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Denturist Services

Examination, Care and Maintenance Recall
          Consultation
         Care and Maintenance entails
            Over-servicing and Informed Consent
 Mobile Services And Geriatric Care
Provision of the full scope of Removable Appliances
            Full dentures
            Immediate dentures
            Partial dentures
            Cobalt-Chrome Metal Plates & Frames
            Over-dentures
            Implant-supported Dentures
            Relines, Rebases & Repairs
            Soft Liners
            Mouth Guards
            Sleep Apnea Appliances
            Tooth Whitening
            Other/incidental services

 

Examination, Care and Maintenance Recall:

Denturists are to begin with the skilled manufacturers of their appliances. The Scope of Practice of Denturists includes clinical work, such as taking impressions, recording the bite relationship, the try-in procedure and fitting of  the appliances they provide. In order to provide such direct services dental technicians needs to be upgraded in terms of patient skills and intra-oral procedures before registration as denturists. That will be the core-focus of their training curriculum and is a prominent feature of the International Baseline Competencies prescribed for Denturists.

Consultation :

Before any work can be done for the patient, the denturist will have an open discussion with the Patient to assess his/her expectations and needs. A preliminary intra-oral examination is then carried out to assess the clinical situation and a treatment plan with clear outcomes is then devised in consultation. Care must be taken to assure that the patient is well informed of the options available, and that the dignity and choices of the patient is respected. Detailed estimates of the cost involved for the various options must be provided. Confidentiality of patients' information must be respected. After reaching informed consent to provide the required removable prosthetic services, and the business of how payment for the procedure is going to be conducted, the process of making the denture/appliance can begin. It is not uncommon for Denturists in many parts of the world to offer an initial free - no obligation consultation to potential customers. This is time well invested in providing the public with informed choices, ahead of any materials being used.

  

 Image source acknowledged to www.denturistinsight.com             Image source acknowledged to www.adpavic.com.au

If any oral disease is prevalent, or preparation- or restoration-work is needed on natural teeth, or if it is necessary or appropriate for what-ever reason, the patient will be referred to a dentist or other appropriate professional health specialist, to assure that the patient is in good oral health before commencing with the measurement procedures of denture provision.

After completion of the procedures involved in the manufacture and delivery of the appliance, the denturist still has a care responsibility towards the appliance and the patient should be followed up for sporadic assessment and maintenance of the appliance. Any manifestation of oral pathology or any other medical condition will be referred to the appropriate health professional. Updating denture wearer’s medical and dental history is a significant segment of their patient files. Changes in medical and or dental health may affect the fit and function of dentures. Annual examinations can assist in detecting oral abnormalities. Changes in tissue and bone can occur for a number of reasons. Ill-fitting dentures may cause further bone and tissue changes. A denturist can assess and recommend solutions for the denture wearer to consider.

Poorly fitting dentures can lead to bite problems, speech impediments and tissue irritations. Leaving this condition unchecked can lead to complicated situations in the future. Denturists are expertly qualified to assess existing dentures for structural integrity such as cracks, chips, and broken or loose teeth. The denturist can provide advice regarding a course of action to remedy such situations, including repair, relining, cleaning and general maintenance of appliances and adjustment to clasps. A denturist also provides education to denture wearers on how to clean and care for their dentures and mouth cleaning-procedures. Similarly denture wearers need to understand the reaction of their oral tissues to new dentures, the effects of resorbtion, how to deal with denture related complications and how to accommodate allergic reactions.  

Image source acknowledged to www.denturewearers.com

Care and Maintenance entails :

 

Over-servicing and Informed Consent :

The practice of denturism is based on trust. Denture wearers trust their denturist to provide appropriate advice and treatment. They trust their denturist to provide reasonable quality appliances at a fair price. Importantly they trust their denturist to keep them informed about all their options and the possible consequences.

Although over-servicing by denturists is reported to be minute, it should be discouraged altogether. A Denturist, with just one limited income source, may for example, be tempted in placing a partial denture for a patient with a number of natural teeth left. However, what is the implications if an important abutment tooth are lost shortly after delivery of a new partial denture? The state of all these natural teeth should first be evaluated and remedied if required, and a proper treatment plan worked out with the consent and co-operation of the patient. All aspects that could impact on such a treatment plan must be taken into account. Prevalence of oral disease or oral pathology especially in unhygienic mouths should be a major deterrent for the overhasty supply of partial dentures. The denturist is a gatekeeper of oral disease and also to prevent "over-servicing " of their services. 

