Posts for: July, 2018
If you’ve lost some teeth you may eventually want to replace them with dental implants. Implants by far are the restoration of choice due to their life-likeness and durability. But those advantages don’t come cheaply — implants can be expensive especially for multiple teeth.
If you’re forced to wait financially for implants, you still have other intermediary options like a removable partial denture (RPD). The conventional RPD has a rigid acrylic base colored to resemble gum tissue supported by a metal frame with attached prosthetic (false) teeth at the missing teeth locations. They’re held secure in the mouth through metal clasps that fit over the remaining teeth.
But these conventional RPDs can sometimes be uncomfortable to wear and don’t always cover the bottom of the gum completely. If this is a concern, you might consider an alternative: flexible RPDs. The base of this RPD is made of a form of flexible nylon rather than acrylic plastic. They’re much more lightweight but still fit securely in the mouth with thin plastic extensions rather than metal clasps. The base can also be more easily formed to cover areas where gum tissue may have receded.
While flexible RPDs hold up better to wear and tear than their conventional counterparts, they must still be maintained like any other appliance. They can accumulate plaque (bacterial biofilm) responsible for tooth decay and periodontal (gum) disease, so daily thorough cleaning is a must. And if there fit becomes loose they can be more difficult to reline or repair than other types of dentures.
They also share a common weakness with other dentures — they can’t prevent and may even stimulate bone loss. As bone ages, old cells dissolve and new ones form to take their place. As we eat and chew our teeth transmit the forces generated through the teeth to the bone to stimulate it to grow. RPDs and other dentures can’t transmit this stimulus, so the bone replaces much slower to the point that the bone volume can diminish.
That’s why it’s best to consider any RPD as a temporary solution until you can obtain an implant for a more permanent and bone-friendly option. In the meantime, though, an RPD can provide you with a great solution for both form and function for missing teeth.
If you would like more information on RPD choices, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Flexible Partial Dentures: An Aesthetic Way to Replace Teeth Temporarily.”
People with missing teeth have more replacement options than ever before, including the ever popular but often more expensive dental implant. But there has also been an expansion of choice on the more affordable side of dental restorations. The flexible removable partial denture (RPD) is one such choice.
Though RPDs have been around for some time, the newer flexible RPD offers some advantages over the more rigid traditional RPD. They’re made of a kind of nylon that’s pliable but also strong and durable. This material is thermoplastic, meaning when heated it can be injected into molds based on a patient’s individual mouth to form an accurate denture base. The gum-colored base can also be formed to cover any receded areas of the gums, which can greatly improve smile appearance.
Older versions of RPDs are made of rigid acrylic plastic that stay in place in the mouth with metal clasps that attach to remaining teeth. The flexible RPD, on the other hand, is secured with finger-like nylon extensions that fit and hold in the natural teeth’s concavities near the gum line. This, along with its relatively light weight, offers a more comfortable fit.
But aside from these benefits, flexible RPDs do have a few drawbacks. Although fracture-resistant, they’re not easy to repair or reline to readjust the fit to accommodate mouth changes. They can stain (though not as much as a traditional RPD), so they require diligent cleaning and maintenance.
We consider the whole category of RPDs as “temporary” restorations, meaning they’re intended as a transitional phase between tooth loss and a permanent restoration like a natural tooth-supported fixed bridge or dental implants. For some, however, the flexible RPD might be a more long-term solution. As mentioned before, to extend their life as much as possible they should be removed daily and cleaned thoroughly. And like any form of denture, they should not be worn overnight.
In either case, flexible RPDs offer an effective way to restore not only dental function diminished by missing teeth but an improved appearance as well. With careful maintenance, they could serve you well for some time to come.
If you would like more information on flexible partial dentures, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Flexible Partial Dentures: An Aesthetic Way to Replace Teeth Temporarily.”
The mouth isn’t an island unto itself — problems there may be indicative of deeper physical or emotional issues. Â The condition of a family member’s teeth and gums, for example, could be signs of bulimia, an eating disorder.
Characterized by food binging and purging through self-induced vomiting, bulimia can also have a severe effect on the teeth. Regular inducement of vomiting introduces stomach acid into the mouth that can attack and soften the mineral content of tooth enamel. As a result, 90% of bulimics develop enamel erosion.
The erosion pattern often differs from that produced by other high acid causes like the over-consumption of sodas. Because the tongue instinctively covers the back of the bottom teeth during vomiting, they’re often shielded from much of the acid wash. Bulimics are much more apt to exhibit heavier erosion on the upper front teeth, particularly on the tongue side and biting edges.
Bulimia and similar disorders produce other signs as well, like soft tissue ulceration or swollen salivary glands that exhibit puffiness of the face. The roof of the mouth, throat and back of the tongue may appear roughened from the use of fingers or objects to induce gagging.
Unlike sufferers of anorexia nervosa who tend to be negligent about their hygiene (which itself increases their risk of dental disease), bulimics have a heightened sensitivity to their appearance. This concern may prompt them to aggressively brush right after purging, which can cause more of the softened enamel to be removed.
Treating the dental consequences of bulimia requires a two-pronged approach. In the short term, we want to lessen the impact of stomach acid by discouraging the person from brushing immediately after purging — better to rinse with water and a little baking soda to buffer the acid and wait about an hour before brushing. We may also suggest a sodium fluoride mouth rinse to help strengthen and re-mineralize the enamel.
In the long-term, though, the disorder itself must be addressed through professional help. One good source is the National Eating Disorders website (nationaleatingdisorders.org). Besides information, the association also provides a toll-free helpline for referrals to professionals.
As with any eating disorder, bulimia can be trying for patients and their families. Addressing the issue gently but forthrightly will begin their journey toward the renewal of health, including their teeth and gums.
If you would like more information on the effect of eating disorders on dental health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Bulimia, Anorexia & Oral Health.”