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Medical Forum / General / Dentistry / August 2006

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Help! Should I Opt for Upper Denture?

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Quito Quito - 25 Feb 2004 04:49 GMT
Dear Dentists, Denture Wearers and Other Readers:

I am 44 and have not quite visited a dentist until two weeks ago. I
had tried to ignore the minor pains and even a number of loose teeth.

According to the X-ray, my dentist decided that I should remove all of
UPPER teeth and use an upper denture. He said that I can consider
implanting some upper teeth later. He also said that I can keep my
lower teeth except for 2 or 3 which need to be extracted.

I feel pretty scared about the idea of extracting all upper teeth and
using a denture and all the subsequent inconveniences and frustrations
I can foresee. I feel that I am too young for a denture and it is like
the end of my life.

According to my dentist, I have lost a lot of bone, and also I can
keep two (2) of upper teeth, but it is not efficient from an
engineering point of view to keep just two. I myself, however, feel
that eleven (11) of my upper teeth are still reasonably firm and I can
eat with reasonable comfort, though I can feel with my finger that
some of them are slightly loose.

The dentist said that if I choose to keep the upper teeth as they are
now, the periodontal disease will continue to cause bone loss, and it
will be difficult to make a denture in the future.

Here are my questions:

(1) Is there any possibility, or technique, for me to reinstate my
upper teeth?

(2) If (1) is not possible, can I keep my upper teeth for some time
while somehow stop further bone loss, so that I can postpone the use
of a denture?

(3) What is the long-term (2 years and up) average cost of maintaining
a denture?

(4) Is it technically feasible to replace EVERY single tooth with an
implant? In other words, can we use implanting to entirely replace
dentures?

Thank you for reading and replying.

Sincerely,
Roland
WB - 25 Feb 2004 05:22 GMT
>Here are my questions:
>
>(1) Is there any possibility, or technique, for me to reinstate my
>upper teeth?

Depends, but there are some advanced  periodontal
treatments available but I have no way of knowing if
you are a candidate for this.

>(2) If (1) is not possible, can I keep my upper teeth for some time
>while somehow stop further bone loss, so that I can postpone the use
>of a denture?

Not sure, would need to see x-rays first.

>(3) What is the long-term (2 years and up) average cost of maintaining
>a denture?

Relatively low, relines costs vary by geographical area.

>(4) Is it technically feasible to replace EVERY single tooth with an
>implant? In other words, can we use implanting to entirely replace
>dentures?

Have seen x-rays of this. Expensive.

>Thank you for reading and replying.
>
>Sincerely,
>Roland

Am not sure of the severity of your periodontal condition.
but, I think that a consultation with a periodontist
(gum specialist) would be well worth your while.

WB

--

"I can dance on the head of a pin as well"
-Yoshimo
Joel M. Eichen D.D.S. - 25 Feb 2004 12:53 GMT
>Dear Dentists, Denture Wearers and Other Readers:
>
[quoted text clipped - 3 lines]
>According to the X-ray, my dentist decided that I should remove all of
>UPPER teeth and use an upper denture.

REPLY

You are too young for dentures!

>He said that I can consider
>implanting some upper teeth later. He also said that I can keep my
[quoted text clipped - 4 lines]
>I can foresee. I feel that I am too young for a denture and it is like
>the end of my life.

See?

>According to my dentist, I have lost a lot of bone, and also I can
>keep two (2) of upper teeth, but it is not efficient from an
[quoted text clipped - 27 lines]
>Sincerely,
>Roland

Signature

Joel M. Eichen, .
Philadelphia PA

DISCLAIMER FOLLOWS:

*********

Dental health-related material
is provided for information purposes
only and does not necessarily
represent endorsement by or an official
position of the SciMedDentistry gang
or any other official agency either
actual or fictitious or Steve Mancuso.

Advice on the treatment or care
of an individual patient should
be obtained through consultation
with a dentist who has examined
that patient or is familiar with
that patient's dental history.

STANDARD DISCLAIMER

Quito Quito - 26 Feb 2004 02:04 GMT
Thank you for your reply. So what are my possible options?

> REPLY
>
> You are too young for dentures!
Joel M. Eichen D.D.S. - 26 Feb 2004 12:34 GMT
My plan"

Restore the restorable ......... dream the dreamable dream.

(Don Quixote)

Begin at the beginning ....etc.

>Thank you for your reply. So what are my possible options?
>
>> REPLY
>>
>> You are too young for dentures!

Signature

Joel M. Eichen, .
Philadelphia PA

DISCLAIMER FOLLOWS:

*********

Dental health-related material
is provided for information purposes
only and does not necessarily
represent endorsement by or an official
position of the SciMedDentistry gang
or any other official agency either
actual or fictitious or Steve Mancuso.

Advice on the treatment or care
of an individual patient should
be obtained through consultation
with a dentist who has examined
that patient or is familiar with
that patient's dental history.

