If you have lost some or all of your natural teeth, dentures can replace the teeth that are missing and improve your quality of life. With a little practice, dentures can make eating and speaking easier. You can smile freely without feeling embarrassed.

Dentures can be made to look like your natural teeth. There may be only a small change in how you look. Full dentures may even give you a better smile. Dentures also support your cheeks and lips so the face muscles do not sag and make you look older.

Types of Dentures

Complete dentures have replacement teeth fitted into an acrylic base. The base is made to closely match the color of your gums. If you still have some natural teeth, they will be removed before your dentures are placed.

Implant-Supported Complete Dentures

A complete denture may also be attached to dental implants, which provide a more secure fit. Implants are posts that are surgically placed in the upper or lower jaw. Properly placed implants make the denture stable and can help reduce bone loss.

Many patients find that implant-supported dentures are more comfortable and secure than conventional complete dentures. However, not everyone can get implants. Patients must be in good health and have enough bone to support the implants. Ask us if you are a good candidate for dental implants.

Implant Dentures

Immediate Dentures

Some patients may have the option to get immediate dentures. These dentures are made before the remaining teeth are removed. Once the denture has been made at the lab and is ready for you at our office, the dentist removes your teeth and the denture is placed right away. With immediate dentures, you do not have to go without teeth during the healing time after your teeth are removed. Healing can take several months. Once healing is complete, the dentures may need to be adjusted or relined. Sometimes a new denture needs to be made.

Conventional Complete Dentures

A conventional complete denture is made and placed in your mouth after the teeth are taken out and the tissues have healed. Healing may take several months. The base of the upper denture covers the palate (the roof of the mouth). When the base of the upper denture rests against your gums and palate, it makes a seal to hold the denture in place.

The lower denture has a horseshoe shape so there is room for your tongue and its muscle attachments. It rests on the gum and bone tissues of the dental ridge. Your cheek muscles and tongue also help hold the lower denture in place.

Conventional Complete Dentures

Getting Used to Your Dentures

New dentures may feel odd or uncomfortable for the first few weeks. This is normal. Keep wearing your dentures until you get used to them. The lower one may feel especially loose until the muscles of your cheeks and tongue learn to hold it in place. You may have extra saliva for a short time. Some soreness should be expected for the first week or two. Your dentist will check on your progress and make any adjustments needed to make you more comfortable.

When you replace missing teeth with dentures, eating is easier. But, it takes practice. Here are some things that can help:

• Begin by eating soft foods cut into small pieces.
• Chew on both sides of the mouth to keep the pressure even. Avoid biting on the front teeth.
• Do not eat very sticky or hard foods or chew gum.

You will also need to practice talking with your new dentures. Try reading out loud and repeating tricky words in front of a mirror. Talk slowly to avoid mumbling or muffled speech. If they slip out of place when you laugh, cough, or smile, bite down and swallow to reposition them.

When you get new dentures, your dentist may tell you to wear them most of the time. After the adjustment period, dentures should not be worn 24 hours a day. Your dentist may tell you to take out the denture at bedtime and put it back in when you wake up. Do not wear dentures around the clock because it can cause your mouth to be irritated.

Denture Adhesives

They should fit securely, but we may tell you to use a denture adhesive as you get used to wearing them. A denture that does not fit well may cause irritation, mouth sores, and infection. While denture adhesive can help a loose-fitting denture for a short time, using adhesives all the time is not recommended. If your denture is loose, have your dentist check it. If you are using an adhesive, make sure you follow the instructions for use.

Caring for Dentures

Like natural teeth, dentures require daily oral hygiene. Here are some care tips:

Clean your denture each day. Take it out of your mouth and carefully rinse off loose food particles. Wet your denture brush and put the denture cleaner on it. Also, brush all the surfaces gently to keep from damaging the plastic base. Your denture is very delicate and can break if dropped even a few inches on a hard surface. Clean them over a folded towel or a sink filled with cool water. It is best to use a special brush made for cleaning dentures, but you can use a toothbrush with soft bristles. Do not use hard-bristled brushes because they can damage dentures. A liquid soap can also be very effective when used with a denture brush. However, you should not use toothpaste to clean your denture. Some toothpaste has abrasive particles that can damage the denture base and teeth. Do not clean them with bleach. Rinse your denture well after using any denture cleanser or liquid. They may contain chemicals that are not intended to go into the mouth.

