Medical Forum / General / Dentistry / September 2007
Denture
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Joyce-MN - 09 Sep 2007 11:53 GMT Is this the "norm" that a dentist has the permanent denture (in this case just the upper denture) made right away after taking impressions. Why don't they let your wear a temp. one first to be sure it fits and looks good. Joyce
George - 09 Sep 2007 15:59 GMT > Is this the "norm" that a dentist has the permanent denture (in this > case just the upper denture) made right away after taking impressions. > Why don't they let your wear a temp. one first to be sure it fits and > looks good. Joyce The norm usually is to do a try-in stage after taking the final impressions. During the try-in the acrylic teeth have been set on a wax base letting you evaluate appearance, occlusion and retention before you proceed to finishing the denture if you're happy with those details. Since the base for the try-in denture is wax, you can't really take it home with you but you get an idea of what the finished denture is going to be like. No such thing as a temp denture I'm afraid.
Regards, George
Joyce-MN - 09 Sep 2007 17:42 GMT She did the impressions and in two weeks (about) I went back and the denture was sitting there waiting for me to wear home. I really liked the way they shaped the teeth and it did fit good. She told me to wear them for 2 weeks and come back and if there was ANYTHING I DIDN'T LIKE THEY WOULD CHANGE IT. I went back and told her she did an excellent job on the shaping and fitting but I told her it was still hard to chew without it scrapping on my bottom crowns (both denture and bottom are porcelain). I am not sure yet but they might not be matching exactly where I am always thinking about where to bite especially with very small amount of food in my mouth. They felt real rough on the denture and sometimes when eating it sounded like when you scratch a nail across a chalk board. I thought maybe it would take time for it to smooth out. She found some sharp edges and took care of that. Then also I asked her if it was possible to make the back of the denture wider so they would touch the inside of my cheek so it would feel like my face wasn't drooping and I would have that FEELING OF MORE SUPPORT. Of course she blamed that onto "old age". I would put little pieces of paper towels around my back teeth to bring them out farther to see how it felt and it changed the way it felt and I didn't have that "pulled down" feeling and I felt I had more control of my facial expressions and the support it gave. My original teeth came out farther and that I guess I sure do miss that part of it. I must mention I have had some real bad dental experience and have been working with anything or anyone I can think of to undo what these first dentists did to me. I was made deals with 2 more dentists since and they left me stranded - The first one admitted after maybe a year,for one thing. they made my crowns (upper & lower) too long but gave me the run around and wouldn't do them over since they first told me they would if anything went wrong. The next dentist was re-doing the upper crowns and while wearing the temp teeth he wouldn't finish them. (another unbelievable store in itself). Trying to function and think thru my pain it took one year to get to someone else who might help me. A long story. Anther one just took my money and told me not to come back . So here is where I am and I really like this dentist - the first one who does show concern. Sorry this is so long, but too, she said come back in 2 weeks but she said they couldn't add on to this denture they would have to make a whole new denture. I was afraid to ask at the time even tho my son was with me, but I THOUGHT probably I WOULD HAVE TO PAY for a whole new denture in that case. I just can't take any more confrontations with dentists and doctors - all I want is to get my money's worth and to feel a little bit of who I always was before these first dentists did me in. Thru all this I got chronic pain 24/7 throughout my whole body and I worked for a good 15 years, when I could see it was finally paying off to get rid of this pain, I got over my chronic pain but now I still have this balance problem when I walk and am still going all over trying to find help for that. Even tho I am getting to that age where this can happen. Seems like the only help I get is chiro, muscle massages and trying to figure out what to work on next. This teeth process and pain was all new to me and I was not getting any answers but criticism so I was fighting something I didn't know what I was fighting. I lost my job, I had to sell my house. I did conquered the pain, (I am pain free where my whole body was full of pain for 15-20 years) so I feel why not try to find the answer to this also. I lost 20 years because of this and want to try to make up for it before I die. thx for listening - sorry so long. Would appreciate an answer on what they do as far as if they make another denture for me - is that my responsibility financially??? I still need so many anwers cuz it happens to still be important to me even tho no one else seems to care that much. Joyce