There are sometimes alternative treatment plans that may also include the expertise of other members of the Oral Health Team to consider. It is the responsibility of the practitioner to ensure that the patient has a clear understanding of their options, the procedures involved and the expected cost. All service providers must morally & legally provide options and cost benefit details, and also possible complication and disadvantages. The more complex and expensive the treatment, the more important informed consent  becomes. 

 

Mobile Services And Geriatric Care

Conventional Oral Health services provided by privately practicing Dentists is globally generally restricted to their urbanized dental surgeries and is in many communities increasingly becoming exclusively an elitist service to the wealthy and Medical Scheme members. Once normalized, Denturism is the service of choice for the wealthy as well as the poor. Denturism is as effective in Industrialized nations as they are in Third World countries and so versatile and accessible that they serve the whole range of denture wearers whether they find themselves in affluent urban communities, peri-urban informal areas or in way-out rural communities.

The anti-denturism lobby claims that dental technicians are, on the whole, even more urbanized than dentists and rural populations will not be serviced and that dentists in SA are capable of supplying dentures to those in need. In reality, where denturists are deployed, they are not restricted to working in areas where dentists are situated like dental technicians are, and would therefore in all likelihood provide better distributed services than dentists do in rural areas. Denturists would service their market where the demand exists.

Few countries can afford extensive state subsidized Community Oral health services to serve the poor effectively, never mind denture services. Health services available to the institutionalised elderly are generally limited and basic; in practical terms Oral Health services do not feature. Geriatric patients with old, worn or dysfunctional dentures seldom have access to replacement services because it is not accessible, or not affordable. Privately practicing Denturists providing Mobile Denture Services have proved in many countries to be an effective way to serve and access sparsely populated rural communities and are often the only denture service available for geriatric patients. Obviously this service costs a little more to compensate for the additional traveling time and incidental expenses.

Denturists providing mobile services in New Zealand and Australia often get complemented on how much a mobile service is appreciated, as many elderly patients can't drive and get to a clinic. Similar to South Africa, there are many retirement-homes for the elderly where nursing staff is not able to get them to a dentist. Not all elderly have their children looking after them and therefore mobile denture services by Denturists are warmly welcomed. It is reported that there is an excellent relationship and communication going on between management and/or nursing staff with Denturists. Needless to say, denture wearers of all ages have appreciation for the professional service and convenience of being treated in the comfort of their homes.  

     

Images with acknowledgement to Oliver Meier

When mobile service is undertaken, the Denturist takes the impressions, bites, shades, try-ins, and final fitting mostly in the kitchen or dining room, close to a water supply or tap. Universal protection of cross-infection control is carried out with each appointment: working on paper towels, spraying impressions with a disinfectant, using disposable impression trays and needless to say wearing latex gloves, etc. It is always best to do the technical work in a laboratory, but in certain instances where a patient is living out far in rural regions models can be poured for special trays or record-block construction. A hydraulic pressure pot provides the curing vessel for repairs and additions, which can be done right there so that the patient is without their prosthesis for as little time as possible. It is ideal to take an electronic handpiece, which is ideal to pack into a case for trimming and adjustment of repairs and final adjustments. Polishing is done with a green acrylic polisher for small areas, and with a pre-measured pumice bag for each patient on larger areas such as peripheral roles etc. This is done on a lathe, which would have to be taken along too, using a disinfected bristle brush on each case. Prosthesis' are pre-soaked in disinfectant before working on an existing denture and prior soaked and rinsed before fitting it again.

The South African Dental Association have stated that conditions associated with the elderly demand special diagnostic skills and therefore the oral health of the public is best protected by dentists who are appropriately trained to assess total oral health needs and provide comprehensive oral health care. We agree and want to make our views quite clear that Denturism is pro-denture wearer - not anti-dentistry, and under no circumstance do denturists intend to interfere with that responsibility of dentists. In fact it is standard protocol throughout the world for Denturists to refer denture wearers to Dentists when appropriate or necessary. In the case of a rural patient presenting the need for adjustment of natural tissue (i.e. removal of a root rest) in the absence of a dentist within reasonable proximity, a dental therapist could do the procedure as effectively. 