Look for denture cleansers and products with the American Dental Association Seal of Acceptance, a symbol of safety and effectiveness. Keep your denture in water when you are not wearing it. Do not let it dry out or it can lose its shape. Your dentist can tell you how to care for your denture and if you should use a denture-soaking solution. Keep your denture away from curious children and pets when you are not wearing it.

Caring for Your Mouth

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 put in your dentures. This increases circulation in the tissues in your mouth and helps keep them healthy. Eating a balanced diet is also important to keep you and your mouth healthy.

You will still need regular oral exams by your dentist even if you have no natural teeth. The dental office will tell you how often you should have dental visits. During a visit, the dentist will look for signs of disease such as cancer of the head and neck. Your dentist will also check to see if your dentures fit well or might need adjustments.

Denture Adjustments

See your dentist if your dentures break, crack, or chip, or if the denture starts to feel loose. Your dentist is the only one who should make repairs to your dentures. A person without the proper training will not be able to fix a denture. Do not try to adjust them yourself. This can harm both the denture and your health. Do not use over-the-counter reline materials or glues on your denture. They may contain harmful chemicals and are not a long-term solution for fixing them.

Denture Replacements

The normal lifetime of dentures is about 5 to 10 years, but this can vary widely depending on the patient. Your gum line and dental ridge will continue to change in shape and shrink even if you do not have natural teeth anymore. Over time, dentures may need relining, rebasing, or replacing. Relining is when the dentist adds new material to the underside of the denture base to fit your gums. This could be either a hard or soft material depending on the condition and sensitivity of your gums. Rebasing is when a new base is made using the existing denture as a model. The artificial teeth from the old denture are used on the new base.

The mouth changes naturally with age. Jaws may line up differently as bones and gum ridges recede and shrink. At some point, your dentures will no longer fit well and they will have to be remade. It is important to replace worn or ill-fitting dentures before they cause problems. Your dentist will let you know when it is time to replace them.

Your New Smile

You are the key to your new smile’s success. These four tips will help:

• Give yourself plenty of time to get used to your dentures.
• Eat a balanced diet for good health.
• Practice eating and speaking with your denture.
• See your dentist regularly.

What Is a Bridge?

A bridge is a replacement tooth or teeth that fills the space where one or more teeth are missing. The bridge restores your bite and helps keep the natural shape of your face.

Before you get a bridge, your dentist wants you to know more about the steps involved. He or she can advise which type of bridge is best for you.

Why Do I Need a Bridge?

A missing tooth is a serious matter. Teeth are made to work together. When you lose a tooth, the nearby teeth may tilt or drift into the empty space. The teeth in the opposite jaw may also shift up or down toward the space. This can affect your bite and place more stress on your teeth and jaw joints, possibly causing pain.

Teeth that have tipped or drifted are also harder to clean. This puts them at a higher risk for tooth decay and gum disease.

When a tooth is missing, the bone may shrink. If that happens, it may change the way the jawbone supports the lips and cheeks. Over time, this can make your face look older.

Position of teeth immediately after a tooth is lost.

If the tooth is not replaced, other teeth can drift out of position and change the bite.

How Do I Replace a Tooth?

Placing a bridge usually takes more than one dental visit. On the first visit, we prepare the teeth on both sides of the gap. Then we will later attach the bridge to these teeth.

We then take an impression or an image of your teeth and the space and send it to a dental laboratory. Technicians at the lab make the bridge. Dr.Amy will place a temporary bridge to protect your prepared teeth while you are waiting for the permanent bridge.