George - 09 Sep 2007 21:01 GMT I won't delve into what you can or you can't do to solve your issues with your current dentist; this is between you and her and depends on what the problem is and if it is addressable or if it was foreseeable. Unfortunately I have no way to peek into your mouth through my computer monitor half the world away, so any info delivered through this forum is more of a general nature. Now, if there are no matching exactly as you said, the dentist may have to so some occlusal adjustments by slightly grinding/easing the teeth on the denture. Dentures are made on a plaster cast which is never a 100% accurate depiction of your mouth - some amount of information is always lost similar to what happens with a photocopy and the original material. Sometimes a difficult case may require several sessions of adjustments before it feels ok. About the fact that your natural teeth were coming out more, a denture needs to serve two functions: esthetics and function. You may have a denture that looks fantastic but pops out everytime you try to eat. Or you may have a denture able to chew through the toughest stakes but doesn't look so good. The successful denture is the one that compromises between esthetics and function. Unfortunately, we cannot place teeth on the denture anywhere we like. Your natural teeth have roots anchoring them to your jaws, but a denture is not nailed in your jaws. The teeth on the denture must be placed on locations that balance with each other, so that the denture is not displaced when you try to eat. A popular saying among dentists is that "a denture is not a good substitute for natural teeth, but it's way better than having no teeth". If the teeth on the denture can indeed be placed more outwards without compomising stability (this is something that your dentist must assess), there is a possibility something can be done without going through all stages again. If the denture base is satisfactory, perhaps the teeth in question can be stripped from the denture, new teeth added for a try-in and then processed if the try-in is ok. But if the teeth are already in the correct locations for a denture, I'm afraid you will have to learn to get used to that.
Regards, George
Joyce-MN - 10 Sep 2007 02:21 GMT I really really want this to work (I guess just like every other dental patient on THEIR problem). I put so much going this alone into getting this far that when they told me after the final denture was completed and I could wear them home the Assistant said come back in two weeks and if you WANT ANY CHANGES, WE WILL CHANGE IT FOR YOU. I guess I didn't know as to what extent they meant. They know how terribly afraid I was of getting a change in dentures because of my past experience with dentists that they would tell me one thing and then do something else and when it didn't turn out right I was told I would have to live with it. So I really fell for this and now when we did go back she said about the making it wider in back that that would mean a NEW DENTURE. They don't tell you anything ahead of time or what I am trying to say we as patients don't know what to expect until it is completely done and then it's a whole new ballgame - that we pretty much have to live with it. Oh, I know you guys can't help me - I am blowing off steam because those who have seen me in person have said they can't help me either. I suppose they don't want to go into someone elses mess. I suppose that was why the dentists, doctors and my work thought I should be going straight to the nut house and sitting in front of the psychiatrist as, yes, I was acting strange and felt I was beginning to go nuts cuz of the way they changed my bite and then made my teeth to long and then told me to stay out of it cuz they knew what they were doing. It felt like my teeth was going in the wrong direction plus I had to pry my mouth open for I don't know how long. Again I should never have started cuz I know no one wants to hear but its like anyone else who has been hurt badly thru death or whatever, I keep thinking I need a closure on this and stupid ole me don't know what more I can do and just keep hoping I will find that closure by chance . Joyce-MN
Steven Bornfeld - 09 Sep 2007 22:13 GMT >> Is this the "norm" that a dentist has the permanent denture (in this >> case just the upper denture) made right away after taking impressions. [quoted text clipped - 12 lines] > Regards, > George In the olden days (even before my little-baby dentist days), when a patient was being fitted for a full denture, the first one would be an immediate denture. After 6-12 months a second denture was made (this is folkloric information, handed down to me by grizzled veterans who never wore gloves, owned one belt-driven handpiece and used boiling water to "sterilize" instruments> The immediate denture was considered a "temporary denture" because it was, well--temporary. Lab fees were lower, and insurance was scarce or nonexistant.
Steve
Steven Fawks - 10 Sep 2007 04:55 GMT If I could spell it, I would say, "Au contrare mon frer".
I always make a temp plate as the immediate denture and take new impressions 6 months after extractions for the final prosthesis.
:-) Steve
> No such thing as a temp denture I'm afraid. > > Regards, > George Joyce-MN - 10 Sep 2007 05:06 GMT Steve - OMG, Without thinking twice, I wish I had you as my dentist. I wish you had been my dentist 20 years ago when all this went wrong. But I am curious what all those words mean you started out with. (is it French, I suppose). Joyce-MN
Dartos - 10 Sep 2007 14:16 GMT It's probably not spelled right, but it means 'on the contrary my friend'.
In dental school (75-79) I was taught to make the immediate denture as the finished denture, and reline/rebase this plate at about 6 months.
Most of them worked out "OK", but the fit was rarely as good as I could get by taking new impressions and starting over. I spent a little time visiting and learning from an older prosthodontist in Kansas City. He used this technique.
Where I practice, dentures are still very common options for many people.
I decided to adopt Dr. Beckley's approach and raised my fee to cover the cost of the temporary plate. I don't think it hurt my business, because I still have all the denture cases that I would like.
JMO, D
> Steve - OMG, Without thinking twice, I wish I had you as my dentist. I > wish you had been my dentist 20 years ago when all this went wrong. But > I am curious what all those words mean you started out with. (is it > French, I suppose). Joyce-MN Newbie - 10 Sep 2007 15:17 GMT >It's probably not spelled right, but it means 'on the contrary my friend'. > >In dental school (75-79) I was taught to make the immediate denture >as the finished denture, and reline/rebase this plate at about >6 months. Same here. Think it largely depends on the number of extractions on how successful the 'one shot' can be. Ususally take all molars and most bi's (depends on occl.) Let that heal for a while before taking an impression.
>Most of them worked out "OK", but the fit was rarely as good as I >could get by taking new impressions and starting over. I spent a >little time visiting and learning from an older prosthodontist in >Kansas City. He used this technique. Rarely have to remake immediates, but there are some. Guess it depends on how good the impression is and how good is the lab. Been using the same removable lab for ~20 yrs now. Consistent quality and we work *together* on cases.
>Where I practice, dentures are still very common options for many >people. Have one of those 'denture mills' nearby. End up fixing alot of their screw ups by starting from scratch.
>I decided to adopt Dr. Beckley's approach and raised my fee to cover >the cost of the temporary plate. I don't think it hurt my business, >because I still have all the denture cases that I would like. Interesting.
>JMO, >D Amatus Cremona - 10 Sep 2007 14:22 GMT Actually, Dr. Turbyfil teaches such a technique
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>> Is this the "norm" that a dentist has the permanent denture (in this >> case just the upper denture) made right away after taking impressions. [quoted text clipped - 12 lines] > Regards, > George Newbie - 10 Sep 2007 15:29 GMT >Actually, Dr. Turbyfil teaches such a technique Though I have heard this from another doc in town, would be very reluctant to send a wax try-in home with a patient.
Too many things could go wrong IMO.
George - 10 Sep 2007 19:43 GMT > Actually, Dr. Turbyfil teaches such a technique > [quoted text clipped - 19 lines] > > Regards, > > George Really? How can a patient use the wax try-in to let's say eat? I would be afraid he could swallow a couple of teeth...
Regards, George
Newbie - 10 Sep 2007 21:16 GMT >> Actually, Dr. Turbyfil teaches such a technique >> [quoted text clipped - 25 lines] >Regards, >George The way I heard it was to instruct thepatient to not eat or sleep with them.
The evaluation is only supposed to be for appearance and speech, by family and/or friends. And for only one day.
Not too keen on the idea myself.