The Society for Clinical Dental Technology acknowledges that the elderly is the most prevalent group requiring removable oral prostheses. Any OH professional serving them should be aware of the presentation of dental and oral diseases and disorders in elderly patients, and the range of psychological and social factors involved in such situations. They should be able to distinguish between normal and abnormal consequences of ageing, and learn to avoid stereotyping elderly patients. In our view, a qualified denturist doesn’t need special skills to diagnose that the elderly who has lost all their teeth needs a denture to rehabilitate their speech, mastication and oral health functioning. As a matter of fact, that is what denturists do! It is their calling.

Due to their flexibility, Denturists are often the only denture service available for institutionalised or hospitalized geriatric patients. Objective Health Professionals assess that the patient is treated more effectively when dentistry is viewed as a team of experts. Although Dentists are not denied from carrying on providing dentures as they have done conventionally, it must be recognized that they are poorly trained in the manufacture of dentures and recognition should be given to Denturists as the denture experts, just as Dentists are recognized as the experts in the prevention and treatment of oral disease and the promotion of oral health. In Australia and new Zealand a Denturist has 4 times and up to six times the level of training in removable prosthetics that a Dentist has. Similar comparisons have been reported from the USA and Canada (5-10 times the amount of patient cases and 1200 hours of theory compared to a total 80 hours of training in prosthetics for dental students ).  In the final analysis, the public (dental consumer) should be given the freedom of choice to decide for themselves whose services to acquire for providing their removable prosthetic services.    

 

Provision of the Full Scope or Removable Appliances

Removable prosthodontics is concerned with the replacement of teeth and their supporting structures by patient-removable devices. Dental prostheses have to conform to strict biological, physical and mechanical principles if they are to restore lost functions effectively. Each patient presents individual problems that require a multi-disciplinary approach to understanding the problem and devising a solution, the provision of which needs highly developed manipulative and dexterity skills. Oral Health Professionals serving these patients must be competent to design and manufacture removable prostheses to a clinically acceptable standard. Advanced forms of prostheses can involve occlusal rehabilitation, sophisticated metal technology, precision attachments and implants.

Globally it is not a simple task to become a licensed denturist. Before obtaining a license a candidate must pass comprehensive practical and written examinations. The written examination challenges candidates to show their clinical knowledge of oral health issues, including microbiology, physiology, oral pathology, head and neck anatomy and more. The practical examination requires candidates to demonstrate their ability to take oral impressions, design a denture from the impression, create a denture from the design, and fit the denture in the patient's mouth so that it works well and is comfortable to wear. When you seek the care of a denturist you will find that as a patient you play an active role in the discussion of the creation of your new dentures. Remember, you are in the hands of a professional who specializes only in the making of removable prosthodontics. Your denturist will involve you in the steps necessary to ensure your dentures fit properly and meet your full expectations.

In all activities and all environments, Denturists work independently with the patient, and collaboratively with other health care providers where appropriate or necessary. See also Practice Guidelines also on this website. Subject to the condition of the mouth, patients may be referred to a Dentist during the first visit to a Denturist. The bottom line in this regard is that there is no substantial reason why a Denturist in South Africa should not provide the whole range of removable dentures, in a co-operative spirit with a Dentist, as it is successfully practiced globally. Most of the initial legislation, especially the limitations on some types of removable dentures, have been upgraded to meet local demands and international tendencies. In the majority of countries were the provision of partial dentures and other removable prosthetic appliances are still excluded from the Denturist’s scope of practice, there is a continued lobby to legalize this omission. In all these countries, Denturists are requested by denture wearers themselves to provide these appliances, whether they are legally allowed to do so or not. Patients continue to consult their Dentist for care and treatment of their natural teeth. There is nothing rational about providing a legal charter for Denturists to get clinical training and register as legitimate professionals if some of the procedures that they are expertly trained for, will still have to be provided illegally, simply because another Oral Health category (with less training in prosthetics than denturists) insists on irrational limitations.  

The denture wearer consults the Denturist for a denture to replace lost dentition. The scope of practice of Denturist’s includes clinical work, but clearly draws distinction between adjustment and alteration to natural teeth or tissues of the mouth, and the intra-oral procedures involved in the provision of removable appliances, such as taking impressions, recording the bite & fitting the denture in the mouth. Denturists receive training in Pathology recognition. Any manifested pathology of the mouth, oral disease and lesions (including unnatural discoloration of soft tissue, lumps and swellings) are referred to a Dentist or Oral Pathologist. Likewise, in those cases that the need arises to take x-rays to assess i.e. sub-gingival root rests, the possible extraction/modification of roots and impacted teeth etc the patient are referred to a Dentist during the planning stage, by the Denturist. This provision would also apply to the procedures of tooth modification needed, such as the preparation for occlusal rests or broken/leaking fillings. In this regard, a professional co-operative spirit of referral between Denturist and Dentist would be to the advantage of the service rendered to the patient. In the UK (the latest denturism legislation to be implemented) the taking and interpretation of oral radiographs is included in the educational curriculum of Denturists.