When the permanent bridge is ready, we fit, adjust and cement the bridge to the prepared teeth. This type of bridge is permanent and cannot be taken out of your mouth without a dentist’s help.

Fixed Bridge Placement

Missing tooth

Teeth next to the space are prepared for placement of the bridge.

The custom-made bridge is placed over the prepared teeth.

The bridge is cemented into place.

Do I Need Implants?

Dental implants may be used to support a bridge when several teeth are missing. Implants are posts that are surgically placed into the jaw. Over time, the bone grows around the implants to hold them in place.

• A key benefit of implants is that they don’t need support from the surrounding teeth.
• Candidates for dental implants should be in good general health and have enough bone to support an implant. For some patients, implants help preserve the jawbone where teeth have been lost.
• Implants may be placed in one day or might require multiple visits depending on your dentist’s treatment plan.

Implant-Supported Bridge

Missing teeth

A bridge is placed on implants

After the bridge is placed

What Materials Are Used in a Bridge?

Bridges are made from metal, ceramics (porcelain), or a combination of the two. Ceramics often are bonded to a metal alloy. Your dentist will talk with you about the materials that are best for you and your mouth.

Caring for Your Bridge

A bridge can fail if the support teeth or the jawbone is damaged by dental disease. Follow these tips for good oral health:

Brush your teeth twice a day and floss or use another between-the-teeth cleaner once a day. Brushing and cleaning between the teeth help remove plaque, a sticky film of bacteria that is always forming on the teeth. See your dentist regularly for exams and professional cleanings. Eat a healthy diet. Look for oral care products that have the ADA Seal of Acceptance. Products that display the Seal have met the American Dental Association’s standards for safety and effectiveness..

Book your appointment today by contacting our office.

Why Do I Need a Crown?

You may need a crown if you:

• have a cavity that is too large for a filling
• have a tooth that is cracked, worn down, or otherwise weakened
• have had root canal treatment-the crown will protect the restored tooth
• want to cover a discolored or badly shaped tooth and improve your smile

Crown Used to Replace a Filling

Before- Filling with decay at the edge

After- Filling replaced by a crown

What are Dental Crowns made from?

Crowns are made from several types of materials. Metal alloys, ceramics, porcelain, porcelain fused to metal, or composite resin may be used. When a crown is made, the material often is colored to blend in with your natural teeth.

Your dentist wants your crown to look natural and fit comfortably in your mouth. To decide which material to use for your crown, your dentist will consider many factors, such as:

• the tooth’s location and function
• the position of the gum tissue
• your preference
• the amount of tooth that shows when you smile
• the color or shade of the tooth

Full porcelain fused to metal crown

Full ceramic crown

How are Dental Crowns Placed?

It usually takes two dental visits to complete the treatment. When a crown is placed over a natural tooth, several steps are involved:

1. The dentist prepares the tooth by removing its outer portion so the crown will fit. Any decay is also removed. If additional tooth structure is needed to support the crown, the dentist may build up the core of the tooth.

2. An impression is made to provide an exact model for the crown. The impression can be made from a mold or by digitally scanning the tooth.

3. You will get a temporary crown while you wait for the permanent crown to be ready. This usually takes less than two weeks. While you have a temporary crown, the tooth may be sensitive to hot and cold. Avoid chewing gum and sticky foods during this time.

4. When the new crown is ready, the dentist places it in your mouth and makes the necessary adjustments. When you and your dentist are happy with how it looks and feels, the crown is cemented into place.

Before crown: Worn filling with decay under filling

Crown is placed over prepared tooth

After crown placement

Caring for Your Teeth

Like natural teeth, crowns can break. And the tooth under the crown can still get cavities. To prevent cavities or damage to your crown:

Root Canal Therapy Can Save Your Tooth

Your teeth are meant to last a lifetime. Years ago, diseased or injured teeth were usually pulled. But today, a tooth can often be saved through root canal therapy.