STANDARD DISCLAIMER

Guess Who - 27 Feb 2004 03:04 GMT
Yeah, but the dentures would be A HELL OF A LOT CHEAPER, unless you really
wanna put a 2nd mortgage on your house.  I opted for dentures (both upper
and lower), and have saved exactly 7 of my teeth.  The 7 that were saved
cost twice as much as pulling the rest and both temporary and permanent
upper and lower dentures.  The most I was willing to go through was root
canals and crowns, and some fillings.  The extractions were no problem at
all.

If you can afford it, or your insurance will cover the bulk of it, then save
what you can.  I couldn't afford it, and didn't want to go through all the
extremely delicate and costly procedures involved with gum therapy, bone
reconstruction, etc to save teeth that have given me grief for over 30
years.

I DON'T regret my decision.  I have adapted to the dentures and can
basically eat whatever I want now. Well, I CAN'T bite into an apple ever
again!  But I don't like apples anyway.

> My plan"
>
[quoted text clipped - 34 lines]
>
> STANDARD DISCLAIMER
Roy Brown - 27 Feb 2004 04:45 GMT
Yes dentures are cheaper, but......

You are talking partial dentures if you have 7 teeth remaining. The original
poster was talking full denture.

Full dentures are like an empty boat in the lake, floating around in what
ever direction a force moves it. Partial dentures are like a boat tied up to
a dock. It still moves around a bit, but is pretty much held in place.

Big difference. And 30 years from now when your gums have shrunk down some
more, there will be even less to hold them in place.

All I do is dentures. I always regret having a patient lose that last tooth
holding their denture in place. When that happens I'm looking at a year of
so or complaints about loose dentures until the patient adapts to a full
denture.
--
Roy
DotSeaEh is .ca

| Yeah, but the dentures would be A HELL OF A LOT CHEAPER, unless you really
| wanna put a 2nd mortgage on your house.  I opted for dentures (both upper
[quoted text clipped - 13 lines]
| basically eat whatever I want now. Well, I CAN'T bite into an apple ever
| again!  But I don't like apples anyway.
Joel M. Eichen D.D.S. - 27 Feb 2004 14:00 GMT
>Yeah, but the dentures would be A HELL OF A LOT CHEAPER, unless you really
>wanna put a 2nd mortgage on your house.

REPLY

For some folks dentures are great .... "better than my old teeth,
Doc."

For others its a nightmare. Who knows before the job is done? No one.

JOEL

> I opted for dentures (both upper
>and lower), and have saved exactly 7 of my teeth.  The 7 that were saved
[quoted text clipped - 54 lines]
>>
>> STANDARD DISCLAIMER

Signature

Joel M. Eichen, .
Philadelphia PA

DISCLAIMER FOLLOWS:

*********

Dental health-related material
is provided for information purposes
only and does not necessarily
represent endorsement by or an official
position of the SciMedDentistry gang
or any other official agency either
actual or fictitious or Steve Mancuso.

Advice on the treatment or care
of an individual patient should
be obtained through consultation
with a dentist who has examined
that patient or is familiar with
that patient's dental history.

STANDARD DISCLAIMER

Quito Quito - 27 Feb 2004 20:23 GMT
Joel, although your advice is more emotional than technical, I do feel
greatly encouraged. Oftentimes, we do need to tread on the cruelty of
reality with a Quixotic spirit? Are you a young dentist with such a
spirit, by the way?

> My plan"
>
[quoted text clipped - 3 lines]
>
> Begin at the beginning ....etc.
Joel M. Eichen D.D.S. - 27 Feb 2004 20:49 GMT
Exactly! Dentistry IS more emotional than technical.

TECHNICALLY, its quite simple!

JOEL

>Joel, although your advice is more emotional than technical, I do feel
>greatly encouraged. Oftentimes, we do need to tread on the cruelty of
[quoted text clipped - 8 lines]
>>
>> Begin at the beginning ....etc.

Signature

Joel M. Eichen, .
Philadelphia PA

DISCLAIMER FOLLOWS:

*********

Dental health-related material
is provided for information purposes
only and does not necessarily
represent endorsement by or an official
position of the SciMedDentistry gang
or any other official agency either
actual or fictitious or Steve Mancuso.

Advice on the treatment or care
of an individual patient should
be obtained through consultation
with a dentist who has examined
that patient or is familiar with
that patient's dental history.

STANDARD DISCLAIMER

Joel M. Eichen D.D.S. - 27 Feb 2004 20:50 GMT
Yup I am a young .......... -at heart dentist!

Univ. of Pennsylvania
Dentistry class of '64.

>Joel, although your advice is more emotional than technical, I do feel
>greatly encouraged. Oftentimes, we do need to tread on the cruelty of
[quoted text clipped - 8 lines]
>>
>> Begin at the beginning ....etc.

Signature

Joel M. Eichen, .
Philadelphia PA

DISCLAIMER FOLLOWS:

*********

Dental health-related material
is provided for information purposes
only and does not necessarily
represent endorsement by or an official
position of the SciMedDentistry gang
or any other official agency either
actual or fictitious or Steve Mancuso.

Advice on the treatment or care
of an individual patient should
be obtained through consultation
with a dentist who has examined
that patient or is familiar with
that patient's dental history.