 

Full Dentures:

 

Image with acknowledgement to www.arrowheaddentalarts.com 

Millions of people experience difficulties associated with missing teeth. These difficulties can severely undermine your self-confidence and quality of life. Missing teeth can compromise your health, eating habits, speech and appearance. When teeth are lost, bone loss usually occurs, which in turn can affect your denture. This can result in the denture becoming loose, which may cause difficulty in stabilization of the denture, decreased chewing ability, and deterioration of the jaw structure over time. As an oral health-care specialist, the Denturist offers various types of dentures to satisfy each patient’s specific requirements.

Your dentures are important to the way you look and feel. That’s why it’s important to maintain dentures and ensure they perform at their optimum so you can perform at your best. A regular check-up with your Denturist is the most effective way for you and your dentures to get the care and attention you both deserve. Your Denturist, in close consultation with you, will determine what those requirements are and how to meet them. State-of-the-art dentures are able to restore your smile as well as be compatible with the sensitive tissues of your mouth.

As a primary oral health-care giver, a denturist can provide various types of quality full denture(s) specific to your needs. A denturist will consult with you to determine your denture requirements. The denturist will help you make an informed and educated decision that will best suit your needs. Specialized state of the art dentures are available to optimize your results. Denturists are Denture Specialists. The denturist will consult with you about the process involved in designing an accurate denture. During the consultation, the denturist wants you to explain your expectation and lifestyle issues. This critical information will help in the design of your accurate denture. Your denturist will recommend solutions specific to your new oral condition, functional needs, and aesthetic requests. As an example: Denture wearers playing some blow instruments have special needs that can only be solved through experimental designs and consistent cooperation between consumer and manufacturer. 

Your prosthesis is handcrafted to match your age, complexion and facial features. Considerations such as the shape of your jaw line, lips, eyes, eyeglasses and hair colour are noted. The teeth are set so that they look natural and your smile is aesthetically pleasing. A certain number of procedures and good quality teeth are used in the construction of your dentures. Patients who have unusual conditions may require additional extensive measurements and alternative procedures in denture construction, to accommodate their needs during everyday life activities, optimizing the ability to eat, speak or laugh confidently. 

Immediate dentures:

To avoid the situation of being without teeth, your oral health care provider might recommend the immediate denture technique. This involves taking impressions of your mouth while your natural teeth are still present. The Denturist is then able to fabricate a transitional denture in the likeness of your natural teeth, or make any necessary modifications you may wish. When your natural teeth are extracted, your immediate denture is then inserted. In this technique, you have avoided having to go without any teeth while you go through the healing process.

Since the Denturist is unable to try-in the denture prior to extracting your teeth, certain esthetic compromises may be necessary. This doesn’t present any significant problems, and the results are normally quite good. An impression is made of your existing teeth and gums prior to the extraction surgery and is used as working models for the construction of your new dentures. From these models the denturist is able to copy and construct a denture, duplicating your original teeth with improvements to your appearance, if you so wish. 

As healing occurs, the oral tissues recede so denture adjustments may be required. Follow-up appointments with your Denturist are necessary. To maintain the best fit and comfort, a temporary liner or tissue conditioner may be placed in the denture. During the next few months, bone and gum tissue will continue to shrink to some degree; however, the rate of change decreases with time. This is a natural occurrence, which is to be expected. After the healing process is complete, either a new permanent full denture(s) will be made or your denture(s) will be relined or rebased to ensure the most comfortable fit possible. Your Denturist will recommend the option that best meets your particular needs.

WHAT DENTURE WEARERS SHOULD KNOW ABOUT IMMEDIATE DENTURES :

Denturists in most cases have no way of trying the denture(s) in before your extractions are completed. In some cases, aesthetic compromises may have to be made in favour of structural integrity or limited space.