Endodontics (en-do-DON-tics) is the branch of dentistry that specializes in treating diseases or injuries to the dental pulp. Endodontists are dentists that specialize in treating diseases of, or injuries to, dental pulp. Your dentist may refer you to an endodontist to perform your root canal procedure.

Treatment Is Needed for Infected or Inflamed Pulp

If the problem pulp is not removed, the tissues around the root of the tooth can become infected, often resulting in pain and swelling. Even if there is no pain, bacteria can damage the bone that anchors the tooth in the jaw. Without treatment, the tooth may have to be pulled.

Removing a Tooth Can Create Problems

The pulp is the soft tissue inside the tooth that contains blood vessels and nerves. When the pulp becomes infected or inflamed, treatment is needed.

Pulp infection and inflammation most often occur if you have:

• a cracked or chipped tooth
• a deep cavity or filling
• other serious injuries to the tooth

All of these can allow bacteria to enter the pulp and cause infection and/or inflammation.

Problems from Infected or Inflamed Pulp

The infection or inflammation in the pulp can spread to the tissues around the root of the tooth. This can cause pain and swelling, but even if there is no pain, bacteria from the infection can damage the bone that holds the tooth in you jaw.

Without a root canal, the infection and damage will continue and your tooth most likely will need to be removed.

Removing but Not Replacing a Tooth Can Create Problems

When a tooth is removed and not replaced, the teeth around it may shift. This can make it hard to bite, chew and clean your teeth. Areas in your mouth that are not cleaned well are more likely to have problems like decay or gum disease.

Root canal therapy can prevent these problems by saving your natural tooth. Also, root canal therapy is usually less expensive than a replacement tooth.

General Steps of Root Canal Therapy

Root canal therapy may involve one or more dental visits. Dr.Amy or an endodontist will perform the necessary steps to save your tooth:

1. Your tooth is numbed for your comfort. A thin, flexible sheet of latex or non-latex material called a rubber dam is placed over your tooth to keep it dry. An opening is made through the crown of the tooth into the pulp chamber.

2. Your tooth’s nerve or pulp is removed from the pulp chamber and the canal of each root of the tooth. Each root canal is cleaned, shaped, and disinfected so that it can be filled.

3. We may place medicine in the pulp chamber and root canal(s) to help treat the infection.

4. The treated root canals are filled with a rubber-like material to seal them.

5. A temporary filling is placed in your tooth to prevent infection of the root canals. You may be given antibiotics if the infection has spread beyond the end of the root(s).

6. Finally, your dentist removes the temporary filling and restores the tooth with a crown or a permanent filling to strengthen it and improve the way it looks. If an endodontist performs the procedure, they usually recommend that you return to your general dentist for this step.

It is very important to follow instructions from your dental team and to attend all of your follow-up appointments.

Before crown: Worn filling with decay under filling

Crown is placed over prepared tooth

After crown placement

Before crown: Worn filling with decay under filling

Crown is placed over prepared tooth

After crown placement

How Long Will the Restored Tooth Last?

When properly restored and maintained, a tooth with a root canal filling can last for many years. But, like any other tooth, it can become decayed or fractured or the tissue around it can get gum disease.

Professional cleanings and regular dental exams will help keep your mouth healthy – whether you’ve had root canal therapy or not.

What Are Wisdom Teeth?

Wisdom teeth are the four permanent (adult) teeth at the very back of your mouth on the top and bottom. They are the last permanent teeth to appear. Wisdom teeth get their name because they usually come in between the ages of 17–21, around the age when a person gains maturity and wisdom. Most other permanent teeth come in a few years earlier, by age 13.

Sometimes wisdom teeth do not have enough room to come in, or they are in the wrong position. They may come in sideways or at a slant, pushing against the teeth next to them (Figure). These wisdom teeth are called “impacted” and may have to be removed so that they don’t cause future problems.

How Do You Know If Your Wisdom Teeth Need to Be Removed?

