Thursday, April 22, 2010

Problems with Dentures Caused by Xerostomia, or Dry Mouth

Summarized from “Dry mouth and Dentures”
By Randy F. Huffines, DDS Ó 2009


Saliva and oral health:
Dry mouth (also called Xerostomia) in most people is usually a side-effect of medications. Chemotherapy, radiation therapy, and some diseases can also cause a decrease in saliva production. It is necessary to have your dentist find the cause of your dry mouth so you can be treated properly. Most people with Xerostomia do not even know they have the condition until they have lost 50 percent of their saliva.

Saliva may appear to be only water, but this is not the case. Saliva actually works as part of your body’s immune system and contains hundreds of chemicals that make it possible to speak, chew, and swallow your food more comfortably. It also helps inhibit the germs that cause oral infections.

Oral lubricants:
There are medical products you can take to replace saliva. Some pharmacists call them “artificial saliva,” but a better term for them is “oral lubricants.” However, science to date has not been able to produce a substance that can replace all of the functions of saliva. Nevertheless, many people feel that oral lubricants make their mouth feel more comfortable. Many of these lubricants can be purchased in spray bottles. Some people even use water. Let your dentist recommend which oral lubricant it best for you.

Eating with a dry mouth:
If you wear dentures, you may have a number of problems if you do not produce enough saliva. Due to inadequate lubrication, it will be difficult to chew and swallow foods—especially dry foods. You can alleviate some of this with gravies and sauces and taking frequent sips of water. You can also use take an oral lubricant a few minutes before you eat. You must remove your dentures prior to using the lubricant so it can coat the parts of the gums that support the dentures. Then place the dentures back in your mouth.

Dry mouth and denture "fit":
Saliva is needed to hold your dentures to your gums. Dentists call this retention. When your mouth is dry, your denture will feel loose. This gets worse when supporting tissues under your dentures continue to shrink through the rest of your life. The amount of shrinkage varies from person to person. As your gums shrink, the denture and the gums become mismatched. This happens a little at a time, but even a small change in denture fit becomes more noticeable when your mouth is dry.

Most people notice this more often with the lower denture. It is easier to wear dentures on the upper arch because of the size and shape of the gums. As shrinkage occurs, you many h ave to have your denture remade or relined more often than someone who has normal amounts of saliva. A relinement is a procedure where additional denture material is added to the part of the denture that contacts the gums. This makes the denture fit closely and conform to the shape of the mouth.

However, even if you have a “perfect fit,” you may still experience some looseness because you lack enough saliva to hold the denture in place. You may need a denture adhesive to help in this case. There are many types available. Your dentist can offer advice on which one will best fit your needs.

Not only may you feel an increasing sensation of looseness, but you may also have sore spots underneath your denture because you have less saliva. Without the natural lubrication it provides, there is an increase in friction between the dry denture and the gum, which results in a sore spot. Your dentist should check denture fit is as close as possible. Then, if no adjustment needs to be made to the denture, you can use an oral lubricant or a denture adhesive.

Continued problems will require additional consultation with your dentist. You may need dental implants. It has been shown that replacing dentures with implants has greatly improved the quality of life for thousands of people. Dental implants are almost identical to natural teeth in both function and appearance.

Dry mouth and oral infections:
Because saliva controls germs in your mouth, dry mouth will make you more prone to mouth infections. Candida, a yeast-like fungus, often infects the mouths of people who wear dentures. One such infection is denture stomatitis. It occurs more commonly under the upper denture, particularly in those who have dry mouth and wear their dentures while they sleep. Most cases do not cause enough pain for people to notice, and may go on for years before finally being detected.

When it is detected, it must be eliminated before new dentures are made. Your dentist may have to treat your mouth with both tissue conditioners and antifungal medications.

There is also angular cheilitis, another problem caused by Candida. It causes sores to form at the corners of the mouth. It is treated with antifungal medications. Be careful how you use these medicines because they are often used incorrectly. Talk to your dentist before use.

If you have some natural teeth, you are more likely to have tooth decay resulting in tooth loss if you have dry mouth. Without saliva to regulate germs that cause decay, bacteria can grow more and cause greater damage. Ask your dentist for ways to prevent and reduce tooth decay.

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Monday, December 21, 2009

Alternatives to Bridges

When you are missing one or more teeth, you have several options.

You can choose to do nothing and delay treatment.
You can choose to get a dental bridge.
You can choose to get dental implants.

Let’s take a look at the advantages and disadvantages to dental bridges and the alternatives to dental bridges.

Delaying treatment
Most people immediately assume they are giving themselves a financial advantage by delaying treatment. After all, not seeking treatment means not having to pay a dental bill.
However, this is only going to cause you more problems. Your health will suffer, and in the long run, your pocketbook will suffer as well. Leaving your teeth as they are will cause them to shift. Over time, your bite will change. This will cause some teeth to become loose, and you will eventually lose them as well.

