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Medical Forum / General / Dentistry / January 2007Bridges, implants or dentures?
I am 55 yrs old and had difficulty all of my life with my teeth. They started out on their own being "bad" and years of drug abuse didn't help them. When I was a pre-teen, my parents took us to a family friend who was the most barbaric dentist practicing dentistry! So, I avoided them like the plague for most of my life. I had serious issues 15 years ago and thought I was in the right hands with a dentist recommended by my sister who worked for one. He didn't do a very good esthetic job, but my mouth was at least healthy. Now I am dealing with poor bridges and wandering if I should just go for the gums. Have em all pulled and get dentures! I really want implants, but you have to be a millionaire, have excellent credit or killer insurance. I am not and do not. I have found a dentist that I really want to use. He is sky high but very good. Any thoughts out there about which route to go? >Now I am dealing with poor >bridges Fixed or removable ? >and wandering if I should just go for the gums. Nah, that's the last resort. >Have em all pulled >and get dentures! Partial dentures are almost always preferable to full dentures. Can you post some pix or x-rays ? > I am 55 yrs old and had difficulty all of my life with my teeth. They started > out on their own being "bad" and years of drug abuse didn't help them. When I [quoted text clipped - 13 lines] > I have found a dentist that I really want to use. He is sky high but very > good. Any thoughts out there about which route to go? The best route will be easier for your dentist to discuss with you. There are a variety of ways to go, and there is no best answer for everyone. It depends on what you have now, your ability to have dentistry done--not only expense, but tolerance for the treatment, tolerance for a removable appliance. It's generally true that you're better saving teeth if you can. But there has to be a good reason for each individual tooth--depending not just on what kind of shape it's in, but where in your mouth it is and how it figures into the restoration of the entire mouth. Steve  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > I am 55 yrs old and had difficulty all of my life with my teeth. They started > out on their own being "bad" and years of drug abuse didn't help them. When I [quoted text clipped - 13 lines] > I have found a dentist that I really want to use. He is sky high but very > good. Any thoughts out there about which route to go? Gosh, we could be twins. Dang near the same age and wanting an answer to the same question. I do wish somebody would answer this. I'm trying to make the same decision myself. I don't want to spend a fortune trying to save these old teeth and then end up having to yank them anyway. So, maybe if I answer your post with another question, somebody will answer. What is the real downside to dentures? Is there really any reason to spend a small fortune to save teeth that are weak anyway? I dunno -- let's see if anybody does answer this one. Eva I think that you should post your x-rays if you can get them. It's very difficult to advise you without more info. Most people wear their uppers but many can't, don't or won't wear the lowers. In most people the bone that the dentures sit on dissolves and in some people it can be pretty severe, requiring patients to get bone augmentation grafts and titanium implants so they can wear dentures. Unless it is a pretty severe case, dentists won't do the extractions if the natural teeth can be restored. If good teeth are removed at your request, this can be considered as "dental mutilation", and the dentist/oral surgeon could be sued under the principle of them having superior knowledge than the patient. Good Luck. I hope you make a well informed decision. >Gosh, we could be twins. Dang near the same age and wanting an answer to >the same question. I do wish somebody would answer this. I'm trying to >make the same decision myself. I don't want to spend a fortune trying to >save these old teeth and then end up having to yank them anyway. Well, if your health isn't worth the money, what is? Periodontal disease is common in my family and there are a heck of a lot of people in dentures. I've got severe periodontal problems, myself, and have chosen to go with implants. I did a lot of research when I started this process and the downside to dentures include continued bone loss (restoring periodontal health and/or implants will halt that), poor bite strength (kiss bagels, apples, and all sorts of good stuff goodbye), poor retention of lower dentures, and gagging from upper dentures. Food gets under them and hurts like crazy, and they loosen over time. The covered upper palate reduces the sense of taste, and eating sticky stuff (peanut butter) simply doesn't work. Embarrassing incidents seem common. As I said, it's implants for me. That said, when I was looking into my options I found an MSN message board for people who wear dentures. They're pretty much relentlessly positive about it ("chosen smile"), happy to answer questions about the whole process from the extractions to relines and having permanents made, and are generally helpful. http://groups.msn.com/DenturesANewSmile SignatureMelinda Shore - Software longa, hardware brevis - shore@panix.com Prouder than ever to be a member of the reality-based community Do you know who is really answering and commenting on the questions? Are they denture wearers themselves? If so, have any of them had dentures for more than a few years? Do they have any financial motives? Having made dentures for 30 years (counting dental school), I would say that denture wearers as a group follow a typical Bell Curve. Fifteen percent of the people are happy to very happy, fifteen percent are unhappy to very unhappy, and everyone else is somewhere inbetween. It's hard to pick out who is going to be where on the curve until after the treatment. By then, it's too late to say, "Let's restore what's there", though implants do remain an option. JME, D > That said, when I was looking into my options I found an MSN > message board for people who wear dentures. They're pretty > much relentlessly positive about it ("chosen smile"), happy > to answer questions about the whole process from the > extractions to relines and having permanents made, and