Jeffrey L. Hardenburg DDS

If youve lost all of your natural teeth, whether from gum disease, tooth decay or injury, complete dentures can replace your missing teeth and your smile.

Replacing missing teeth will benefit your appearance and your health.

Without support from the denture, facial muscles sag, making a person look older. Youll also find it harder to eat and speak things that people often take for granted until their natural teeth are lost.

There are various types of complete dentures.

A conventional full denture is made and placed in the patients mouth after the remaining teeth are removed and tissues have healed which may take several months.

An immediate complete denture is inserted as soon as the remaining teeth are removed. The dentist takes measurements and makes models of the patients jaws during a preliminary visit. With immediate dentures, the denture wearer does not have to be without teeth during the healing period.

Even if you wear full dentures, you still must take good care of your mouth. Brush your gums, tongue and palate every morning with a soft-bristled brush before you insert your dentures to stimulate circulation in your tissues and help remove plaque.

And even if you wear full dentures, its important to visit your dentist regularly to maintain your overall oral health and get early warning of serious issues such as oral cancer.

Sealants are made from plastic material applied to the back teeth to protect the enamel from plaque and acids.

The plastic bonds into the depressions and grooves (pits and fissures) of the chewing surfaces of the back teeth – premolars and molars.

Although thorough brushing and flossing can help remove food particles and plaque from smooth surfaces of teeth, the toothbrush bristles cannot reach all the way into the depressions and grooves to extract food and plaque.

The benefit of sealants is that they protect these vulnerable areas by “sealing out” plaque and food.

Your dentist can apply sealants quite easily and it takes only a few minutes to seal each tooth.

The teeth being sealed will first be cleaned. Then the chewing surfaces are roughened with an acid solution which makes it easier for the sealant to stick to the tooth.

The sealant is then ‘painted’ onto the tooth enamel, where it bonds directly to the tooth and hardens.

Sometimes a special curing light is used to help the sealant harden.

As long as the sealant remains intact, the tooth surface will be protected from decay.
They usually last several years before a reapplication is needed. Your dentist will check the condition of the sealants during your regular visits and reapply them when necessary.

Sealants are ideal for children because the risk of developing pit and fissure decay starts early in life. However, many adults can benefit from sealants as well.

Your dentist can tell you whether sealants would help your oral hygiene program.

With many people concerned about the taste and purity of tap water, the sales of bottled water have increased significantly in recent years.

Tap water goes through a process of purification designed to eliminate suspended materials, remove tastes and odors and kill microorganisms.

Fluoride is added to most tap water supplies with the aim of reducing cavities.

Fluoride becomes incorporated into our teeth as they develop and makes them more resistant to decay. It can reverse the progress of early cavities and reduce the need for dental treatment.

Mass water fluoridation has played an important role in reducing tooth decay.

The problem with bottled waters is that they usually don’t contain fluoride.

So there is a risk that drinking bottled water can increase the risk of cavities for some people.

If you drink a lot of bottled water, you can make up for this by using fluoride toothpaste and mouth rinse.

Your dentist may even suggest a fluoride supplement if they notice an increase in cavities.

Osteoporosis is a disease that weakens bones and increases the risk of fractures.

It affects about 10 million Americans of whom 8 million are women and another 34 million are at risk of developing it.

So this is a disease that affects more women than cancer, heart disease and stroke combined.

But what does it have to do with your dental care?

Well, many people in these categories are treated with a group of prescription drugs called oral bisphosphonates. Studies have reported that these drugs reduce bone loss, increase bone density and reduce the risk of fractures.

But some people have been alarmed and confused by recent news reports about oral bisphosphonates because of uncommon complications that have been linked to these drugs.

The drugs have been associated with osteonecrosis of the jaw (ONJ), a rare but potentially serious condition that can cause severe destruction of the jawbone.

The true risk posed by oral bisphosphonates remains uncertain, but researchers seem to agree that it appears very small.

Given the risks associated with osteoporosis and the proven benefits of oral bisphosphonate therapy, you should not stop taking these medications before discussing the matter fully with your physician.

If your physician prescribes an oral bisphosphonate, its important to tell your dentist so that your health history form can be updated.

In this case, some dental procedures, such as extractions, may increase your risk of developing ONJ, so your dentist needs to be able to take your full health picture into account.

Dental implants are increasingly popular as a way to replace missing or damaged teeth.

Their great advantage is that they look natural and feel secure helping you to restore your smile and eat more easily.

Implants are an ideal solution for many people but they are not an option for everyone.

Placing implants requires some surgery so patients must be in good health, have healthy gums and have adequate bone to support the implant.

They must also be committed to taking action to maintain their oral hygiene and to visiting the dentist regularly.

The process for placing implants is as follows:

First, surgery is performed to place the anchor. This can take up to several hours. Following the surgery, you may need to wait up to six months for the bone to grow around the anchor and firmly hold it in place. Sometimes follow up surgery is required to attach a post to connect the anchor to the replacement teeth. Alternatively, the anchor and post may already be attached and are placed at the same time.

After the gums have had several weeks to heal, the next step is to fit specially-made artificial teeth to the post portion of the anchor. This can take a few weeks to complete as several fittings may be required.

Implant surgery can be done either in a dental office or in a hospital, depending upon a number of factors. A local or general anesthetic may be used. Usually pain medications and, when necessary, antibiotics are prescribed.

After your implants are fitted, your dentist will give you tips and advice on maintaining your oral hygiene.

Your dentist can help you decide whether you would be a good candidate for implants.

