Teeth problems result from the extra plaque that can collects around your partial denture, if you are not looking after it properly.
This can lead to dental caries
or periodontal disease
, or both and all the consequences of these diseases including pain, tooth abcesses, fillings
, loose teeth, root canal treatment
- to name a few. It just depends on how much they progress and whether problems are picked up early and dealt with.
It could be minor such as needing a filling, (the location of which, may or may not affect the fit of the denture) or major, such as caries that goes into the nerve and so far under the gum that your tooth needs to be taken out.
It is probably easiest to highlight the potential problems with a case I had recently. A patient came in to see me with an upper partial denture. She was missing all her back top teeth, except one large molar that was providing much needed support and grip to the whole denture.
When she took the denture out, there was masses of dental decay going into the nerve and that wrapped around the whole of the tooth. It had been 4 years
since her last dental visit. This tooth was key to the comfort, fit and support of her denture- without it, control of the denture would be much more difficult as the back would have a tendency to drop down. Where no teeth exist at the back to hold the denture, we typically get some rocking and movement- this is known as a 'free- end saddle' . If you have this on one side, it tends not to be too bad, but where this situation occurs on both sides, much more muscle control is needed.
So what could we do for her?
(i) Root canal treatment and crown the tooth- (about $3500)
(ii) Extract the tooth and add it onto the denture- (about $500)
(iii) Extract the tooth, place an implant and an attachment into a new denture- (about $5000), or an implant and crown for the partial denture to grip around- (about $6000).
Obviously finances come into this, hence why I put the figures in brackets, so you can understand all the implications. Now ideally, I think we would do option (i). However, the amount of decay has weakened the tooth, making the long term prognosis a little more questionable, especially when you add in to the mix, the bit of periodontal disease that has been going on simultaneously. Option (ii), the cheapest, would lose virtually all the grip and support, the denture would be harder to control and make developing good muscle control an absolute must. Option (iii), a great long term solution but the most involved- is there sufficient bone for the procedure without grafting? A suitable medical history? Does the 6 month time frame fit in with the patient? Lots of additional things to consider.
I sat her down and we went through each of the options, and the benefits and limitations of each, not just the costs, but also the procedures and the timeframes. This dilemma all started because of an issue with one important tooth!
If the issue had been with a less important tooth, extracting it and adding it to the denture may not have affected the wearing experience in the slightest. Each case is different and needs to be assessed in the context of you- the teeth, the mouth, and the dentist doing it. You can begin to appreciate that what may look like a simple problem, may actually have more consequences to consider.
This is not a one off case, we see happening all the time and it can be a real pain (for you)… learning to properly care for your denture
is absolutely essential.