Get a grip on your dental health

Posted by Dr. Edward Magida | Filed under , ,

With all we know about dental disease - its causes and its treatment - there is no good reason that anyone should end up losing most or all of their teeth.

Teeth can last a lifetime, and all it takes is the commitment to take care of them.

However, I must still prescribe dentures and partial dentures to my patients when they need them. I do it, but deep down I always get an uneasy feeling, worrying that the patient will eventually have problems with them.

Over the past 12 years, I have treated hundreds of patients with dentures who are either homebound, or reside in nursing homes.

Many of these people had their teeth removed years ago, and now their jawbones have shrunk tremendously. It's harder to make a denture stable when the jawbone is hardly there.

I wish that these people were never talked into having their teeth removed. If the teeth remained, the bone would not have shrunk.

I can be of limited help to them. If the denture is still intact but loose, I will reline the denture, which will make it fit the new, shrunken shape of the gums. If, however, the person has lost too much bone over the years, then even this procedure cannot create miracles. Or bone, for that matter. If the bone is gone, the foundation for the denture, even the most perfect denture, is compromised.

So, what's a person to do?

Think suction cups.

Have you ever seen an octopus? Their arms are lined with suction cup like suckers that create great holding power for the octopus, which puts the creature at a great advantage.

Now those suction cups have been recreated on dentures.

People who have poorly fitting dentures can improve their quality of life with suction cup dentures because chewing is made easier. And that's important. The simple fact is that if dentures don't fit well a person cannot properly chew food, and instead of eating a variety of nutritious foods, the person ends up eating only soft foods.

However, when the underside of the denture is made with all these little suction cups, the retention of the denture improves.

Here's how they work: As the person places the denture, the suction cups engage the gum tissue and grab on, much like a plunger would if you pressed it against the floor. The net result of all these little suckers is a denture that has dramatically more hold. You really have to see these dentures to realize how superior they are compared to the normal type.

If you or anyone you know is having a problem with dentures that don't fit properly, you owe it to yourself to find out about the "dentures from the deep," suction cup dentures. They are truly phenomenal.

Geriatric Dental Patients

Posted by Dr. Edward Magida | Filed under , , , ,

Since 1988 I have been the staff dentist at numerous nursing, convalescent and adult care facilities. While at times, most people would find it a difficult, if not eye opening experience, I personally find it very rewarding to be able to help these patients with their dental needs and help with their problems. While most patients do not pose too much of a problem, there are some, due to their mental and/or physical ailments, that can be a true challenge to treat.

Dentists, at least most of us, are perfectionists. While in my office I strive for this all the time, I have had to learn that for some elderly patients, due to the limitations they present to dental treatment, this is not always possible. Sometimes I can only offer the best I can do given the circumstances. I know that there is no one else many times who would even attempt to help so I feel that at least I am trying my best.

Nursing home patients' needs are somewhat different than the rest of us. Many of them wear full or partial dentures. These are many times in need of repair or replacement. Teeth that have been removed should be added to the person's dentures to maintain a full compliment of teeth. I can't tell you how many people are wearing partial dentures that were made for them years ago. In the interim, someone took out one or more teeth but never bothered to replace the now missing teeth on the person’s denture. I don’t know how some people eat. Not being able to eat properly and nourish yourself, is a major downfall of patients in these types of settings. You wouldn’t think of buying one set of tires for your car and expecting to have them last your lifetime. You shouldn’t expect Uncle Bob’s denture to be a perfect fit forever either. The denture teeth wear down over the years and this makes it hard to chew, as well as causing the person’s face to "sink in" so to speak. Properly sized teeth give a person a more youthful look as well as increased chewing ability.

Sometimes the denture is fine but the patient has lost a lot of weight so the denture now "kind of swims" in the person’s mouth. In this case a reline of the teeth will allow it to fit properly to the shrunken gums. The biggest complaint I come across is the pain related to sore spots caused by pressure of the dentures on the gums. Sometimes all that is needed is some minor adjustment to the denture to make it a winner. Sometimes the reline procedure is needed to make a more intimate fit with the gums.

