Healthly Smile: I Have A Coat Hanger In My Mouth

by Jeffrey Gross, DDS, FAGD of The Healthy Smile

I was confused as I had no idea what she meant by that statement. We never met before this appointment, yet she stated that she read this column for a long time. I noted the frustration in her voice as she explained to me in detail her journey to replace missing teeth. One tooth showed an unfinished implant and on the counter was a new partial denture. Her coat hanger reference was directed towards her new partial. She didn’t wear the partial as it had a lot of metal. The design of the partial denture was such that when she talked, the metal was very noticeable. She worked with the public, and this show of metal was unacceptable.

Before I go any further, let’s talk about dentistry’s obsession with metal. We have silver fillings and gold crowns. We have partial dentures that are mostly metal and tooth-colored crowns that show metal near the gum. What makes metal so popular that its use is widespread in dental care? Let’s talk about this for a little bit. Teeth are the hardest structure in the human body. When dentistry first looked to repair damaged or missing teeth, it sought a strong replacement. The technology of the world for centuries used metal as its prime component. Metal could be made into various shapes and could withstand the forces of chewing and the years of use. Cosmetics had a different meter. A gold tooth was sought after as it was the in style. It signified wealth and accomplishment. Silver fillings were inexpensive and well-tolerated by the body.

Partial dentures were no different in the metal parade. The first partials were all gold and quite heavy. I remember that my mother had a partial denture with a gold base. I am amazed that she could hold her head straight as the dental appliance weighed a ton! Back in the seventies, gold gave way to a silver metal called chrome-cobalt. We referred to it as surgical steel. It is lightweight and could be made very thin. The magic silver metal was less expensive than gold and became the primary material used in partial dentures.

As decades moved along, cosmetics became king. We wanted artificial teeth to look like natural teeth. The appearance of metal in the mouth became objectionable. When a dentist designs a partial that involves metal, he takes into consideration how much metal shows. When a lab tech plans a partial, he has no idea about the appearance of the patient. All the lab sees is a model of the mouth. No skin or lips are involved. I design all of my partials with the guiding principle of hiding metal if I decide to use metal. Today I have many other choices besides metal also.

What did I do for our coat hanger patient? Fortunately, the lab design of the partial involved a lot of extra components. I removed some of those sections without compromising the integrity of the partial. She was thrilled as she expected to pay for another partial denture. I left metal that wouldn’t show and adjusted some other components. Within five minutes, I solved her problem and didn’t charge her a fee.

If you are struggling with treatment and need some guidance or simply want to talk about your needs and wants, please call us at 440.892.1810. I will do my best to get you moving in a positive direction.

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

The Healthy Smile • 27239 Wolf Road, Bay Village, OH 44140 • 440-892-1810 •

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