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My Dental Work is Failing, Whats Next?

October 29, 2019
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Posted By: Rajan Sheth DDS

Solutions to Failing Dental Work on Scottsdale, AZ

So you’ve got some failing dental work or your teeth have gotten to a point where they need to be replaced.

This is something that is not quite unusual, and something we see quite often at Scottsdale Dental Solutions. Over a period of time dental work wears out. We see that under restoration teeth become soft and slowly decayed. This process may take years or sometimes even decades but due to the hostile nature of the oral environment teeth have a propensity to wear out.

You can see below that crowns and bridges, fillings and even normal and natural teeth start to fail.

Patient with failing dental implants | Implant Dentist in Scottsdale AZ

Here is a picture of a close up of why the teeth need to be removed.

Teeth with bad tooth decay | Dental Implants Scottsdale AZ

 

There comes a point when sometimes a patient’s teeth cannot be salvaged as there is not enough good tooth structure available to hold a restoration. It is at that point that tooth/root removal would need to be considered. Options who may need their teeth removed include traditional dentures or a combination of dental implants with a fixed or removable prosthesis.

Advantages to Removable and Fixed Dental Options

Removable options include traditional dentures, overdentures, and snap-in/click tight dentures. The major benefit to a removable denture is the ability for the patient to remove it and keep the prosthesis clean along with the gums and any remaining salvageable teeth. It also makes the prosthesis a little bit easier to repair if the patient has a problem as it can be easily removed from the patient's mouth, fixed by the dentist and returned to the patient with little to no interruptions.

Problems that we sometimes see arise with removable dentures are their fit and comfort. By their nature, they sit on the gums and bone and use implants and teeth as support vs a fixed option where the actual prosthesis is resting on the implants and only touches the gums to provide a seal from food and air. Also, over time the connection between the implant and denture can wear out resulting in the plastic housings needing to be replaced to ensure a nice fit. Patients with strong chewing muscles and strong bites can easily wear through these plastic pieces resulting in more frequent maintenance.

Diagram of Implant Supported Dentures in Scottsdale AZ

Traditional Dentures 85254

In comparison, traditional dentures only allow for a patient to have about 30% of their chewing capacity restored to normal. With the addition of implants to help hold and retain their dentures, the patient patients are typically restored to around 60% of their full chewing capacity. Traditional dentures are by far the cheaper option but with diminished chewing capacity and lack of stability most patients opt to have dentures secured with dental implants. It's my opinion that traditional dentures are for a patient with no teeth and not a substitute for teeth. We here at Scottsdale Dental Solutions make beautiful dentures that fit our patients comfortably and look great, however, even with a great fitting denture, there is a learning curve. We help educate and work with our patients to get the most out of their prosthesis, but most patients opt for securing their denture with dental implants to improve the fit, security and reduce the possible embarrassment of the denture coming loose at the most inopportune time.

We will dive into how the procedures are performed in other posts as the intent of this post is to show patients different implant options available.

Tooth Replacement Process

Tooth removal

When a patient is presented with needing to having some or all of their teeth removed, there are lots of different options. Most of the time we can remove all the teeth at one time and through the use of sedation dentistry, we can make the experience a very pleasant one. At Scottsdale Dental Solutions we offer our patient's tooth removal with nitrous oxide, oral sedation, IV sedation or even general anesthesia (through a dental anesthesiologist or CRNA). These services make dental experiences extremely pleasant and the patient takes a nice sleep while their work is done and wake up to their dental work being completed.

Grafting

There are times when there is not an adequate amount of bone needed to place a dental prosthesis or boney structure to anchor a dental implant. There are many techniques for grafting bone in the upper and lower jaw. In some cases, we can treat patients without the need of grafting, but these are case by case. The only way to determine if there will be a need for grafting is through getting an accurate assessment of the underlying bone with either a thorough physical examination and use of CBCT. At Scottsdale Dental Solutions we use CBCT technology to help plan and evaluate the bone so we can accurately address any areas of concern to help build back the bone.

Dental Implants

Dental implants are root-form titanium screws that are placed into the jawbone. Depending on what we are looking to accomplish and the patient’s treatment plan we can place implants immediately (the same time teeth are removed) and/or delayed (teeth are removed, grafted, bone allowed to heal) and then the dental implants are placed. Each technique is patient-specific and based on the available bone and tissue the patient has available to them.

 At Scottsdale Dental Solutions we have a lot of patients that want to leave with a new smile day of surgery. Through the use of immediate dental implants, we can give patients a brand-new smile that is fixed in the mouth that very same day. We are able to do this because the dental implants are braced together and stabilized.

Top row of implant supported dentures | Dentist in Scottsdale AZ

Close up of implant supported dentures in Scottsdale, AZ

 

With removable teeth, snap-on dentures we typically cannot attach the denture to the implants the same day because the up and down forces on the implants would affect their ability to integrate with the bone and would result in a failure. At Scottsdale Dental Solutions, we would typically remove the teeth, place the implants and then allow for sufficient healing and then attach their denture to the integrated implants.

Dental X-Ray Taken at Scottsdale Dental Solutions in 85254

Prosthesis

Once the implants are fully integrated, we construct the chewing and esthetic part of the dental prosthesis or appliance. These dental solutions can be either fixed or removable and sometimes a combination of both.

Fixed Implants Solutions- Fixed implant solutions are supported with implants alone and without the need of tissue support to help retain the prosthesis. Some examples of these are crowns and bridges sitting on implants, teeth in a day, hybrids wrapped in acrylic, hybrids made from zirconia or other ceramic material.

Removable Implant Solutions- retained with implants but require the use of the patient’s anatomy, soft-tissue to help support the prosthesis. There are partial dentures that utilize implants for anchorage, snap-on denture, click tight dentures. These solutions typically snap into place through the use of little inserts that help a denture or parital denture.

Combination of Fixed and Removable Tooth Replacement Options

In some cases, based on the treatment the patient will be receiving we will need to do a combination of fixed and removable. In these cases, the prosthesis functions like a fixed prosthesis but is removable to the patient for cleanliness. An example of this would be a bar-overdenture.

In short, it's really hard to determine exactly what each patient needs without a thorough examination. Teeth over a period of time teeth wear out and need to be replaced. I know you've probably heard this time and time again but the best way to really figure out what solution would be best is to get a custom treatment plan. You can easily schedule a complimentary exam and CBCT scan at our office located in Scottsdale, AZ and get a custom plan and smile design. At Scottsdale Dental Solutions, we are able to educate you on all the options and figure out a dental solution that fits best into your budget.

Contact Our Scottsdale AZ Dental Clinic

I hope this post helps explains some of the nuances to different dental and dental implant treatments and if you have any questions. Please feel free to reach out to our Scottsdale, AZ dental office to schedule an appointment in the 85254 area.

With love and gratitude,

Dr Rajan Sheth
480-536-9050
info@scottsdaledentalsolutions.com

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