In an ideal world we wouldn’t get cavities, have gum problems, or ever lose a tooth. Perhaps, the world might not be ideal, even then, but at least we wouldn’t have those problems.
Unfortunately, it is a fact of life that many people do lose their teeth – either to tooth decay or periodontal disease – and then require tooth replacements. Despite the growing popularity and acceptance of dental implants as prosthetic tooth substitutes, removable dentures still constitute the most common solution to missing teeth.
If a person still has some natural teeth, they may get what we term a “removable partial denture.” If they have lost all of their teeth, typically they will get a full denture. A commonly observed problem, however, is that once the dentures are made, patients tend to wear them far beyond the point where the denture continues to function well. A little background regarding the problem with dentures may help clarify why this is so:
Some people think that if they get rid of all of their teeth and get dentures they will finally see an end to their dental problems. This is far from reality. Actually, what happens is that patients simply trade one set of dental problems for another. While many patients will tell you that they eat just fine with their dentures, it has probably been so long since they had their real teeth, they have forgotten what it is like to eat normally.
What are some of the disadvantages of wearing dentures?
You lose up to 50% of your biting force.
A full upper denture covers your palate and interferes with your ability to taste your food.
Dentures can move when you eat, speak, cough, or sneeze.
Food accumulates around your dentures after a meal.
Sore spots can develop when the hard denture rubs against your gums.
Patients with an active gag reflex may not be able to even wear a denture without feeling as though they will gag.
Multiple relines of the denture may be required as the shape of your mouth changes. This can happen as a result of gaining or losing weight, or as a result of bone shrinkage and aging.
Atrophy of the upper or lower jaws can make it impossible to develop suction with the denture.
How long do they last?
This is an interesting question, because it is not unusual to encounter patients who tell you their denture was made twenty or even thirty years ago. Believe me, at that point, they are seldom good-looking dentures! But it underscores something about denture wear that is not well understood.
Once a denture is made and, assuming it fits well at the time of delivery, most patients expect – and can experience – good retention and stability.
But the key point is – once made – the dentures don’t change. Yet your mouth can – and often does. New medications can also cause your mouth to become dry, leading to irritation and sore spots. Osteoporosis could lead to shrinkage of the jaw. Despite these changes, many patients attempt to make up for new problems with denture adhesives. Unfortunately, this can open the door to even more irritation, and denture creams containing zinc have even been linked to other health problems such as numbness, tingling and muscle weakness.
While relines can assist with these changes and correct the fit of your denture to improve retention, many patients would do well to consider re-making their dentures after about five years to seven years. In my experience, waiting too long beyond that time period can make the transition to a new denture more difficult.
200 Year-Old Denture
When the change is minimal, such as one might expect after about five years, the transition is generally quite easy. It also helps to have a spare denture for those “oops!” moments. Over the years, I have experienced patients dropping dentures into the sink while cleaning them, accidentally dropping them into garbage disposals, having dogs and cats chew them, and more. Patients will bite into hard objects and break a tooth, they take them out at night and sometimes sit on them, they get stepped on – and one, believe it or not, was even stolen! That was simply too strange a story to recount here.
If your denture is over five years old, talk to your dentist about whether it is time to reline or remake your denture. You will be glad you did.
Bad teeth may not only have negative consequences for your health, they can cost you a job.
Many people with visibly unattractive teeth go through life avoiding eye contact with strangers for fear of having to smile back or even to make small talk. Not infrequently, when such people do talk or feel compelled to smile, they cover their mouths with their hand.
Unfortunately, in a job interview, this will not go over well. Yet, for the person with dental problems, to smile or talk would compel them to reveal something they are deeply embarrassed about – their teeth. There is an old saying that you don’t get a second chance to make a first impression. And first impressions are typically based upon appearance. Your teeth, or even your breath, can either enhance or completely destroy your chances of landing that new position.
Teeth that are blackened by decay, are crooked, discolored, or even missing may not just be embarrassing – they may turn off prospective employers. Also, hiding your smile during an interview can be one of the worst things you do. A smile and a confident response project self-assurance and make a person appear likeable.
This is just one of many subtleties employers may take into account when interviewing a prospect. Teeth that are stained by coffee, tea or cigarettes may distract the interviewer from what is really important – you and your qualifications.
Likewise, coffee and cigarettes leave a smell that can be easily detected. Apart from not showing visible stains, a prospective job-seeker should also avoid certain other foods shortly before their interview. The most obvious offenders are garlic, onions, anchovies or tuna. But it is also prudent to steer clear of such lunch meats such as salami, pepperoni or pastrami before your interview. Strong cheeses, such as Roquefort, Camembert, or Bleu cheese also leave persisting odors and, similarly, should be avoided.
Women are cautioned to avoid getting lipstick on their teeth. Softer shades or lip gloss are preferable to bright red. Lipstick on your teeth can give you the appearance of being careless or hurried – which may also sink your prospects the moment you open your mouth to speak.
In today’s economy, competition for work is fierce. Applicants need every advantage they can get to land the job. Applicants’ teeth need to be as good looking as the way they dress, comb their hair, or even shine their shoes, because employers can afford to be selective with so many qualified people looking for work.
Recent research conducted in the U.S. estimates that those prospects with well-maintained teeth experience as much as a 58% higher chance of finding a job than those whose teeth are perceived as unattractive. It also seems that potential employees who have invested in dental treatment with cosmetic dentistry are regarded as more professional, congenial, and trustworthy.
