Modern dentistry offers several great ways to permanently replace missing teeth, including high-tech dental implants and traditional fixed bridgework. But sometimes, for one reason or another, it isn’t possible to have these treatments done right away. If you need an aesthetic way to temporarily replace missing teeth, a flexible partial denture could be the answer you’re looking for.
Certain kinds of removable partial dentures (RPDs) can be used as permanent tooth replacement systems, especially for people who aren’t candidates for dental implants or fixed bridges. But in the past, if you needed a temporary tooth replacement, one of the few alternatives was the type of rigid RPD often called a “flipper.” This consists of a firm, relatively thick acrylic base that supports one or more lifelike replacement teeth. It attaches to the “necks” of existing natural teeth via metal clasps, which gives it stability and strength.
However, the same rigidity and thickness that gives these rigid RPDs their durability can make them uncomfortable to wear, while the acrylic material they are made of is capable of staining or breaking. Over time, the RPDs are prone to coming loose — and they are also easy to flip in and out with the tongue, which gives them their nickname.
Flexible partial dentures, by contrast, are made of pliable polyamides (nylon-like plastics) that are thin, light and resistant to breakage. Instead of using metal wires to attach to the teeth, flexible RPDs are held securely in place by thin projections of their gum-colored bases, which fit tightly into the natural contours of the gumline. Their elasticity and light weight can make them more comfortable to wear. Plus, besides offering aesthetic replacements for missing teeth, their natural-looking bases can cover areas where gums have receded — making existing teeth look better as well.
All RPDs must be removed regularly for thorough cleaning — but it’s especially important for flexible RPD wearers to practice excellent oral hygiene. That’s because the projections that hold them in place can also trap food particles and bacteria, which can cause decay. And, like most dentures, RPDs should never be worn overnight. Yet with proper care, flexible RPDs offer an inexpensive and aesthetic way to temporarily replace missing teeth.
Every year dentists place over 5 million dental implants for lost teeth, often removing the problem tooth and installing the implant at the same time. But getting a “tooth in a day” depends on a number of health factors, especially whether or not there’s adequate bone available for the implant. Otherwise, the implant’s placement accuracy and success could be compromised.
Bone loss can be a similar problem when a tooth has been missing for a long period of time. If this describes your situation, you may have already lost substantial bone in your jaw. To understand why, we need to know a little about bone’s growth cycle.
When bone cells reach the end of their useful life, they’re absorbed into the body by a process called resorption. New cells then form to take the older cells’ place in a continuous cycle that keeps the bone healthy and strong. Forces generated when we chew travel through the teeth to the bone and help stimulate this growth. But when a tooth is missing, the bone doesn’t receive this stimulus. As a result, the bone may not replace itself at a healthy rate and diminish over time.
In extreme cases, we may need to consider some other dental restoration other than an implant. But if the bone loss isn’t too severe, we may be able to help increase it through bone grafting. We insert safe bone grafting material prepared in a lab directly into the jaw through a minor surgical procedure. The graft then acts like a scaffold for bone cells to form and grow upon. In a few months enough new bone may have formed to support an implant.
Bone grafting can also be used if you’re having a tooth removed to preserve the bone even if you’re not yet ready to obtain an implant. By placing a bone graft immediately after extraction, it’s possible to retain the bone for up to ten years—enough time to decide on your options for permanent restoration.
Whatever your situation, it’s important that you visit us as soon as possible for a complete examination. Afterward we can assess your options and hopefully come up with a treatment strategy that will eventually include smile-transforming dental implants.
If you've ever been alarmed to find oddly-shaped red patches on your tongue, you can relax for the most part. Most likely, you're part of a small fraction of the population with a condition known as geographic tongue.
The name comes from the irregular shape of the patches that seem to resemble land formations on a map. Its medical name is benign migratory glossitis, which actually describes a lot about the condition. The patches are actually areas of inflammation on the tongue (“glossus” – tongue; “itis” – swelling) that appear to move around or migrate. They're actually made up of areas where the tiny bumps (papillae) you normally feel have disappeared: the patches feel flat and smooth compared to the rest of the tongue.
We're not sure why geographic tongue occurs. It often runs in families and seems to occur mostly in middle-aged adults, particularly women and non-smokers. It's believed to have a number of triggers like emotional stress, hormonal disturbances or vitamin or mineral deficiencies. There may also be a link between it and the skin condition psoriasis. Under a microscope the red patchiness of both appears to be very similar in pattern; the two conditions often appear together.