Joyce-MN - 10 Sep 2007 23:33 GMT To start out with it was all about crowns. I had to wear a "splint" for 6 months before to change my bite. There was never any discussions face to face on the condition of my bite. There were x-rays, etc and the dentist, my insurance company and my workplace & I talked about on how long this and that would take and how much I would pay and how much my Ins. would pay and exactly when to pay it each month. I remember after that time nothing was said until just 10 minutes before he started filing down my first tooth, he said "you stay out of it, we know what we are doing". What a convenient time for his sake to bring this up. I think that was the beginning of the end for me right there. I was alone and too far into this that I could not get up and walk away, I didn't think and never dreamed I would be having to go thru this unnecessary hell the rest of my life. I was wearing something temporary and during a dinner my work had and sitting at a long table with my co-workers and bosses, I did lose a tooth - didn't swallow it, it fell in my plate. This was just one embarrassing thing that happening in trying to get different teeth in my mouth to satisfy them (not me). They took control over my whole being. Eventually, I lost it (almost). I was in such a fog trying to deal with this pain and teeth in my mouth, trying to hold down my job (without a job I had no income) and teeth so long that felt like they should have gone in a horses mouth. I had short teeth and he put in long teeth within a months time and I could not adjust to them evidently. I was living in so much pain in my face and neck and like I said it seemed to throw my whole body off eventually, I think to try to compensate for the pain in my mouth and my jaws. I would then started tightening up my whole body when anyone would approach me as my work was giving me hell for not doing my job. I got to where I couldn't remember to many things. (I was a secretary at a large company). I would take a message over the phone and had to rewrite it 3 times before i could get it legible. I would go out to eat with the girls at lunch time and end up just sitting there staring into space with my hand over my cheek cuz it hurt so bad. Of course none of them understood what the heck I was talking about when I mentioned the pain in the face and must have thought I was really going off the deep end. I would complain to the dentist and it just went over his head and we got into arguments. Again, I didn't know enough about it to know what questions to ask or to know what to expect right off the bat or what was to eventually straighten itself out. Down the road the one prominent doctor (maybe neurologist- I had been to plenty of them). This one said I had Fibromyalgia. By this time I had heard of this. And by this time I had gotten my Webtv and found a TMJ Group. As expected all my tests came out negative seemed like for anything I took. After the crowning of the teeth it felt like my whole face had fallen and I felt I didn't have that automatic smile anymore - to me it felt like he shoved my teeth half way down my throat and I had no support. I think now that I am able to sort things out and pinpoint different problems that I feel I need this upper denture to come out further to my cheek so i have that support. I was left with so many problems before I couldn't pinpoint anyone thing what was wrong. AND, now I wonder about this bite - if my mouth/teeth should go straight up and down when I chew or upper rub across the lower ones??? On top of everything else as much as I do like this new dentist, she is from China or Viet Namese (sp). It wasn't so noticeable because she had her assistant from the U.S. there to do most the talking where after I got the permanent denture, she was alone with us and I was just worn out trying to understand some very important things she maybe was telling us and for me to try to get across to her how I felt. I just don't know what my "rights as a patient is" and its like its a secret and i don't want to cause anymore hard feelings. I was left with being so misunderstood and hard feelings over all this by so many people. Theres enough problems in this world, I just need for this to go smoothly. I had two bad marriages and ended up raising 6 kids alone and I was going to finally have a life of my own then I get the word that these teeth have to be done or else. My problem then was just that I put tension in my jaw and, yes, my teeth were worn down otherwise not much problem with my teeth. After all the bad marriages and raising the kids, sorry to say these dentists were the ones who BROUGHT ME TO MY KNEES. it was tho they took my control away from me and this was something no one can fix themselves so I had no choice at the time. Funny, even my grandchildren know. One bought me a pin for my last birthday saying "I've Survived Damn Near Everything". I told her i was going to wear it on my purse for ever and I would carry it to my grave. Joyce-MN
Mary - 11 Sep 2007 04:02 GMT > otherwise not much problem with my teeth. After all the bad marriages > and raising the kids, sorry to say these dentists were the ones who [quoted text clipped - 4 lines] > her i was going to wear it on my purse for ever and I would carry it > to my grave. Joyce-MN Joyce, I drop in here once in a while. I needed help with a crown a while back and got some good advice here. I read your story and I feel sorry you are having such a bad time with your dentures. Your last paragraph of your above message really hits the mark. I've never seen a pin saying "I've Survived Damn near Everything" but I feel like that myself sometimes and yes, you should wear it on your purse forever just to remind yourself that you have gone through a lot but you have survived and you will keep on surviving. I hope you can get your denture problems fixed. There are a lot of good dentists on this group and hope they can help. You deserve a lot of credit for your perseverance. You will find the solution eventually.