During the healing period, postoperative instruction from the Oral Surgeon and Denturist must be followed carefully. Your gums and bone recede to a much smaller size, because of the tooth sockets closing. Regular check-ups and maintenance to ensure ideal healing are required. Temporary linings or tissue conditioners will be required to ensure a positive fit. This procedure may be repeated a number of times based on your physiological rate of healing. At the completion of the healing period, a permanent reline or a new denture may be constructed to ensure a comfortable and an exact fit.

Temporary liners, tissue conditioner and relines are additional services that follows beyond the service of manufacturing the immediate denture(s). Consult your denturist concerning the benefits of an immediate denture and the procedure that best meets your specific needs.

 

Partial dentures:

A removable partial denture is usually made to replace one or more (but less than all) teeth, and is customized to a patient’s specific requirements. Removable partial dentures restore a person’s natural appearance and greatly improve the ability to chew and speak clearly. Partial dentures do not harm remaining natural teeth. A partial denture may prevent your natural teeth from shifting or drifting into the space left by the loss of a natural tooth. In fact, a partial denture may help maintain the position of your natural teeth by providing them with additional support. With a partial denture, you’ll look better, feel better and chew better!

Your partial denture is an inexpensive solution to the problem of missing teeth and is designed to comfortably fill gaps left by missing teeth. Partial dentures can be constructed out of a metal and acrylic composition or completely out of acrylic or flexible thermoplastic. The design process involved in creating a removable partial (denture) is specific to the patient’s needs. Every effort is made to design a self-cleansing partial denture that preserves the remaining teeth and oral structures. Metal clasps around your natural teeth may be necessary to keep the denture in place and ensure stability in the mouth.

When a partial denture is designed, the denturist acknowledges that chewing places a strain on the remaining teeth during eating. Partial dentures are designed with this in mind so that the chewing forces can be distributed evenly over the entire arch of remaining teeth and soft tissues to preserve and prolong the life of the remaining natural teeth. Design modifications to your remaining teeth may be required to help equalize these forces. Any adjustment of this nature will be carried out by a dentist or dental therapist working cooperatively with your denturist to provide the best possible outcome for you - the consumer.

A partial denture is essential for even distribution of bite forces and stability of opposing dentures and adjoining natural teeth:

    

With acknowledgement to Brookswood  Denture Clinic, Langley, BC, Canada at www.yourdenture.com 

The number of teeth remaining, the position and the stability of the teeth are only a few of the factors that help to determine what style or type of partial denture would be best for you. Partials can be made of different materials, including acrylics, a metal/acrylic combination or flexible thermoplastics. Metal partials are considered stronger structurally, thinner and more hygienic than an acrylic partial. Acrylic partials are usually recommended as a transitional or temporary replacement of missing teeth, depending on your personal circumstances. Taking your needs and preferences in to account, and the unique technical challenges your denture design requires, your denturist will guide you to determine the appropriate treatment plan and the appropriate partial for you, with your co-operation and consent. 

Thermoplastic partial dentures :

  

The new highly flexible thermoplastic materials have the advantage of esthetics and flexibility. They are designed to include gum-colored wing-clasps that is unobtrusive in the mouth and flexes into position to keep the denture in place, thus including the stability of a metal partial denture and the esthetics of a plastic partial, and does away with the need for unsightly metal clasps and rests.  

All partial dentures are designed to be removable and should be removed nightly to contribute to a healthy oral environment. With newer designs, materials and techniques, partials are more comfortable than ever before. Ask your Denturist about the many designs available.

 

Cobalt-Chrome Metal Plates & Frames: 

Images with acknowledgement to Oliver Meier

The metal/acrylic partial - commonly called a cast partial or chrome cobalt partial, is usually a more rigid and permanent style of denture. The metal is either a highly compatible chrome cobalt alloy or titanium, which are both ultra thin, light and very strong. Ask your Denturist about the many designs available, some of which have no visible clasps and are virtually undetectable.

In the case of full dentures with a history of midline fractures, a full metal palate will strengthen the denture sufficiently to put an end to this tendency. Metal partial dentures are constructed using one of the dental industry’s most reliable alloys. This material is extremely strong and ideal to cast a very thin framework that takes up a minimal amount of space in your mouth. This is a big advantage over an ordinary plastic denture that needs to be quite thick to be strong enough but feels bulky in the mouth and interferes with tongue space and speech pronunciation.