The bad news is we can't cure geographic tongue. But the good news is the condition is benign, meaning it's not cancerous; it's also not contagious. It poses no real health threat, although outbreaks can be uncomfortable causing your tongue to feel a little sensitive to the touch with a burning or stinging sensation. Some people may also experience numbness.
Although we can't make geographic tongue go away permanently, you should come by for an examination to confirm that is the correct diagnosis. Once we know for sure that you do have migratory glossitis, we can effectively manage discomfort when it flares up. You should limit your intake of foods with high acidity like tomatoes or citrus fruits, as well as astringents like alcohol or certain mouthrinses. We can also prescribe anesthetic mouthrinses, antihistamines or steroid ointments if the discomfort becomes more bothersome.
It may look strange, but geographic tongue is harmless. With the right care it can be nothing more than a minor annoyance.
If you would like more information on benign migratory glossitis, 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 “Geographic Tongue.”
Fans of the legendary rock band Steely Dan received some sad news a few months ago: Co-founder Walter Becker died unexpectedly at the age of 67. The cause of his death was an aggressive form of esophageal cancer. This disease, which is related to oral cancer, may not get as much attention as some others. Yet Becker's name is the latest addition to the list of well-known people whose lives it has cut short—including actor Humphrey Bogart, writer Christopher Hitchens, and TV personality Richard Dawson.
As its name implies, esophageal cancer affects the esophagus: the long, hollow tube that joins the throat to the stomach. Solid and liquid foods taken into the mouth pass through this tube on their way through the digestive system. Worldwide, it is the sixth most common cause of cancer deaths.
Like oral cancer, esophageal cancer generally does not produce obvious symptoms in its early stages. As a result, by the time these diseases are discovered, both types of cancer are most often in their later stages, and often prove difficult to treat successfully. Another similarity is that dentists can play an important role in oral and esophageal cancer detection.
Many people see dentists more often than any other health care professionals—at recommended twice-yearly checkups, for example. During routine examinations, we check the mouth, tongue, neck and throat for possible signs of oral cancer. These may include lumps, swellings, discolorations, and other abnormalities—which, fortunately, are most often harmless. Other symptoms, including persistent coughing or hoarseness, difficulty swallowing, and unexplained weight loss, are common to both oral and esophageal cancer. Chest pain, worsening heartburn or indigestion and gastroesophageal reflux disease (GERD) can also alert us to the possibility of esophageal cancer.
Cancer may be a scary subject—but early detection and treatment can offer many people the best possible outcome. If you have questions about oral or esophageal cancer, call our office or schedule a consultation. You can learn more in the Dear Doctor magazine article “Oral Cancer.”
In an instant, an accident could leave you or a loved one with a missing tooth. Thankfully, we can restore it with a dental implant that looks and functions like a real tooth—and the sooner the better.
But if the patient is a teenager or younger, sooner may have to be later. Because their jaws are still developing, an implant placed now could eventually look as if it's sinking into the gums as the jaw continues to grow and the implant doesn't move. It's best to wait until full jaw maturity around early adulthood and in the meantime use a temporary replacement.
But that wait could pose a problem with bone health. As living tissue, bone cells have a life cycle where they form, function and then dissolve (resorption) with new cells taking their place. This cycle continues at a healthy rate thanks to stimulation from forces generated by the teeth during chewing that travel through the roots to the bone.
When a tooth goes missing, however, so does this stimulation. Without it the bone's growth cycle can slow to an unhealthy rate, ultimately reducing bone volume. Because implants require a certain amount of bone for proper placement and support, this could make it difficult if not impossible to install one.
We can help prevent this by placing a bone graft immediately after the removal of a tooth within the tooth's "socket." The graft serves as a scaffold for new bone cells to form and grow upon. The graft will eventually resorb leaving the newly formed bone in its place.
We can also fine-tune and slow the graft's resorption rate. This may be preferable for a younger patient with years to go before their permanent restoration. In the meantime, you can still proceed with other dental treatments including orthodontics.
By carefully monitoring a young patient's bone health and other aspects of their dental care, we can keep on course for an eventual permanent restoration. With the advances in implantology, the final smile result will be worth the wait.
If you would like more information on dental care for trauma injuries, 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 “Dental Implants for Teenagers: Factors Influencing Treatment Planning in Adolescents.”
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