeth which are much prettier and harder than plastic, without seeing as much shrinkage of the underlying bone over time. When our dentures are processed we also use a technique of heat, pressure and controlled shrinkage which allows our Deluxe Turbyfill dentures to have less than .1% shrinkage which means less sores than a traditional denture processing that allows for 6-7% shrinkage of the denture acrylic.
Question: Can you discuss what you mean by makeover dentistry? My husband has dentures he doesn’t like and I am slated for getting dentures, does makeover dentistry give us a different option than dentures?
First, a makeover refers to changing a person’s appearance by using a single procedure or a combination of procedures to effect the desired change. On the hit television show it seems to involve liposuction, veneers, and other procedures. So for this television show a group of specialists from plastic surgeons to dentists and dietitians are used.In our office we work with physicians, certified personal trainers, dietitians, plastic surgeons and any other professionals required to aid our patients with any level of transformation they desire. Certainly we are the quarterbacks for the change of a person’s smile! A makeover can be a new deluxe Turbyfill denture with porcelain teeth, a full set of gorgeous veneers or crown and bridgework or implants to replace missing teeth. There are combinations of these treatments with bleaching, super deep bleaching and gum lifts to drastically change the color of someone’s smile or the gum tissue levels around their teeth. In fact with today’s dentistry we can alter speech, lip support, tooth color and shape and redistribute space problems to give people the smile they have always wished they could have.In order to provide the finest dentistry available we often do MDM or master diagnostic models to show patient’s the blue print for their new smile. We use digital photography, or digital imaging when needed to really evaluate people’s goals so we can “begin with the end in mind.” It is always important to understand a persons expectations so we can deliver what we say we can. In fact at Hampton Dental Associates, we warranty all of our work, so that if something happens to our beautiful smile designs in the first year it is replaced at no charge. We prorate this for 5 years as long as people come in for their preventative maintenance.
Implants with overdentures that allow your teeth to be permanently cemented or fixed in your mouth are my favorite makeover as it not only creates beautiful smiles but gives back great chewing at the same time!
Question: Can you tell me your opinion about how to know when your dentures should be relined or remade? I have had my dentures for 15 years and although they are stained they fit pretty well.
Dentures should be relined or remade every 5-7 years. Insurance companies pay to remake dentures every 5 years as that is the average period of time dentures can remain functional and comfortable before breaking down for most people.At Hampton Dental Associates we make different kinds of dentures. If you have read our column you are familiar with our Turbyfill deluxe dentures which have soft silicone liners, tinted gums, and special impressions that are made with a person eating, speaking swallowing, etc. to generate a functional or dynamic impression. Even these gorgeous dentures are in need of relining or remaking every 5 to 7 years.When dentures are kept in someone’s mouth too long several problems can occur. First, teeth wear out! Especially plastic denture teeth can wear down over time. This means that the worn out teeth allow noses to get closer to chins and deeper wrinkles aren’t far behind. If your teeth look flat, if the pink denture acrylic is at the same height as the teeth, or if they just don’t look like teeth any more- it’s time to have them evaluated. If a denture is wearing but still comfortable it is possible to buy time by relining the denture. This procedure refreshens the interior of the denture with fresh acrylic, resulting in a better fit, less slippage and more stability in chewing function.
If the teeth look good but the acrylic is chipped, cracking or worn out we can perform a rebase procedure. This is similar to a reline with the exception that the entire denture acrylic is replaced. The teeth are not changed but it is the closest thing to a denture remake without actually changing your denture.
It is important to visit your dentist yearly so oral cancer screenings, checking of your denture and teeth can be done in a timely fashion.
At Hampton Dental Associates, most clients end up with two dentures. The standard denture, which can be made quickly, is comfortable and affordable, and the more deluxe denture which offers superior comfort, esthetics and function. With two dentures, you have the luxury of NEVER having to be without your teeth when relines, rebases, tooth repairs or any other service to your dentures have to be performed. In fact we even offer “embarrassment dentures” which are all acrylic copies that can be made along with your dentures for emergency situations.
Question: Can you help me decide if I should get veneers. I am not sure if I should get the ones made out of composite or porcelain.
Veneers are porcelain pieces that are bonded or cemented on to your teeth. They are made in a dental laboratory and can be expected to provide 10-15 years of service if maintained properly.Usually veneers are made to fit on to teeth that have been reduced .5 to .75 millimeters. So they are more conservative than traditional crowns that often require 1.5 to 2.0 mm of reduction.Composite veneers are tooth colored resins, (tooth colored filling material), that is also bonded to your teeth. They have a life expectancy of 5-7 years, which can be longer or shorter depending on diet, maintenance and force factors of chewing.
In order to answer your question we must realize that there is no one correct answer. If someone has beautiful teeth with minor spacing or chips, a composite veneer can be an excellent, option. It will be less expensive than a laboratory fabricated veneer as there is no lab expense. They can be done in one visit as opposed to porcelain veneers; which must be made in a dental facility and cemented at a second appointment. So often times direct or dentist made composite veneers can be a more conservative, less expensive option which can be beautiful for many years.
Porcelain veneers are made with different techniques. They are fabricated by my dental specialty lab under 25 power magnification by a master porcelain ceramist. If a veneer is thought of as a piece of art it can be understood better. The canvas or gum tissues must be healthy and free of bacteria. Digital photography conveys subtle nuances of color, opalescence, translucency, surface characterizations, age cracks, light reflection, and the list goes on! Any of these are topics for complete articles on their own. Also the layers of color, and levels of beauty are built in with patience, tender loving care and an eye on the beauty of nature.
Temporary veneers can act as a template for the patient and Dentist to decide on color, size, shape and feel of the veneers before they are even finished. Then models of these temporaries can be used to guide the lab in ideal final form and function for these veneers.
So when people speak of instant orthodontics or instant smile make-overs they are often speaking of porcelain laminate veneers, lumineers or porcelain crowns. This is a misnomer as we aren’t actually straightening teeth as much as shaving them down, and resurfacing them in a more favorable and esthetic orientation.
Extreme Makeovers are usually done with Porcelain Veneers. These veneers can be substantially more expensive than a composite veneer and you definitely get what you pay for. Porcelain veneers can be indetectable to the human eye if done properly.