Mary
Joyce-MN - 11 Sep 2007 22:34 GMT Mary, Thanks, thanks so much for your reply. No, this denture is fine (So far). But I am so scared cuz the last 3 dentists promised something and never followed thru and left me to figure it out for myself. This last one whom I do like promised me too, after wearing it a couple weeks said "come back and we will change anything you want changed". When i went back and asked if it was possible to make the back part of the denture wider so as to hit the instde of my cheek so I would have that feeling of support. Sounds like it could be done but would have to make a new denture. PERIOD. Nothing to the effect if I would have to pay for another denture or what. I am so tired of things made complicated that could be so easily discussed. So I will have to see as time goes on. Trouble is if I take too long all she has to say you waited too long to complain. been there done that too. Anyway, yes I feel bad that ppl/my kids when I tell them exercising to keep those bones and muscles functioning it really helps. Mary, good luck on your new crown. Joyce-MN
Mary - 12 Sep 2007 00:29 GMT > Mary, Thanks, thanks so much for your reply. No, this denture is fine > (So far). But I am so scared cuz the last 3 dentists promised something [quoted text clipped - 11 lines] > kids when I tell them exercising to keep those bones and muscles > functioning it really helps. Mary, good luck on your new crown. Joyce, I already had the crown done a few months ago. I meant, before I got it done, I got some advice on this group. I am wondering when you went back to your last dentist (the one you like), did she say that you would need a new denture to make things the way you want? Did she say if this new denture will be made, you would have to pay for it? When was it you went back to her? It sounds as if you discussed your problem, but were not satisfied with her answer? Does the denture feel uncomfortable, or can you wear them OK?. If you are not clear on what she said and want to make sure she understands what you want, you should go back and see what she says even if its been a while. You need to be direct with her about what you want and what your options are and what the cost might be, if any.
I am sympathetic to people with dentures, because my married daughter had most of her teeth out about 5 years ago when she was 35 because according to the dental surgeon, he said a lot of her teeth were loose due (he said) to bungled orthodontic work done when in her early to later teens. She was very very upset.I would probably be even worse if I had been told when I was 35 that most of my teeth had to come out. Even 5 years later is still very upset and sometimes says she regrets not getting another opinion. Losing most of your teeth where it changes your looks can be psychologically devastating to some people. Yet no one mentions it. She is a very small girl with small bones and had difficulty getting the denture to feel comfortable, and was always getting adjustments. She goes to a denturist but goes through periods when she says the top dentures are not comfortable and has to take them out sometimes. I really feel sorry for her. I am in my early 60's and have my own teeth, but some of them are not too great, so who knows for how long I'll have my own teeth.
Mary
Joyce-MN - 12 Sep 2007 01:29 GMT Mary, will you e-mail me as I have a few boring questions I'd like to ask you. thx. I tried to e-mail you but it was returned to me. Joyce-MN
Amatus Cremona - 11 Sep 2007 00:15 GMT His technique is to fabricate a complete denture off an alginate impression through specific steps to get tooth position. Moving and re-setting teeth as needed on this denture. Once the patient can function on it and is happy with the appearance of it, he has it duplicated with new teeth and the first one becomes a spare.
