CHAPTER 17 Prosthodontics, Removable
Dentures Replacing All or Some Teeth
Among the most well known but least desired areas of dentistry is removable prosthodontics. However, well-made and fitted artificial dentures can be relatively satisfactory replacements for teeth and surrounding bone and soft tissue for a predictable period. Unknown to many persons is the fact that the jawbones and gum tissues shrink a known amount when teeth are removed, and even more upsetting is that shrinkage continues to occur throughout the remainder of the person’s life. Acceptance of this fact is a major decision for a person considering tooth removal. Frustration with the maintenance of natural teeth can lead a person to think that tooth removal is an easy solution. However, tooth removal usually substitutes other problems for the one you are trying to avoid. Usually, but not always, retention of natural teeth is the best decision. Having your teeth removed can be compared to having an arm amputated. You can get a new artificial arm, but it will never function as well as the original arm. if you have lost some or all of your natural teeth, you should find a general dentist whose practice includes removable prosthodontics or a prosthodontist for acceptable treatment.
Implants are among the best ways to replace missing teeth, and Chapter 10 on implant dentistry should be read in addition to this chapter.
(FIG. 17.1). The signs and symptoms of one or more teeth missing are described in the section on fixed prosthodontics. Please refer to that information about what you see or feel (p 140). Most persons prefer to have one of the fixed prosthodontic options (bridge attached into mouth) when one or many teeth are missing, but for financial or other reasons removable prosthodontic options may be best. All of the treatment alternatives follow, some of which are removable prostheses:
Numerous conditions cause this situation, including dental caries (decay), gum and bone disease (periodontal disease), accidents, congenital deformities or other abnormalities, cancer requiring radiation and/or chemotherapy, or other conditions. When all of the teeth must be removed, some decisions must be made as to whether the teeth should be:
Patient dissatisfaction with removable dentures is known to be one of the highest of any area of dentistry. The facts are that natural teeth are meant to remain in the mouth, and that artificial removable dentures replace natural teeth to only a small portion of their original effectiveness. Also, we all have varying abilities to tolerate the many challenges of removable complete dentures. Some of the following conditions can be corrected easily, whereas others may not have simple solutions. The conditions listed are followed by alternative solutions described in the next section of this chapter, What Your Prosthodontist or General Dentist Can Do.
Several types of treatment are available in the area of removable prosthodontics. Most general dentists accomplish some removable prosthodontic procedures, but if your condition is especially complex, or if you have had difficulty with previous prosthodontic treatment, then you may want to seek the services of a prosthodontist (a dentist specially educated in prosthodontics) (p 15).
Repair may be a choice, but it will probably be only a temporary remedy that will require more comprehensive therapy later. Consult your dentist to determine the desirability or feasibility of repairing your current prosthesis (denture). The following are relatively simple, common maintenance or repair procedures for dentures that may satisfy your needs without requiring a new denture: