This is the first post of my Blog and my hope is that I can offer answers to questions and information about restorative dentistry.
I would like to share the differences between a removable implant retained Denture and a non-removable fixed denture to implants as described by my patients.
I have had many patients with both types of prosthetics. Certainly, having implants secured teeth to their jaws that eliminate having to use denture adhesives is a much more desirable than conventional traditional dentures.
The advantage of implants also allows the patients to not have the entire palate or roof of the mouth cover as in a conventional upper denture. This allows patients to not only taste their food but also feel the temperature.
Dental implants afford confidence in smiling, speaking and chewing and now with new techniques and advances in dental implants patients that were told in the past that they were not candidates for implants can now have them and eliminate grafting and waiting periods to have there teeth.
Why would people choose teeth that are removable vs. fixed (non-removable by the patient)?
The answer is cost. With removable dentures that can attach to implants, patients need fewer implants to secure their dentures. With dentures that are attached to the implants that are non-removable by the patient the lab fees are much higher, more appointments are necessary and the patients require more implants to support the denture.
The best way to describe the difference is that the removable type of denture that attaches to implants is not really supported by the implants. The implant attachment holds the denture in place. But the patient still chews with pressure on the gums. It is the gums that support the denture and the implant attachment are the anchors for retention.
Dentures that are fixed in place, meaning screwed directly into the implant, is rigid and actually supported by the jaw bone and not the gums.
Both serve patients well. The comments about the removable type of denture are that it moves or can rock.
Many patients adapt to the function of the removable type of implant denture. Some choose to upgrade if it is in their budget to a denture that is non-removable and fixed in place.
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About Me
- Dr. Peter S. Balle
- Las Vegas, Nevada, United States
- Dr. Balle holds degrees in Biology and Doctor of Dental Surgery from San Diego State University and Case Western Reserve University. He established Balle and Associates Cosmetic and General Dentistry of Las Vegas in 1991. He has advanced training in dental reconstruction. He both surgically places and restores dental implants in one location. He holds active dental licenses in Arizona and Nevada. Dr. Balle has earned Fellowship awards in the Academy of General Dentistry, American College of Dentists, and the International College of Dentists. He is a member of the American Academy of Implant Dentistry, American Dental Association, is currently serving as Vice President of the Nevada Dental Association. He has achieved Mentor recognition at the world renowned Kois Center for Advanced Dental Education in Seattle, WA. Dr. Balle is a Faculty dental educator at UNLV School of Dental Medicine. He has actively trained dental students and dental residents. He has taught nationally.He enjoys time with his family working out, boating, traveling.
13 comments:
Please feel free to post any question or concern that you have about dentistry. I would like to be able to provide information that is accurate. I would like to be a resource to answer any concerns or questions, alleviate any anxieties people may have regarding dental services. I can provide my professional input to you at no obligation to better educate before any commitments are made about any dental restorative care from simple fillings to complex full mouth esthetic reconstructions from removable dentures to implant supported and retained teeth.
It would be nice to have a forum that professionals and lay persons can communicate without the obligation of fear of treatment, budget without committing to going to the dental office environment until the person is ready to improve any dental unhealthy dental condition or unaesthetic concern they may have.
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My hope is that this Blog will alleviate fears and apprehensions many people have about modern dentistry. No questions are stupid. Things have changed a great deal in technology in modern advanced techniques that many people are unaware of.
There is so much hope now that was not available just a few years ago. From treating anxiety with a pill to make a fearful patient not care and minimize any discomfort with the latest new anesthetics, to rapid treatments with one day ceramic crowns that used to take 3 weeks and patients had to endure 3 weeks of wearing a plastic temporary. There are lasers that virtually eliminate bleeding and significantly reduce discomfort in the treatment of gum disease and deformities.
To Removing hopeless teeth and replacing with teeth fixed secured with implants that feel and look like natural teeth without the patient ever to be inconvenienced by going without any teeth, or bone grafting or waiting for implants to integrate. Even people who were told they were not candidates in the past now can have this type of care and not be inconvenienced in their every day lives.
All of these treatments can be made affordable to budget for just about everyone who needs or wants these types of care by financing or staging there treatment. The end results are a dramatic improvement in the quality of life.
So please feel free to participate and I and others in the profession will make every effort to help to inform you to making educated decisions as to your individual needs and desires.