Choosing a dental bridge
A dental bridge is an excellent way to replace one or more missing teeth and restore stability to your mouth. A bridge is a natural replacement that is attached securely to the supporting teeth. They are dependable, easy to care for, and they look great.

This is why many Houston dentists recommend dental bridges. A bridge fills the space between existing and restores your natural bite and smile.

The disadvantage to a bridge is it has to be anchored to natural teeth and will wear on the enamel, damaging them in the process.

Trying a partial denture
A partial denture is a removable replacement for missing teeth. A partial will work well if several teeth are missing in the mouth because it will in the spaces and keep surrounding teeth in alignment.

The disadvantage to a partial as an alternative to a dental bridge is that dentures of any kind are not as strong as natural teeth and make less than ideal replacements.

Some dentures also make annoying sounds when you eat, and all have to be removed and cleaned at times. Of course, the more you are willing to invest in high quality dentures, particularly fixed partials, the better your chance at getting something workable in terms of a tooth replacement.

Still, dental implants are the best alternative to dental bridges if you have enough remaining bone mass to implant them.

Getting implants
Dental implants really are the best form of tooth replacement. They are designed to be permanent and completely assume the function of natural teeth. An implant with a crown can also replace a tooth, and it does not require us to work on the teeth next to the space. Implants stop bone loss and require surgery. Treatment time is somewhat longer, but the outcome is cosmetic and often indistinguishable from natural teeth.

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Friday, September 4, 2009

Replace Your Lower Dentures With Lower Jaw Implants

If you have a lower denture it is a good idea to go ahead and get it replaced with a lower jaw implant. A lower jaw implant will look much more like a natural tooth and will provide you with a more effective chewing surface.

You already know how uncomfortable a lower denture can be. You have probably noticed that it hurts to choose sometimes. This is because when you lose teeth, the bone in your jaw starts receding. Nerves that run to the surface of the bone become sensitive when you bite down.

Partial dentures are not the best solution to the problem of missing teeth because they do not anchor to the jaw itself. Lower jaw implants do, however. Shaped like cylinders with screw-shaped bottoms, these tooth root replacements are embedded in the bone itself, which then believes them to be natural tooth roots. This stops the process of bone recession, and it provides a sturdy base to cap with a porcelain crown that looks just like a natural tooth.

You may be saying at this point that you have lost too many teeth to replace all of your lower dentures with implants. In this case, we recommend you schedule an appointment and at least start with a combination of dentures and implants. What we will do is to connect the new lower jaw implants with a bar, then clip the new dentures to the bar.. These clips snap down on the bar and keep the denture from moving around and making those obnoxious, embarrassing noises. You can still take out your dentures to clean them, however, and this will also help you better clean the bar and the porcelain crowns.

Regardless of the option you ultimately go with, be aware that any implantation procedure is the one sure way to take the pressure off of jaw bones and nerves. And, like we already mentioned, they give the bone something to grow around so that bone loss gets stopped in its tracks.

Lower jaw implants are placed in your mouth in a two-phase process. The first phase is the surgical phase. Patients are sedated during this phase to prevent them from feeling pain. The dentist makes a small incision in the gums and screws the titanium base into the jaw bone. Over the next few months the jaw bone grows around this base, thinking it is a new tooth root.

Lower jaw implants are placed using a two-phase procedure. The first phase is called the surgical phase and involves sedating you so you will not feel any pain. The dentist makes a small incision in your gum and screws the implant in to the jaw bone. A few months are needed for the bone to accept the implant and properly heal.

Once it heals, a porcelain crown is then made that looks identical in size and coloration to your surrounding teeth. This is placed over the artificial root to provide a hard, comfortable surface for chewing that looks so close to the real thing no one will even know you are using a tooth replacement.

Not only will this make eating more enjoyable, but it will make you feel more confident when you smile and talk to other people.

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Tuesday, June 9, 2009

Can Mouth Appliances Be Used With Dentures?

Can a mouth appliance be used for a person that wears dentures? I was always told to remove my denture when sleeping. Thank you
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Thanks for the questions – yes, we have always told denture wearers to take their dentures out at night, and this is still logical. Giving the tissue a rest overnight is good.

However, there are situations in which it is better to wear the dentures:

1. Pain in jaw when dentures are out – wearing the dentures gives more support to the jaw and is more comfortable
2. Obstructive sleep apnea – with certain sleep disorders, using appliances for jaw positioning can help the problem
3. Patients that have some remaining teeth or implants in place to stabilize dentures can sometimes grind on those and create wear and tear problems. In these situations, it is better to wear the overdentures to protect the teeth or implants from excessive wear.

So, as in life, there are no hard and fast rules. It depends on your personal situation and need. Let me know if you want any more information.

Chuck Campbell, DDS
713-795-5905

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