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About Services Testimonials Our Team What's New Resources
Reconstructive Services
Extractions
Most of the work we do is geared towards saving teeth. But the main goal of dental treatment is to fulfill the functional and cosmetic needs of our patients, and sometimes we need to extract teeth to meet that goal. A tooth which is heavily decayed, extensively fractured, mispositioned, or poorly-supported may be non-salvageable. In such cases, it’s often better to remove the tooth so that it can be replaced with a prosthetic substitute like an implant, bridge, or denture.
Partial Dentures
When multiple teeth are missing, a partial denture may be used to fill in the empty spaces with false teeth. Partial dentures are removable prosthetics, meaning that they can readily be taken in-and-out of the mouth. They differ from fixed prosthetics, like implants and bridges, which are permanently installed in the mouth.
Often, patients who are considering getting partial dentures ask us about having all of their remaining teeth extracted so that can get complete dentures, in which all teeth are replaced by the prosthetic. This is an understandable question; after all, a partial denture is made to fit around existing teeth, and if any of those teeth should be lost in the future, the partial denture may need to be remade in order to compensate for the loss of teeth. Why take that risk? Why not take out all the teeth, make a complete denture, and avoid the possibility of any future tooth-related complications? In general, partial dentures are more comfortable than complete dentures because they are held in place by the remaining teeth, making it easier to eat and speak without the dentures becoming dislodged. This is especially true for lower dentures, which are inherently less stable than upper dentures.
Because partial dentures depend upon existing teeth for support and to remain well-fitted, diligent oral hygiene is a necessity. This includes twice daily brushing, flossing, and regular dental cleanings. Collectively, these practices will help maintain the health and stability of the denture-supporting teeth.
Complete Dentures
When a patient has no teeth, or any remaining teeth cannot be salvaged, we may opt to make a complete denture. The complete denture consists of a full set of false teeth which may be taken in-and-out of the mouth. They are custom-made over the course of several appointments, during which we verify that the final product will be comfortable and esthetic when the patient eats, speaks, and smiles.
No denture lasts forever. Over time, the shape of the gums, jawbone, and mouth may change such that a denture which was once very comfortable becomes loose and ill-fitting. When the misfit is minor, we may consider relining the denture- changing its shape to better fit the patient’s new oral contours. But when the discrepancy is larger, we may recommend making a new denture.
Life with dentures is different from life with real teeth, and there will be an adjustment period when a patient is given his or her first denture. Often, denture patients have gone decades without a full set of teeth, and their facial muscles need time to adjust to the change. A common misconception is that denture patients don’t need to worry about their oral hygiene, since they don’t have any teeth. To the contrary, denture patients must practice diligent oral hygiene to prevent infection of the mouth’s inner linings. Taking dentures out overnight and cleaning them daily allows the gums time to rest and helps prevent infection.
Implants
In the old days, we had very limited options for replacing lost teeth- namely, bridges and dentures. More recently, the advent of dental implants has given us a new way of replacing missing teeth. A dental implant consists of two parts. The implant fixture is like a screw which is inserted into the patient’s jawbone and will serve to anchor a false tooth which will eventually be built above it. The screw is made from titanium, which allows it to become well-integrated and attached to its surrounding bone. After a healing period, we build a crown (a false tooth) and attach it to the implant fixture in the patient’s mouth.
Not everyone is a good candidate for dental implants, and some patients may require special consideration before an implant can be placed. Dental implants rely upon the support of a robust foundation of bone. Some patients may not have enough bone to reliably support a dental implant, and so the jawbone must first be augmented by placing a bone graft. For patients seeking dental implants to replace upper teeth, a sinus augmentation may be necessary to create adequate room for the implant(s) without entering the patient’s sinuses. All of these needs are determined through diligent screening and imaging processes.
A common misconception is that implants don’t require hygienic care since false teeth won’t decay. However, an implant may be vulnerable to peri-implantitis, an inflammatory response to bateria around the implant fixture, which may cause loss of its supporting bone and eventual failure of the implant. The best way to limit this risk is through meticulous oral hygiene. Brushing and flossing around an implant will help remove bacteria from its vicinity, thereby helping to avoid any long-term inflammatory reaction around the implant and preserving its supporting bone.
Implant-Supported Prosthetics
Implants are great for replacing individual teeth, but they can also be used to reconstruct larger areas in which multiple teeth are missing. For example, imagine a span in which four consecutive teeth have been lost. Instead of placing four individual implants, we may opt to place one implant at either end of the toothless area, and then built a bridge between them comprised of four false teeth. In this manner, we’ve effectively replaced four missing teeth using only two implants.
Dental implants may also be used to support complete dentures. A common complaint among denture-wearers is poor retention. That is, despite our best efforts to make dentures sit stably in the mouth, the wearer’s oral anatomy is sometimes not favorable for keeping the dentures firmly in place. As a result, the dentures may rock or become dislodged while eating or speaking. This is especially true of lower dentures. Whereas upper dentures are held in place by suction to the roof of the mouth, lower dentures lack any similar phenomenon. But by placing implants, we can actually make dentures which lock onto those implants, allowing them to be firmly anchored to the jawbone. These so-called overdentures are still removable- they still come in-and-out of the mouth. However, when inserted, they snap onto the implants, such that they won’t become dislodged involuntarily. For patients who already wear dentures but would like to have overdentures, their existing dentures can generally be modified and thereby converted to overdentures after the implants have been placed.
Some patients are missing all their natural teeth, but don’t wish to have removable dentures. For these patients, we can consider permanent implant-supported prosthetics. Like implant-supported dentures, this would allow the patient to have a full set of teeth supported by only a few implants. But unlike dentures, they are less bulky and remain permanently installed in the patient’s mouth.
This is a small sampling of the many ways we can use dental implants to replace missing teeth. During your visit, we’ll discuss which options would work best for you based on your needs and desires.