When Natural Teeth Meet a Denture
Question:
Dr. Crapo: Since I was a small boy I’ve been deathly afraid of the dentist. Last week I was forced to go because my teeth are in such bad shape and my dental insurance that I’ve had for twenty-five years is about to expire because I’m retiring. It’s a sad commentary that I was so afraid that I let teeth break off – even front teeth and I’d live with not smiling instead of going to the dentist. I had to take a sedative just to get past my angst. In any case, I made it and discovered what I already knew – that I needed implants or dentures to get back my teeth. I can’t afford implants – not now. That will come later on but right now I’ve got an eyetooth on my upper right that’s still standing and a tooth that sits besides my upper left front tooth that’s still standing but the rest are off at the gum. I’ve got two good molars at the very back and that’s it. After I discovered I wasn’t going to spring for implants, I settled for a denture. I was told that I was not a bad candidate for an upper denture as the roof of my mouth will produce good suction. I think I’m ready to go, so I just have to know if that’s it. I go, the dentist puts me out, I get the teeth yanked and the denture goes in. My lower teeth have no decay. They need cleaning but they’re good. Will it be painful to get the teeth out after the anesthetic wears off? What can I expect?
Answer:
If you’ve planned to have an upper denture, several things need to be considered. If your upper front teeth broke because of pure force, this is a very important piece of information. If they decayed until they snapped off, that’s also important. Lastly, if your lower teeth have good gum and bone support despite infrequent hygiene visits, it’s important to know the dynamics between your own lower teeth against a denture. Natural teeth will put ten times the pressure that lower denture teeth would put against an upper denture. This powerful force needs to be countered with excellent resistance under your upper denture. You have two choices to protect the bone your upper denture sits on. The first is to leave your upper roots sticking partially above the gums, so that they act as pilons under your upper denture, capable of resisting force from your lower natural teeth. These roots will need to have root canals to perform this service. The second choice is to have the teeth out and have the sockets grafted. The bone placed in the sockets will eventually become your own and will be there when you decide to have implants. Bone preservation will happen in either choice, making sure you have better choices for stronger teeth in the future.
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Based on actual patient cases.