A cobalt-chrome frame is constructed around your remaining teeth, with the artificial teeth being closely matched to the shade and shape of your existing natural teeth. Chrome partial dentures are comfortable to wear, very strong and generally last considerably longer than an acrylic partial, therefore providing better long term value for money.

 

Over-dentures:

Sometimes a denture wearer has a partial denture with only a dwindling few natural teeth left, that are heavily decayed. By cutting off the remainder of the teeth, and filling the gaps on the partial denture with artificial teeth, such a partial denture can be turned into a partial over-denture or a full over-denture. If there is a functional partial denture in place that fits well, and the cost of a new denture is of a decisive consideration, this type of alteration is worth considering for the sake of affordability and long term maintenance of the underlying bone structure. 
In some situations, it is recommended not to extract certain teeth that are decayed, but instead to cut the crown off and root-fill the root section. The tooth then acts as a support under the denture and also decreases the level of bone loss. In the case of an over-denture, modification of roots or tooth stumps to support a denture covering existing tooth structures, are taken into consideration when designing and planning are done by the Denturist in consultation with the denture wearer. The Denturist refers the assessment and tooth modification or extraction, if necessary, to a Dentist during the planning stage.   

Before the Denturist can start with manufacturing of the over-denture, the patient gets referred to a Dentist who will then remove all that is left of such abutment teeth to the level of the gingiva. Effectively only the roots are left behind, and needs to be stabilized by doing a root-canal filling before the Denturist can commence with taking an impression to manufacture the over-denture. After completion of the denture, the Denturist fits it in the denture wearer’s mouth. An over-denture has in principle the same shape and dimensions as an ordinary full denture. For this reason, once the abutment roots eventually have to be removed, an over-denture can be transformed into an ordinary full denture with little modification by simply relining the fitting surface in that area.

 

Implant-supported Dentures:  

  When teeth are removed, our body assumes there is no need for the bone that supported the teeth. Over time, the bone slowly yet progressively diminishes. This process, called resorbtion, occurs at a more rapid rate if all teeth in the jaw are missing. Left untreated, the loss of bone can progress so far that even the best quality denture will no longer function satisfactorily. Fortunately, dental implants, a discovery by Swedish scientist and orthopedic surgeon Dr P.I. Branemark, has led to a vastly improved quality of life for many patients who suffer from the problems associated with missing teeth.

Not just for people who want to replace one or two missing teeth, dental implants are medically pure titanium devices that are placed into the jawbone. They act as an anchor to provide a solid base for a denture. Loose dentures can be remedied with the addition of implant anchors. Your Denturist might refer you to a dentist or dental specialist for the placement of implants, and will fit dentures over these implants to provide stability, increased chewing force, reduced tissue irritations, and decreased bone loss.

   

 Image with acknowledgement to www.embassyrowdental.com        Image with acknowledgement to www.zoerhof.com

 

        

Images with acknowledgement to www.dentureclinic.com

Implant retained dentures are no longer financially out of reach for the average consumer. Your Denturist will help you in understanding the facts and procedures involved in implant dentistry. Optimum tooth replacement is achieved with implants. Implants are root replacements. Once implanted into your jaw, the bone and the implant body integrate into one cohesive member and provide a stable and reliable anchor on which a tooth may be fabricated. Implant bodies are also employed as retention abutments used in retaining full or partial dentures. In studies, dental implants are shown to preserve bone and reduce gum tissue loss. Eating, speech and laughter can now be performed with confidence. Patients feel better and gain a new found zest for life, as implants are the closest thing to natural teeth.

Historically, dental implants have a high clinical success rate. Patients who have opted for dental implants often remark how similar the implant feels to their own natural teeth. The patient can enjoy new found confidence. Implant benefits includes:

 

Relines, Rebases & Repairs:

What is resorbtion?

A denturist can help you understand the circumstances involved in ill-fitting, loose or broken dentures. After your teeth are extracted, you will suffer bone loss over time.   As you can see in the images below, your jaw-bones will shrink (bone resorbtion), which will alter the comfort, fit and effectiveness of your dentures. Once the natural teeth have been extracted, the stimulation of the mastication forces that were transferred to the surrounding bone tissue by the roots of the teeth have been lost and as a result the underlying bone and soft tissue starts shrinking away. This process called resorbtion, stabilizes after a few months and becomes quite gradual, although it caries on for life. As a result of resorbtion the immediate denture typically gets very loose and the fitting surface of the denture needs to be filled up after a few months. Thereafter the shrinkage stabilizes, but your lower jaw is in a constant state of resorbtion, from the day you have your natural dentition extracted, and for the duration of your natural life. This bone loss occurs at different rates from patient to patient, but for most, it is a measurable change every two to five years.