STANDARD DISCLAIMER

Steven Bornfeld - 25 Feb 2004 14:28 GMT
> Dear Dentists, Denture Wearers and Other Readers:
>
[quoted text clipped - 42 lines]
> Sincerely,
> Roland

    I agree with WB.  Some points to consider:
1) Taking teeth out is easy.  Saving them is harder and more expensive.
2) Someone your age, if your periodontal disease is as advanced as your
dentist says, has very aggressive periodontal disease.  It is likely
that you may lose your teeth anyway, but aggressive, full-tilt
periodontal therapy might very well delay the loss of these teeth.
There are clear instances that it is not worth it; others where it
almost certainly is.  Unfortunately, many cases are a judgement call.
No one can guarantee long-term retention of teeth.  We can only make an
informed guess, based upon the patients we have seen in the past.  How
long you might keep your teeth depends to some extent on your genetics,
but also on such factors as your willingness to comply with your
periodontist's instructions for meticulous oral hygiene and regular recalls.
    Many patients don't want to make the decision themselves, but in the
final analysis it is theirs to make.
3) It is true that continued retention of severely periodontally
involved teeth, if the wrong decision, can lead to loss of alveolar
bone.  However, the bone is slowly lost anyway, and if your teeth are
severely periodontally involved, much of this bone has already been
lost.  There are ways to augment the bone you have now, depending upon
the location and other factors such as your general health.  This does
increase the expense of an already involved and expensive treatment plan
if you're looking to replace a full arch of teeth with implants.
4) Perhaps the most important consideration:  most patients do quite
well with full upper dentures.  Most people don't do so well with full
lower dentures.  This means from a practical point of view that unless
you've got both deep pockets and tolerance for a great deal of
treatment, your resources are (IMO) best spent on the retention of your
lower teeth now.  If you hit the lotto, you can worry about implants on
the upper jaw later.

Hope this helps,
Steve
Quito Quito - 26 Feb 2004 02:31 GMT
Thank you very much, Steve, and WB, for your detailed and informative
answers. I have been otherwise in very good health, and I like
swimming a lot. I am in southern Virginia. I will discuss with my
dentists if they can do those treatments you suggested.

The cost for implanting here is $1400 per tooth. But are there
patients who have all upper or lower or both upper and lower teeth
implanted? Do they feel comfortable?

> > Dear Dentists, Denture Wearers and Other Readers:
>  ......
[quoted text clipped - 3 lines]
> dentist says, has very aggressive periodontal disease.  It is likely
> ......
Steven Bornfeld - 26 Feb 2004 15:37 GMT
> Thank you very much, Steve, and WB, for your detailed and informative
> answers. I have been otherwise in very good health, and I like
[quoted text clipped - 4 lines]
> patients who have all upper or lower or both upper and lower teeth
> implanted? Do they feel comfortable?

    If they work out they're great.  Implants supposedly do not feel
identical to normal teeth, as I've heard there is no proprioception from
the implant fixtures.  I take this to mean that there is not the same
feeling of pressure on the implant fixtures when you bite as there would
be on natural teeth.  But I've never heard from a patient that this is
any problem, esp. when compared to the accomodation necessary for dentures.
    I agree with Roy--retaining a couple of roots for an overdenture can
greatly improve comfort and acceptability of dentures.
    $1400/tooth is a low-average fee for each implant FIXTURE.  I rather
doubt that it includes the abutment and crown that must be placed on the
fixture.  Discuss fees with your restorative dentist and make sure that
you understand all the fees involved before making your decision.

Good luck,
Steve

>>>Dear Dentists, Denture Wearers and Other Readers:
>>
[quoted text clipped - 4 lines]
>>dentist says, has very aggressive periodontal disease.  It is likely
>>......
Roy Brown - 26 Feb 2004 05:46 GMT
I'd agree with WB and Steven, with two possible additions.

Depending on which 2 upper teeth your dentist said you might keep, you might
be able to keep those roots and have an overdenture using the roots for
attachment. This can be very efficient from an "engineering point of view",
I call them natural implants.

For maintenance costs, you should factor in a reline or two in the first
year depending on how quickly your bone heals and shrinks. After that a
reline for an upper every 2-3 years suits the majority of people. You will
need to replace the denture every 5-8 years.

--
Roy
DotSeaEh is .ca

| Dear Dentists, Denture Wearers and Other Readers:
|
[quoted text clipped - 42 lines]
| Sincerely,
| Roland
flygirl79 - 08 Aug 2006 07:17 GMT
Hello, I know how you feel trust me. I'm 26 years old and had ALL my teeth
pulled, it's so terrible for me. I can't stand looking at myself in the
mirror. And poligrip makes me throw up. I can't afford Implants, but I'd
rather be dead right now then have these thing.
flygirl79 - 08 Aug 2006 07:17 GMT
Hello, I know how you feel trust me. I'm 26 years old and had ALL my teeth
pulled, it's so terrible for me. I can't stand looking at myself in the
mirror. And poligrip makes me throw up. I can't afford Implants, but I'd
rather be dead right now then have these thing.
 
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