Regular dental visits allow us to track the growth and condition of all of your teeth. After doing an oral exam and taking X-rays, your dentist can look at your wisdom teeth and talk to you about whether they should be removed. Wisdom teeth extraction, or removal, may require surgery.

Why Are Wisdom Teeth Removed?

We will examine your wisdom teeth and may recommend having them removed so they don’t cause future problems.

Possible Problems with Wisdom Teeth

• Teeth and gums can become infected. When a wisdom tooth partially comes through the gums, it can create an opening where bacteria may enter. This can cause pain, swelling and jaw stiffness.
• They can damage or crowd other teeth. This is caused by a wisdom tooth that doesn’t have enough room in the jaw to grow in or one that is coming in sideways or at an angle.
• A fluid-filled sac (cyst) or tumor can form on or near an impacted tooth, destroying surrounding bone or tooth roots.
• Periodontal (perry-oh-DON-tal) disease, also known as gum disease, can develop because wisdom teeth are hard to brush and clean between.
• Pericoronitis (perry-kor-on-EYE-tus) can develop. It is an infection of the soft tissues that cover an unerupted or a partially erupted tooth.

How Are Wisdom Teeth Removed?

We can perform wisdom tooth extractions. But, if we see a need for any special care, you may be referred to an oral and maxillofacial (max-UH-lo-FAY-shul) surgeon. This is a dentist who specializes in surgery of the hard and soft tissues of the mouth, including the removal of impacted wisdom teeth. If we refer you to a specialist, we will work together to provide you with the best care.

What Can You Expect?

Before Surgery:

• We will explain what to expect and help you plan for the appointment. We may recommend dressing comfortably in loose clothing and arranging for someone to be with you after your dental visit.
• Extractions are usually performed under local anesthesia. This means you stay “awake” but your mouth is numbed with a pain medication. You can discuss with us the types of anesthesia and pain or anti-anxiety medication to determine what is right for you.
• Talk to us about any questions you have about the procedure. He or she will also tell you how you can get advice after office hours if you have any problems after surgery.
• Tell us about past illnesses and current medications you are taking — this should include both prescription and over-the-counter drugs.

After Surgery:

• Be prepared to rest and avoid vigorous activity. Recovery time will vary from person to person, so be sure to follow our instructions on when you can return to normal activities.
• Avoid solid foods that require a lot of chewing. Stick to soft foods and liquids. Do not drink with a straw. The “sucking” action could make the wound site take longer to heal.
• You may have some swelling and discomfort. This is normal, but we will talk to you about what you can do to help manage these problems.
• Be sure to know how to reach your dentist during non-office hours in case you have any questions or concerns about the healing process.
• There will usually be a follow-up appointment to ensure the site is healing.

In some cases, there may be complications after treatment. It is possible to get “dry sockets.” Dry sockets can develop when the blood clot that forms over your socket is displaced, leaving bone and nerves exposed. Smoking can increase the risk for complications and delay healing. Follow our instructions carefully to reduce the risk for complications.

Not everyone’s teeth develop on the same schedule. See your dentist regularly so he or she can monitor the growth of your wisdom teeth.

What about pain relief?

Some people think that pain after wisdom teeth removal can only be tackled with prescription medicines. But that’s not true. Studies show that a combination of ibuprofen and acetaminophen—both common pain relievers you can buy off the shelf under many brand names—work just as well as prescription medicines without the side effects like the potential for addiction. Talk to our team about options for pain relief. 

If you use tobacco in any form, it is important to quit. Smoking and vaping can cause problems with your healing process. Ask us or your physician for information about ways to quit.

Post-Operative Instructions for tooth extraction:

A Few Simple Guidelines

Sometimes, teeth need to be removed due to decay, disease, or trauma. Having a tooth “pulled” is called a tooth extraction.

When you have an extraction, it’s natural that changes will occur in your mouth. We will give you instructions to follow after the extraction, and it’s important to talk to your dentist if you have any questions or problems. Here are some general guidelines to help promote healing, prevent complications, and make you more comfortable.