People who have no more natural teeth left, lose on average 1 mm of jawbone height each year. Gum tissues (ridges) shrink along with jawbones-up to 1/2" in 10 years. This is what makes your denture loose. Not all of these situations will require a new denture. Symptoms of less stability when chewing, food entrapment under plates, or more frequent sore spots are common indications change has taken place. Some patients experience no noticeable symptoms at all, but never the less that shrinkage factor is ongoing. Ill fitting dentures left unchecked can lead to more rapid loss of ridge, making it more difficult for patients to wear dentures in later years.

                         Natural Teeth                                         Resorbtion - 10 years                                        Resorbtion - 30 years

     

                                                      Images with acknowledgement to www.mainstreetdenturist.com

 

 

 

 

 

 

RELINES:

A reline or rebase may resolve your problem. The requirement for relining occurs when bone and tissues change due to shrinkage.

Possible causes may be:

  • Post immediate dentures
  • Tooth loss
  • Weight loss
  • Bone loss in the upper or lower jaw
  • Sickness or disease
  • General physiological aging
The bite position, existing teeth and acrylic base(s) must be in good condition and not worn or stained to provide a reline procedure. An impression of your oral tissue is taken inside your denture(s) to provide a working model. New acrylic base material is added to your denture to fill up the space created by shrinkage to produce a correct fit. The appearance of your dentures will not change.

A Denturist is the ideal service provider for the relining of immediate dentures because one and the same person does the clinical and technical work. Likewise any adjustments that might be needed to the occlusal surfaces or muscle trimming and flange contours.  

REBASES:

Denturists in most cases have no way of trying the denture(s). The procedure is similar to relining. The difference being, that a rebase replaces all the pink-acrylic denture base material. The existing teeth remain in the exact same place. Reasons for rebase procedure:

  • Broken denture
  • Weakened or old pink denture base
  • Immediate denture

REPAIRS:

Dentures are made from specialized materials specially formulated for the purpose. Despite the addition of various fillers and ongoing research to improve the physical, aesthetical and microbiological properties of artificial acrylic dentures does not guarantee that they are unbreakable. When they slip out of your hand during cleaning procedures, a broken tooth or fracture often occurs. Repairs restore a fractured or damaged denture close to its original condition. Most denturists can provide denture repair procedures on a same day basis or sometimes even while you wait. Your denturist will advise you of the condition of your denture and the necessary steps needed in preventing further breakage.

 

Soft Liners:

If your denturist has meticulously adjusted your denture's fit and you are still unable to find comfort with your denture, you may want to consider a soft liner. Soft liners are a medical grade soft polymer material applied to the tissue-fitting surface of your hard denture base. Soft liners behave like a shock-absorbing cushion when you are chewing. Soft liners can be applied to new dentures, old dentures, relines and rebase situations. Over 20 years of research, advances and developments have been invested in quality soft liners. Increased comfort are acquired during chewing and daily wear. Clinical evidence indicates a high acceptance by patients. Based on patient home care cleaning, soft liners have an average lifespan of two to four years depending on your physiology. Soft liners are appropriate for:

 

Mouth Guards:

Image Source acknowledged to www.scheu-dental.com

People should wear a mouth guard whenever they are involved in an sport activity with a risk of falls or of head contact with other players or equipment. This includes rugby, soccer, baseball, basketball, hockey, boxing, skateboarding, even gymnastics. We usually think of hockey as the most dangerous sports for teeth, but a large percentage of sports-related mouth injuries in the USA also occur in basketball and baseball. When it comes to sports equipment, mouth guards are a priority. They protect not only the teeth, but the lips, cheeks, and tongue. They also help protect a person from concussions and jaw fractures. Athletic mouth guards are made of soft plastic. They are adapted to fit comfortably over the upper teeth

For sports people requiring dental protection on the field or court, a range of professional grade mouthguards and oral protectors are available, made from flexible polymer material. Custom made for each patient, you are able to choose from a range of mouthguards according to the sport you play and the level of protection you require. A range and combinations of colors can be chosen from, so you can even match your team uniform or wear your favorite color.