I am excited about the blog and hope that I can not only help educate and inform many patients but also learn from them their fears and apprehensions about dentistry.
Thank you for your participation.
Peter S. Balle, DDS
One nice feature about dental implants is that if you suffer from decay or periodontal disease on natural teeth , implants are not effected and provide a much longer predicatable survival of crowns or bridges anchored to dental implants
As a dentist I talk about benefits of dental implants. One of the biggest reasons people choose not have dental implants is FEAR.
I had a lovely lady read this new blog and schedule an appointment with me for a comprehensive exam. She reminded me that worry about the expense is not the only fear. She stated that after reading the blog she felt comfortable with me. She had feared the dentist her whole life and has avoided going up until now.
Dentistry has changed much in the last several years. One of the best things I use in my practice is medications that significantly reduce anxiety and fear. Anesthetics and techniques have also improved. I have had many patients tell me that they felt no pain whether administering anesthetic, removing a tooth or placing a dental implant into their jaw bone.
Many of patients’ fears are from past experiences that were bad. This combined with time and the mind makes for phobic patients.
I can say that we as a profession have come a long way in dealing with patients fears. We still have much room for improvement.
If you are fearful of treatment, don’t hesitate to let the dentist know so he/she can help with this sometimes even paralyzing condition. As far as fear of expense, our practice offers financing which allows these procedures to fit most patients’ budgets.
Mini implants are a great immediate way to secure dentures for people who have trouble holding their lower dentures down. Many patients lacking bone who do not wish to go through extensive grafting and waiting petiods elect to have Mini implants secure their dentures.
The are economical and immediatly gratifying.
Due to better education about dental hygiene, nutrition and preventative dental care more people are keeping their teeth longer than previous generations, some still lose their teeth from disease and accidents. According to AAMOS (American Association of Oral and Maxillofacial Surgeons) Almost 70% of adults between the ages of 35 and 44 have lost one or more teeth. Over 25% of adults by the age of 74 have lost all their teeth. In the dental research literature it is said that people who have no teeth have a 5-7 year less life span to those who have retained their teeth. I would attribute this statistic to poorer digestion. Dental implants are the closest solution to what nature intended.
What makes implants so revolutionary and different than conventional restorative treatment is that dental implants preserve bone that would vanish with the loss of teeth. No other dental treatment can preserve bone. Many people do not realize the implications long term of tooth loss. The truth is that bone is lost over time resulting in collapse of facial structures. The damage is not immediately apparent when one tooth is lost. Replacing the tooth with a bridge avoids the shifting of teeth which prevents bite problems and TMJ (Temporal Mandibular Joint) damage. Unfortunately, when a bridge eventually fails it wipes out and destroys one or both of the teeth that support the bridge resulting in a domino effect of deterioration over time. As teeth are lost so is bone that supports the facial appearance.
The consequence of tooth loss is profound because bone loss causes facial support to collapse given the premature aging to a person resulting in psychological implications beyond chewing and speaking. Even the most well made dentures contribute to bone loss from the constant pressure and lack of tension on the bone as teeth or implants would do.
Could you imagine how the simple act of sneezing ones teeth out in public could impact someone’s life? There is no better substitute for restoring confidence, esthetics, chewing (the beginning process of digestion), and speech than dental implants.
One dental implant can be used to restore a single missing tooth without any changes made to any other teeth.
One of the most basic entry level dental implant systems for someone missing all their teeth is to have a minimum number of implant with attachments to hold dentures down and in place. Just having this relatively simple system can avoid embarrassing moments of teeth slipping or falling out. For some people who have to rely on unreliable bad tasting sticky adhesives, it is a life changing solution to have dental implants. They can go out into society and not be psychologically traumatized from fear of embarrassment. Many of my patients tell me that their spouses do not know they have teeth that come out. So, you can imagine what a surprise it might be when kissing your spouse for your teeth to end up floating into your mate’s mouth. One patient shared this story with me. It really is hard to imagine what people go through with unreliable denture adhesives unless you experience it.