are > generally helpful. http://groups.msn.com/DenturesANewSmile >Do you know who is really answering and commenting on the >questions? Are they denture wearers themselves? If so, >have any of them had dentures for more than a few years? >Do they have any financial motives? Pretty much all of them seem to be denture wearers or prospective denture wearers, although there are one or two denturists who are regulars. There's one guy who's an anti-implant evangelist but he's treated like the nutjob he probably is. Pretty much everybody talks about their experiences, which is what I found useful. A lot of them seem to be in dentures because they can't afford restorative work. Anyway, it's a good resource if you'd like to talk to people who have positive things to say about dentures. >It's hard to pick out who is going to be where on the curve >until after the treatment. By then, it's too late to say, >"Let's restore what's there", though implants do remain an >option. I gather that implants are not an option for some of the people there (smokers, insufficient bone) and most of them just can't afford it. A bunch of them seem to use discount denture chains and whatnot. SignatureMelinda Shore - Software longa, hardware brevis - shore@panix.com Prouder than ever to be a member of the reality-based community If someone has had ugly, painful teeth for years, and feels 100% better after getting rid of the pain, then putting up with diminished chewing ability may not be that big of a trade off. Then if they can function with a $395 special, they get the added bonus of feeling as though they have beaten the system. I have no problem with that. D > I gather that implants are not an option for some of the > people there (smokers, insufficient bone) and most of them > just can't afford it. A bunch of them seem to use discount > denture chains and whatnot. >If someone has had ugly, painful teeth for years, and feels >100% better after getting rid of the pain, then putting up >with diminished chewing ability may not be that big of a >trade off. Sure, and I apologize if it sounded as if I thought that people who chose cheap-a.s dentures over really bad oral health were making a bad decision - I don't. A lot of people really don't have very many options, and many of the people who post to the MSN board have extremely limited financial resources. But still, that's a corner case and not what was being asked about, which was what the downside is to dentures as opposed to restorative work, and what kind of people were posting denture-positive messages to the MSN "Dentures A New Smile" board. SignatureMelinda Shore - Software longa, hardware brevis - shore@panix.com Prouder than ever to be a member of the reality-based community >and many of the >people who post to the MSN board have extremely limited >financial resources. And yet, they have computers, isp accounts, and oodles of time to post, eh ? Sounds like a matter of priorities to me. >>and many of the >>people who post to the MSN board have extremely limited >>financial resources. > And yet, they have computers, isp accounts, and oodles of time to post, eh ? > > Sounds like a matter of priorities to me. Yes it is for the most part. I make quite a few dentures. Most patients that are making the initial transition to dentures are over 50, smoke, have not had routine dental care, and have a little sugar habit somewhere (I said *most*...there are exceptions). By the time they show up in the office, the possibilities for rebuilding the remaining teeth are not very favorable for long term success. In an ideal world, 3-4 endos & crowns, pero treatment, and a partial denture would be nice. That would necessitate a huge change in home care and dental visits by the patient. Few patients are truly motivated enough to alter their life style enough to make this work. Therefore, if you 'sell' them this treatment, they are usually out a bunch of money, and back in the same shape in a short time. Even though this is largely "a matter of priorities", it doesn't mean these are 'bad' people and do not deserve respect. They just don't see things from the same perspective as a dentist. It wouldn't hurt to try and understand their side of the issue and provide a service that they can appreciate. JMO, D >>>and many of the >>>people who post to the MSN board have extremely limited [quoted text clipped - 27 lines] >JMO, >D Agreed. My point was that the 'limited financial resources' statement wasn't necessarily true. I make many a partial, extract the bad ones and off you go. Also there is the 'transitional' denture that is usually a better service than the complete, it at least gives some support. And there's always overdentures. No argument from me. :-) D > My point was that the 'limited financial resources' statement wasn't > necessarily true. [quoted text clipped - 4 lines] > > And there's always overdentures. > If someone has had ugly, painful teeth for years, and feels > 100% better after getting rid of the pain, then putting up > with diminished chewing ability may not be that big of a > trade off. > > Then if they can function with a $395 special, At the end of every year, there is a special issue of the NY Times magazine called "The Lives They Lived" about people of greater or lesser celebrity who'd died during the previous year. This year, one of the guys who died (don't remember his name) was the advertising guy who invented the phrase "But wait...THERE'S MORE!!!" Steve they get > the added bonus of feeling as though they have beaten the > system. [quoted text clipped - 7 lines] >> just can't afford it. A bunch of them seem to use discount >> denture chains and whatnot. SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > Do you know who is really answering and commenting on the > questions? Are they denture wearers themselves? If so, [quoted text clipped - 6 lines] > happy, fifteen percent are unhappy to very unhappy, and everyone > else is somewhere inbetween. That sounds about right to me. Happy New Year! Steve > It's hard to pick out who is going to be where on the curve > until after the treatment. By then, it's too late to say, [quoted text clipped - 10 lines] >> extractions to relines and having permanents made, and are >> generally helpful. http://groups.msn.com/DenturesANewSmile SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 |
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