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>> Actually, Dr. Turbyfil teaches such a technique >> [quoted text clipped - 25 lines] > Regards, > George krzysztof polanowski - 10 Sep 2007 09:17 GMT The thearapy of full dentures should be done in 2 steps in most cases becouse of bite modification and adaptation period. Its the best and the most accurate methods based on Earle Pound ideas. regards Kris-Polanowski DSS
> Is this the "norm" that a dentist has the permanent denture (in this > case just the upper denture) made right away after taking impressions. > Why don't they let your wear a temp. one first to be sure it fits and > looks good. Joyce Joyce-MN - 10 Sep 2007 10:08 GMT Kris- I swear I am beginning to get the courage that if I don't sense these dentures are right I will go back and tell her. I am so confused. I only have an upper denture. The lower are crowns. Back in 1986 the dentist crowned my 28 teeth. He said if I didn't have it done I would lose all my teeth. It had to be done their way (I think by the book). I didn't wear all temp then either. He did four at a time and I wore the four for a week or so and then he put them in permanently and so on until all the teeth were done. He said it was a plan from someone in Chicago (I can't remember the name off hand) and he said it was the best they had at that time. I got so I just sat in a daze after eating and holding my face. My neck started hurting and the back of my head and then down my spine - all kinds of things were happening to me at that time and the dentists and doctors either laughed at me, yelled at me or ignored me. I don't have a very good name around here with some of these professional people and all because they were hurting me so badly and my body couldn't take it that it seemed to eventually throw my whole body and mind out of kilter. Sounds strange maybe but I know how my body reacted to things all my life and this was doing very strange and destructive things I didn't understand and it scared me to death. I ended up being so bad seems like I was fighting everyone - before terrorist became a household name, during all this time I felt like these were terrorists after me and I was fighting third world war all alone. I just had to keep fighting and looking for answers to keep my head above water even tho I didn't know what I was fighting, I had to keep going. I suppose that was why they thought I needed a psychiatrist. You get that way with chronic pain along with the "unknown". Sorry, I'm spouting off again - it makes me feel I really do have meaning. Good Night. Joyce-MN
krzysztof polanowski - 10 Sep 2007 12:31 GMT yep The denture is not only for esthetic.. The denture is a treatament and keeping the apt occlusion. Depends on case and examination We have couple methods of treatment. There is quite often situation called TMD . So if you had some strange symptoms before or You had unsteady bite occlusion You should check the Bite first (rtg etc) next depends on situation take plan of treatment...
For me Its difficoult to determine the reasons but ALWAYS the dentures needs the examination first and next the plan of treatment.
As I understood The denture was made directly Its the cheapest and fastest way.. Not high quality .
If you have the upper denture keep it and use as a diagnostic /treatm,ent denture of course You need very close and good examination before next steps..
The dentit should perform to You the reasons and next the plan of treatment.
regards kris-Polanowski DDS
> Kris- I swear I am beginning to get the courage that if I don't sense > these dentures are right I will go back and tell her. I am so confused. [quoted text clipped - 24 lines] > spouting off again - it makes me feel I really do have meaning. Good > Night. Joyce-MN Melinda Shore - 10 Sep 2007 15:37 GMT >My neck started hurting and the back of my head and >then down my spine - all kinds of things were happening to me at that >time and the dentists and doctors either laughed at me, yelled at me or >ignored me. I have a friend who was experiencing a lot of jaw pain and was wolfing down painkillers and asking her doctor for more, and he had her involuntarily committed to a psych ward because he thought she was abusing them. Turned out she had osteomyelitis.
Anyway, when I was trying to figure out what to do about my mouth and trying to find out everything I could about people's experiences with implants I found an MSN discussion board that's pretty active and has people with a big variety of experiences with both dentures and implants. It's almost completely patients, not dentists, and I think it's a good place to go to find out what other patients are experiencing, what problems they've had, and how they've dealt with dentists they clashed with. The URL is http://groups.msn.com/DenturesANewSmile
 Signature Melinda Shore - Software longa, hardware brevis - shore@panix.com
Prouder than ever to be a member of the reality-based community
Joyce-MN - 10 Sep 2007 19:11 GMT I hope I am not too much of a pest but I really do need some answers that I am not getting from my dentists. Maybe because my insurance doesn't pay for me to go every few days to ask questions as they arise. One more thing, right now, I am wondering if when you chew does your teeth go straight up and down to hit each other or do they kinda rub together very slightly when chewing. (am I explaining this right). Another thing, I think this dentist has me cornered as I asked her if the bottom would need to be filed for one reason or another could she do it. She said I would have to go back to the original dentist who did the crowns and have him do it. This is one of the things I have had to put up with, I can't take these teeth out and do all this myself and still no one is cooperating to help me. I am so shocked and disappointed in this one dentist I thought we could really work together with each other and for her to think I would go back to this dentist who left me hanging with dysfunctional teeth and bite, plus the person before me with him was back for the second time to have her teeth redone because they were not "right" for her, but at that point I was so naive (sp)-this doesn't look right) how did I know this would end up being an ongoing horror story. Someone else might have him in prison now or have him hanging by his teeth somewhere - who knows. LOL. When I told a couple dentists whom I met in a TMJ class who it was, they right away said "oh no", they knew him and said he was one of the most brutal bast---s on earth. So there you go. I am taking all your answers to heart and hope it will help me when the time comes. Joyce-MN
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