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Dra. Claudia Bruns
Although very few people have a situation in which they have lost all their teeth, sometimes we meet friends who suffer from certain diseases that have that risk, and they never fail to express with great concern how they will be able to eat and continue with their daily habits. That is why we have today the specialist in oral rehabilitation, Dr. Juan Antonio Martinez, who shares with us the experience of his patients and clarifies how advisable it is to make a total dental prosthesis.
1. Doctor, what is the main cause of people losing their teeth? Is it related to a systemic disease?
A/The main cause of tooth loss has always been periodontal disease, because when there is destruction of the bone that supports the teeth, there is not much that can be done to retain the teeth. Of course, other causes are advanced caries (even under restorations that appear to be fine) as well as accidents or occlusal trauma. Less likely are adverse reactions to drugs or medical treatments.
However, having periodontitis and not treating it in time increases the risk of suffering from systemic diseases such as diabetes, hypertension, cardiovascular diseases, respiratory diseases, arthritis and metabolic syndromes, as well as alterations in pregnancy.
2. How to make a dental prosthesis comfortable and functional for a long time?
A/ Just as our health condition may vary, the durability of a prosthesis is very different from person to person and involves the following:
Ø The care taken by the patient to clean it.
Ø Periodic visits to the dentist to evaluate the tissues that support the prosthesis and the wear it may have.
Ø If there are detrimental chewing forces that alter the patient's bite.
Ø The type of diet you have
Ø The quality of the materials from which the denture was made (plastics are less durable than porcelain, for example).
VERY IMPORTANT: even if the patient wants to sleep with it for esthetic reasons, the TOTAL DENTURE must be removed every night to let the gums and bone rest. Just as a person takes off his shoes to sleep, so the prosthesis must be removed every night to avoid damaging the tissues.
With all the above, I can tell you that the longevity of the prosthesis is between 5-7 years, and can be much more when the prosthesis is supported by dental implants.
How do I know that the prosthesis needs to be adjusted or changed?
R/ When it starts to feel looser than usual or changes color. Also if the patient notices that the prosthesis makes pressure and/or hurts the gum or if he/she notices that there are changes in the buccal mucosa. It is normal to see that the teeth of the prosthesis have wear, this is a sign that it should be changed. The dentist will be the one to tell you if you can make a reline in the same prosthesis to re-adapt it or it is better to make a new one.
4. What can be done to avoid the use of glues or adhesives?
A/ Well, if the denture fits well, it is not necessary and it is better not to get used to using adhesives. Patients seek this option when they feel that their denture is already loose, but it is better to evaluate in the office and determine the cause. The problem with adhesives is that they make it very difficult to clean the denture and lead to a bad odor or bacteria build up. As I mentioned, if the diagnosis shows that there is not much bone to support the prosthesis, it may be necessary to consider other procedures such as the placement of implants and bone grafts It is true that it is a much more expensive treatment, but in the long run it allows to have a more functional and esthetic denture.
5. So you do recommend a prosthesis on dental implants?
R/Totally! With the technology that exists, excellent results can be achieved. BUT: communication between SPECIALISTS (the implantologist and the rehabilitator) is vital to plan the treatment very well because it is a process that can last between 6-8 months. It must be determined how many implants and of what type, as well as the type of restoration that is most convenient.
This is not something that a general dentist would ideally handle. There are also factors that rule out the option of placing implants, such as certain medications, systemic diseases, malocclusion or bruxism habits, tobacco use or if you are under any medical treatment that may compromise the bone formation process to adapt the implants. As a last observation, if the patient decides to have a prosthesis on implants, more care is required in the cleaning at home, because many times it cannot be removed unless it is done by the dentist. I recommend using the WATERPIK to irrigate pressurized water under the prosthesis and around the implants.Periodic visits to the dentist CANNOT FAIL.
I am very grateful for the collaboration of Dr. Martinez, who clarified a lot on the subject. Whether due to an accident in life or as a consequence of oral disease, losing teeth has a strong impact, not only psychologically on the person, but also on the health and esthetics of the smile, and thanks to science, today dental clinics offer effective solutions supported by the criteria of professional specialists.
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