My new patient began our meeting with that statement. He wore an upper partial denture for many years. Whenever we see someone who uses a partial denture for an extended time, many changes occur to that dental appliance. At times we see decay on the teeth that hold the partial denture in place. We fix the decay, and then the partial (which is short for a partial denture) may require some modification to maintain a good fit. If a tooth presents with extensive decay, a crown or root canal is often needed.
A crown made under an existing partial is a complicated procedure to perform well. I discussed this in previous columns and pointed out that new technology makes this procedure much more doable. Nonetheless, those doctors who don’t have a newer digital technology struggle, and the partial denture will often need a laboratory modification to remain in function.
The most drastic and dramatic change to a patient with an existing partial involves tooth removal. The tooth in question is usually the one that the wire connector hooks on to. Remember, a partial denture maintains its stability by anchoring to the adjacent teeth. Food collects around the wire connector, and decay ensues. The worse the decay, the closer the tooth comes to extraction. The removal of a tooth always necessitates a major laboratory repair and modification.
My new patient had a number of these extractions and modifications. The entire upper left side teeth were gone. He came to me because he had an abscess on the last anchor tooth on that side of his mouth. Unfortunately, the only treatment available involved removing this last tooth. Once the tooth goes away, he heard that the rest of his teeth required extractions, and a full denture lies ahead for him.
Let me explain why this so. A full upper denture relies on suction to stay in place in the mouth. The denture touches the gums and roof of the mouth intimately, and a seal develops against the soft palate back near the throat. Not everyone gets the best seal, but that is the goal of a dentist. The denture touches all of the gum tissue, and there are no openings to prevent this suction seal. If there are one or more openings in the upper teeth, a closed seal will not develop.
The patient cannot hold a partial in place since he has no teeth on his upper left side. Also, he can not rely on suction to stabilize the teeth because there are many openings in a partial denture. These facts result in advice to remove the rest of the teeth and make a full denture.
Those types of discussions are typical and frequent in a dental practice. Using modern techniques, I advised the patient that he did not need to go down the full denture path. I recommended that we keep his partial denture and use dental implants to anchor that side of this mouth. I even suggested that changing the partial was not needed. I can connect and anchor to his existing partial. He wanted to get started and move in that direction.
If someone told you that all of your teeth require removal, I encourage you to get a second opinion. Please call us at 440.892.1810 and we will answer and help you. Frequently, there may be a way to avoid that direction. I look forward to hearing from you.
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 • www.jeffreygrossdds.com