The biggest problem I see is the lack of basic oral hygiene. Either the person does not brush their teeth, or has it done for them on a daily basis, or it is done but is not very effective. This can easily lead to major cavity formation as well as periodontal disease. Both of these will ultimately lead to tooth loss. Many medications the elderly take will tend to adversely affect the teeth and gums. Many meds will dry out the person’s mouth which makes it easy for cavities to form. Someone with a dry mouth needs to pay extra attention to their oral hygiene.

If you know of someone in a nursing or convalescent type facility, please insist that the staff pay good attention to the oral hygiene of the person. This advice even goes to someone homebound or bedridden at home. I have on many occasions attended to people in these situations. The relative or personal aid must make sure the patient keeps his or her teeth as clean as possible. I know it sounds like common sense, but many times it just doesn't happen.

Getting back to why I do this. It is a great thrill to have the ability to help someone in need, and to help them in a way that no one else can or will. Just seeing a person’s new smile when all is said and done, goes a long way.

Denture Adhesive

Posted by Dr. Edward Magida | Filed under ,

Denture Adhesive - Can we make it a thing of the past

Take a trip down the personal hygiene aisle of any supermarket and stop when you get to the area designated for denture adhesives. These products are sold to the tune of $1 billion annually and a look on the shelves gives an indication of that. There are pastes, powders, gels and of course the newest type on the block, the liner pads. They kind of remind me of a cross between pimple pads and flypaper. All of these products are made for one purpose, and that is to basically glue a persons' denture in place.

The reason people need to use this stuff is because they have little to no bone left for the denture to seat on and therefore the denture becomes unstable. A person will lose bone over time after his or her teeth are removed, some people quicker than others. As the bone decreases, so does the amount of retention the denture has until the person resorts to using denture adhesive to hold things in place. Even someone with a new denture or one that was recently relined will have problems if there is not a good foundation for the denture to rest on.

Ask anyone who uses adhesive if they really like using it. I doubt that you will find many who do. It tastes lousy and is hard to clean off your gums. It needs to be reapplied every so often because it seems to disappear over time. Guess what, it's not disappearing, you are swallowing it. The whole situation is just not good.

What a person with dentures to do? In the past I have spoke of getting dental implants to help hold your denture solidly in your mouth. Dental implants are titanium cylinders that are placed in your jawbone to replace the teeth you lost. They are used to help anchor a persons' denture by having the denture attach itself to the secure implants. Since the implants are very solidly imbedded in the bone, the denture is given this secure base to fit on.

Today I am going to write about a new type of denture held in by implants. It is called the NOVUM denture and I have to say that it is pretty slick. The procedure for conventional implants is such that once the implants are placed in the patients' bone, a waiting period of from 3-6 months is needed for the bone to mature around the implants. This time period is needed for the bone to adhere to the implants and stabilize them. The new denture which will be made to attach to these implants can not be started until the 3-6 months has past and the implants have "healed" in the bone. Then it usually takes another month or so for the dentist to take impressions and have several fittings to make sure the denture will attach to the implants properly.

Enter the Novum type denture. This is a denture which can only be used on a persons lower jaw. This is so because the bone on the lower jaw is usually denser and of better quality than the upper jawbone. In this procedure, it is possible to place 3 special implants in the lower jaw in the front part of the mouth, and have the corresponding denture made at the same time. This will allow the person to get new, secure teeth in a day. We're talking about teeth that look good and feel very secure. Forget about the typical 3-6 month waiting period. The procedure is also good for the person who is wearing a lower partial denture held in place by several questionable teeth. The bad teeth are removed at the same time the implants are placed and the new denture is placed in time for dinner.

If you or someone you know are tired of having your dentures move and being full of denture adhesive "glop," please have them contact their dentist and inquire about the different alternative that might be possible. Bon appetit.