Understanding what’s covered by your dental insurance is an important part of making sure you get the best oral care possible.

Here are some common questions that arise when people want to understand their cover better.

– If treatment my dentist recommends is not covered by my insurance, does that mean it’s not necessary?

Some plans make exclusions such as sealants, pre-existing conditions, adult orthodontics, and specialist referrals. This depends on your dental plan and you should not let the level of cover determine whether you need treatment.

– My dental benefit will only pay for a large filling but my dentist recommends I get a crown. Which should I choose?

Some plans will only cover the least expensive solution but it may not be the best option for your needs. You should decide based on your health needs and not on your insurance cover.

– My dental plan says it will pay 100 percent for checkups and cleanings but the insurance company says I owe for part of the dentist’s charge. How can this be?

Some plans provide cover based on a “customary fee” for each procedure. So, if your dentist’s fee is higher, your benefit will be based on a percentage of the customary fee instead of your dentist’s fee. Although these limits are called “customary,” they may not accurately reflect the fees that dentists charge in your area.

– Will my plan cover the care my family will need?
If your employer offers more than one plan, check the exclusions and limitations of the coverage as well as looking at the general benefits. It’s a good idea to discuss your family’s likely needs with your dentist before choosing a plan.

The plan document should specify who is eligible for coverage under the plan.

Plans offered by the same provider or employer can vary according to the contracts involved so your dentist will not be able to answer specific questions about your benefit or predict what the coverage for a particular procedure will be.

If you have specific questions about coverage, talk to your plan provider.

It would be easy to get overwhelmed by the huge range of dental care products now available.

Even looking just at toothbrushes present a wide range of choices.

There are hundreds of manual and powered toothbrushes to choose from.

Start by looking for products that carry the American Dental Association Seal of Acceptance – this is an important symbol of a the product’s safety and effectiveness.

When you buy a toothbrush, replace it every three to four months. Replace it sooner if the bristles become frayed as a worn toothbrush will not clean your teeth properly.

Make it easy for your children to brush their teeth by choosing a child-sized toothbrush and make it more interesting for them by selecting fun colors and designs.

Often people who have difficulties with hand, arm or shoulder movements find that powered toothbrushes are the best choice. However, it’s also possible to make a few small changes to modify a manual toothbrush and make it easier to use.

For example, you can:

– Enlarge the handle with a sponge, rubber ball, or bicycle handle grip
– Lengthen the handle with a piece of wood or plastic
– Bend the handle slightly while running it under hot water

Your dentist will give you tips on what toothbrushes would be right for your needs.

A healthy mouth is a good indication of your overall health and helps you to keep a great smile and continue eating what you want for many years to come.

There are a few steps you can take to make sure your mouth is as healthy as possible:
– Brush your teeth twice a day using a good quality toothbrush
– Renew your toothbrush regularly. It will only keep your mouth healthy if the brush is in good condition and the bristles are strong. You should replace it at least every three or four months
– Clean between your teeth. Your toothbrush can’t reach everywhere and bacteria can linger between the teeth so its important to clean between them every day using floss or an interdental cleaner
– Visit your dentist regularly for professional cleaning and oral examinations

Your dentist will be able to give you tips on what other products you should consider to help improve your oral health.

For example, antimicrobial mouth rinses and toothpastes can reduce the germs in your mouth and reduce the risk of gum disease.

Also, fluoride mouth rinses can help reduce and prevent tooth decay. Studies have shown that using mouth rinses provides valuable protection over and above that provided by fluoride toothpaste alone.

Look out for the ADA seal when buying toothbrushes and other dental products. This is a sign that the product has met American Dental Association standards for safety and effectiveness.

Following these steps can help ensure that you continue to enjoy great oral health.

Your saliva plays an important role in your oral health and reduced saliva flow can lead to health problems.

Reduced saliva flow can lead to a dry mouth and this is a common problem among older adults.

It can be caused by various medical disorders and is often a side effect of medications such as antihistamines, decongestants, pain killers and diuretics.

Dry mouth can be associated with various problems such as a constant sore throat, burning sensation, problems speaking, difficulty swallowing, hoarseness or dry nasal passages.

Drying irritates the soft tissues in the mouth, which can make them inflamed and more susceptible to infection. Without the cleansing effects of saliva, tooth decay and other oral health problems become more common.

So, if dry mouth is not treated, it can damage your teeth.

Without adequate saliva to lubricate your mouth, wash away food, and neutralize the acids produced by plaque, extensive decay can occur.

Your dentist can recommend various methods to restore moisture. Sugar-free candy or gum stimulates saliva flow, and moisture can be replaced by using artificial saliva and oral rinses.

People who have not followed adequate dental care for some years may have already lost most of their teeth and feel a little hopeless.

Sometimes they ask a dentist to remove the remaining teeth as they are often broken and have deep cavities.

It’s true that, sometimes, removal of the remaining teeth and replacing them with full dentures is the only option.

But more often there are other options available.

Some or all of the remaining teeth could be repaired and used in conjunction with a partial denture. While a full denture replaces all of the teeth on the upper or lower jaw, a partial denture replaces some of the teeth.

If only a few weak teeth remain on the upper jaw, it might be preferable to have them extracted and a full upper denture made. Full upper dentures can be more secure than lower ones as the upper denture gets added stability from the palate and is not easily dislodged by the tongue.

If only a few teeth remain on the lower jaw, however, the dentist will usually aim to save them and use a partial denture if necessary.

Ideally, all teeth that can be saved should be saved but this is not always possible – often due to finances.

In such cases, having teeth removed and dentures may be the only option.