Individuals seeking employment can increase their chances of getting work by taking several steps before their interview. These include getting a dental examination, completing unfinished restorative work and possibly even having cosmetic dentistry. The number of job seekers getting their teeth whitened and getting porcelain veneers placed (as a way to increase their chances of hiring success) is increasing for these very reasons. So what do you do if you can’t afford a Hollywood smile? Don’t worry, there are affordable answers.
If you need a lot of work and it is out of your reach, temporary cosmetic solutions such as a Snap-On Smile® can make a dramatic change in your appearance – very often at less than one quarter the cost of a more permanent solution. This is on the order of a functional, but temporary, smile design that snaps over your natural teeth. Once you land the job and start making an income, you can consider something more permanent!
Recently, I saw four new patients in my dental office during a given week. All four of those patients scheduled their visits because they perceived pieces of their tooth chipping away. In three out of four of those cases, the offending tooth was so badly decayed that the tooth couldn’t be saved. Yet only one of those patients came in with any discomfort.
The common thread in each of these cases is that the patient waited until the tooth was actually breaking apart to seek dental care. All too often, the trigger that brings people to the dentist is pain. Yet here, we had at least three cases where pain was not a factor and yet the tooth was decaying.
How is this possible?
A little understanding of dental anatomy helps here. The outer layer of teeth, the enamel, is the hardest substance in your body. Because its composition is predominantly mineral, it is possible to have decay throughout that layer without experiencing any sensation. In fact, it is even possible for your dentist to drill that part of the tooth (in most cases) without pain. The next layer under your enamel is called dentin. Decay can travel into the dentin – where it usually spreads more quickly, because it is not as hard – and a person still may not experience pain.
By the time a tooth that is decayed hurts, the decay has generally travelled so far that it nears the innermost layer – the pulp. The pulp contains nerves and blood vessels – so, naturally, pain becomes a factor. If a patient is lucky enough to have enough tooth structure remaining, chances are that the tooth will need a root canal if it is to be saved. Otherwise, extraction is the usual alternative.
One lost tooth can lead, in turn, to still other dental problems. Most notably these include shifting teeth, TMJ problems, periodontal problems, cosmetic difficulties or simply difficulty chewing. It may even lead to the loss of more teeth – not to mention the fact that tooth replacement options can become rather expensive.
Hopefully, just understanding that a lack of pain does not equate to a lack of problems will prompt some readers that haven’t seen a dentist in a long time to do so. Sometimes people fear learning that they have cavities that need to be treated, and so they put off the examination. Consider, however, that it is better to learn you have five teeth that need fillings, than to learn you have several that have to be extracted.
In almost any field there are basics, the fundamental facts or principles from which other truths can be derived.
Without an understanding of these basics we lack the building blocks for greater knowledge or competence. For example, before we can write we learn our ABCs. Geometry first requires an understanding of arithmetic, and so on.
Lacking these basics, we can become lost in a sea of information, lacking the correct drops of water that hold the answers to our questions or allow us to be effective.
Know the basics of automotive care and you are likely to have a car that runs well and needs few repairs. Understand the basics of grammar and you can communicate.
What, then, are the basics of dental care?
While there are several key concepts which I cover in some of my earlier articles, there is one often overlooked principle I want to briefly cover herein.
Let’s first assume you are already in good dental health or, perhaps you weren’t, but now you got things under control. You are starting off with a “clean slate.” So, what do you do now?
The simple answer is taking a look at what got you there.
You spent months and maybe hundreds, even thousands, of dollars to handle dental problems that may not even have been causing you pain. Things feel good and you have gotten the clean bill of dental health from your doctor. What now? Continue to do what fixed the problem.
Did you start brushing after meals? Good. Continue.
Did you change your diet to reduce refined carbohydrates? Good. Continue.
Do you floss every day? Good. Continue.
Do you come back for your regular visits? No?! Why not?
If that was a successful part of the formula, don’t make the mistake I see so many people commit. There is probably many a dentist who will vouch for the fact that patients come in to them and say: “Yeah, I had a bunch of dental work done somewhere about fifteen years ago and it is starting to come apart.” When asked about the time of their last dental visit: “Oh, it was around then. Since my teeth were fine, it didn’t see the point of going in for a dental visit.”
Didn’t see – that’s a key point. There are many conditions that the patient neither sees nor feels. More importantly, dental health has a direct relationship to overall health. So the fact that one doesn’t feel gum disease, bone loss, dental cavities or oral cancer – especially in the early stages is a poor excuse not to see your dentist. Regular checkups are fundamental to defending yourself against serious problems. Caught early, your treatment can be approached conservatively, saving you time in the dental chair, the potential discomfort of extensive work and, of course, money.
Why is it that patients who visit the dentist regularly seem to need less dental work? I’d like to think it also has to do with their increased care and effort – but that effort includes keeping up with regular visits. These checkups can prevent small problems from turning into big ones and help to keep your existing work in good shape. Don’t be a penny wise and a pound foolish. See your dentist at least twice a year.
Dr. Richard Walicki is a dentist practicing general and cosmetic dentistry. While we hope you find the information contained herein interesting and useful, this blog is for informational purposes and is not intended to diagnose any oral disease. Dental conditions should be evaluated by your dental health professional or a qualified specialist.
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