Anesthetics

Before the tooth extraction, you will be given an anesthetic to reduce your discomfort. Your mouth will remain numb for a few hours after the extraction. While your mouth is numb, you’ll want to be careful not to bite your cheek, lip, or tongue. Do not eat any foods that require chewing while your mouth is numb. The numbness should go away within several hours. If it doesn’t, contact our team.

Bleeding

We may place a gauze pack on the extraction site to limit bleeding. This will also help a blood clot to form, which is necessary for normal healing. This gauze pack should be left in place for 30 to 45 minutes after you leave our office.

Do not chew on the pack. There may be some bleeding or oozing after the pack is removed. If so, here’s what to do:

• Fold a piece of clean gauze into a pad thick enough to bite on. Dampen the pad with clean, warm water and place it directly on the extraction site.
• Apply pressure by closing the teeth firmly over the pad. Maintain this pressure for about 30 minutes. If the pad becomes soaked with blood, replace it with a clean one.
• Do not suck on the extraction site or disturb it with your tongue.
• A slight amount of blood may leak from the extraction site until a clot forms. However, if heavy bleeding continues, call your dentist. (Remember, though, that a little bit of blood mixed with saliva can look like a lot of bleeding.)

Do Not Disturb!

The blood clot that forms in the tooth socket is an important part of the normal healing process. You should avoid doing things that might disturb the clot. Here’s how to protect it:

• Do not rinse your mouth vigorously, or drink through a straw for 24 hours. These activities create suction in the mouth, which could loosen the clot and delay healing.
• Avoid alcoholic beverages or mouthwash containing alcohol for 24 hours.
• If you are a smoker, talk to your dentist before the surgery on ways to quit. You should not smoke after surgery.
• Limit strenuous activity for 24 hours after the extraction. This will reduce bleeding and help the blood clot to form.
• Sometimes the blood clot does not form in the first day or two after the extraction, or it forms but breaks down. The result is called dry socket. This can be very painful and should be reported to your dentist. A dressing may be placed in the socket to protect it until the socket heals and to reduce any pain.

Cleaning Your Mouth

Do not clean the teeth next to the healing tooth socket for the rest of the day. You should, however, brush and floss your other teeth well and begin cleaning the teeth next to the healing tooth socket the next day. You can also brush your tongue. This will help get rid of the bad breath and unpleasant taste that are common after an extraction.

The day after the extraction, gently rinse your mouth with warm salt water (half a teaspoon salt in an 8 oz. glass of warm water) after meals to keep food particles out of the extraction site. Try not to rinse your mouth vigorously, as this may loosen the blood clot. If you have hypertension, discuss with your dentist whether you should rinse with salt water. Avoid using mouthwash during this early healing period unless your dentist advises you to do so.

Medication

If your dentist has prescribed medicine to control pain and inflammation or to prevent infection, use it only as directed. If the pain medication prescribed does not seem to work for you, do not take more pills or take them more often than directed-call your dentist.

Swelling and Pain after a tooth extraction

After a tooth is removed, you may have some discomfort and notice some swelling. This is normal. To help reduce swelling and pain, try applying an ice bag or cold, moist cloth to your face. Your dentist may give you specific instructions on how long and how often to use a cold compress.

When to Call Our Team

If you have any of the following issues, call us immediately. If you cannot reach us, go to a hospital emergency room.

• fever, nausea, or vomiting
• ongoing or severe pain, swelling, or bleeding
• pain that gets worse with time instead of better

Eating and Drinking

After the extraction, drink lots of liquids and eat soft, nutritious foods. Avoid hot liquids and alcoholic beverages. Do not use a straw. Begin eating solid foods the next day or as soon as you can chew comfortably. For the first few days, try to chew food on the side opposite the extraction site. When it feels comfortable, you should resume chewing on both sides of your mouth.

Follow-Up

If you have sutures that require removal, your dentist will tell you when to return to the office.