The cost of one implant per tooth can be prohibitive to many. It may not be so bad if you are missing one or a few teeth. But if you are missing all your teeth, it is not economical or necessary to replace each tooth with an implant. A quadrant of teeth can be restored with several implants in the form of dental bridges. Lack of bone can and is usually one of the obstacles to using implants to replace teeth. One of the biggest challenges today is that many people wait too long before restoring missing teeth. People lose so much bone that bone grafting is necessary before any implants can be placed in the jaws. Bone grafting is very predictable. However, it increases costs and can create more discomfort during the healing period. Grafting also prolongs the time it takes to restore the teeth with dental implant. When grafting is done it may take over a year to complete teeth replacement therapy.
A new technique that was pioneered by an oral surgeon from Portugal has been sweeping the country which virtually eliminates the need to graft bone, requires no waiting period to receive teeth and reduces costs by using only 4 implants. The technique involves placing only four implants at angles attaching to as much bone as is available per jaw to restore an entire set of teeth. Implants were not designed to be placed at angles, but this new technique makes use of tying all the angled implants with the prosthesis to make the system extremely stable and allow immediate use.
What makes this technique so innovative is that it eliminates the grafting, and waiting periods that are customary to implant dentistry.
This new concept has been referred to as “All-on-4” and “Teeth-in-a-Day.”
Dental implants have provided a more predictable outcome over previous types of restorative treatments. Not only have dental implants provided solutions for esthetics, function and speech problems, they more importantly have improved the quality of life for many people.
When patients are presented with options of replacing all their teeth they want to know how it feels to have different types of implant systems. Another words, what is the difference from having a couple of implants that hold down a denture compared to having say six implants that hold an attached bridge?
It is a very interesting question. Over the years I have learned from my patients that have had implant treatment and they shared their experiences with me. The more implants the less bulky and the prosthesis feels.
The main differences between a fixed non removable bridge and a prosthesis that can be removed by the patient are there is some movement in the prosthesis that is removable.
So, the best way is to compare to natural teeth. We accept the fact that your natural teeth function at 100%. We know from studies that dentures without implants that sit on your gums at best can only achieve 20% of normal function and feel of teeth. A two implant system that holds down a denture will give a person about 40-60% the function of natural teeth. And a bridge that is screwed down on implants can achieve as high as 90% function of natural teeth.
Two situations compel people to have dental implants. They have teeth that infected. They hurt so bad that they no longer function or are so unattractive that they are uncomfortable smiling and being around others for fear of embarrassment. Their outlook on life changes for the worst.
Some people can’t tolerate conventional dentures when they lose their teeth. Conventional dentures can only satisfy one need. That is appearance. Dentures can never provide the normal function and feeling dental implants can offer. For people who have dentures they seem to adjust. Adjusting is not necessarily desirable but it is a way of coping to not having ones teeth.
Some stop dining out and avoid foods with textures. They avoid intimacy. Some swallow foods whole because they are unable to chew affecting overall health and digestion. Others choose less nutritious foods with no fiber. Many spouses keep the secret that they have no teeth from their spouses. When dentures break as they inevitably do, it is catastrophic situation to be without teeth.
One of the most gratifying things about being a dentist is the effect I can have on someone’s life. Many times I don't even know what impact I have had until a patient shares their story with me.
Mary a long time patient recently told me that I changed her life. I asked how? all I thought I had done was improve her dentures by securing them with implants and eliminating the denture adhesive.
She shared with me that she was always so scared about eating out in public for fear of her teeth falling out. She would never go and enjoy the company of friends and experience a nice restaurant. She told me she feared going to the beach and losing her teeth in the surf. Mary said her life was inhibited to the point she was unhappy.
She said getting implants was one of the best decisions she ever made.
Now her life has all changed and she credits what I do as a dentist with this happiness.
I am so blessed and fortunate to be able to contribute to someone in such a remarkable way.
My patient Joe lost all his teeth and could not wear dentures because of his severe gag reflex.
He went for a year without teeth. He was embarrased to smile, even go out to eat.
He decided to change his life an have the All on 4 dental implant procedure which attached his prosthetic teeth to 4 implants.
Just like 4 legs supporting a table, the legs are the rooted into the jaw and the teeth are the table that are the teeth.
The prosthetic teeth were attached in one day. Joe now brushes his teeth in his mouth. Joe was so happy that he could feel the crunch of food as he once did with his natural teeth. It was also nice to see him smiling from ear to ear and was thrilled to tell me all the compliments he gets for his smile.
The best thing is that he did not have to have bone grafting and wait a long period of time to get is teeth
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