Any mouth guard is better than no mouth guard. However, it is important to choose a mouth guard that fits comfortably. If a mouth guard interferes with breathing or speech, or if it feels bulky, experience indicates that it won’t be worn by the athlete. The best way to ensure the proper protection, fit and comfort is to consult a Denturist. When not in use, all mouth guards should be stored in a plastic container to avoid damage due to excessive heat or cold. They should be washed after each use, using cold or lukewarm water. Hot water may cause distortion. Prior to insertion, a mouth guard may be rinsed in mouthwash to freshen the taste. As a general rule, it is recommended that a standard mouth guard be replaced every two to three years.

Whatever your age or sport, mouth guards are an important part of sports safety and your exercise routine. Participation in sport is a recommended healthy activity. Do what you can to protect your smile and preserve your health. Ensure that you have a properly fitted mouth guard made by a professional.

 

Sleep Apnea Appliances:

60% of all men and 40% of all woman over 60 snore. For some, snoring is no more than an occasional, inconvenient habit. However, chronic, heavy snoring can be more serious. Simple snoring can disturb others and cause a dry mouth or sore throat. Heavy snoring is often a symptom of sleep apnea, which can be associated with hypertension, stroke and other cardiopulmonary problems. Is someone snoring in your house? People with untreated sleep apnea stop breathing repeatedly during the night, often for a minute or longer. Snoring results from the vibration of the temporary relaxed muscles of the upper respiratory tracts. The soft parts of the palate and mucous membrane in the mouth throat area tremble. The tongue muscle which relax during sleep fall backwards and closes the throat - a breath standstill results.

WHAT ARE THE SIGNS OF SLEEP APNEA? 

SLEEP APNEA MAY CAUSE THE FOLLOWING 

Intra-oral appliances can achieve a 90% reduction in snoring and up to a 50% reduction in Sleep Apnoea; results that are scientifically proven. Rather like a sports mouthguard in appearance, Mandibular Advancement Devices sound complicated, but actually provide a very simple solution to the problem of snoring. These devices increase the airway space by holding your lower jaw slightly forward, so that air velocity reduces, and with it snoring caused by soft tissue vibration. If you suffer from snoring, these devices can help you to have better health, and a deeper, more restful sleep.

   

Image reproduction and text with acknowledgement to www.denturetech.co.nz 

A Denturist can fit you with an oral appliance specially designed to treat snoring and sleep apnea. Oral appliances are small and easy to wear. They weigh only a couple of ounces, which makes them easy to travel with. In addition, they are relatively inexpensive when compared to other alternatives such as surgery and other drastic procedures. Furthermore, oral appliances are non-invasive, and non-surgical. Internationally it is reported that the custom fitting of oral appliances by a specially trained Denturist is simple and painless. Imagine the convenience of having a local Denturist to serve your needs?

 

Tooth whitening:

Through the use of a custom-made delivery system and the latest in teeth-whitening technology, you can have whiter and brighter natural teeth. Teeth whitening is a simple and effective process that lightens discoloration of enamel and dentin. The system uses a peroxide-based gel retained in a custom-fitted appliance that is worn over your teeth. It can be used during the day or while you sleep. There are several causes for tooth discoloration, the most common being ageing, staining substances (coffee, tea, colas, tobacco ), trauma, tetracycline (antibiotic ) staining, excessive fluoride, and nerve degeneration.

Beauticians and novice health/vanity service providers are advertising on the web to make and provide devices for bleaching teeth. Any South African can mail order an American kit containing standard-shape trays (not fitting your mouth shape and size as well as custom made trays) or buy them from the local pharmacy. A dentist is a mandatory diagnostic gatekeeper in the possible delivery of these devices; yet, the unregulated cadres of international opportunists will circumvent common sense and State regulations because they can turn a profit. These techniques, devices, and chemicals could be potentially dangerous to fillings, tissues and decaying teeth, when used incorrectly. Greening of leaking amalgam fillings has been reported due to bleaching gels. No publications have been done to show the effects of these gels on decayed teeth or open pulps or untreated gum disease. As basic dental treatment becomes more exclusive these untreated conditions are becoming more common. Dental spokespersons have proposed that these kits should be controlled and not be admitted, unless accompanied by a dentist’s prescription, because of the potential threat of damage to sensitive oral tissue. The Society does not recommend the provision of this bleaching treatment in an unhealthy mouth. However, if the bleaching trays are supplied and customary manufactured for individual use by accredited denturists, they cannot do physical damage to the soft tissues of a healthy mouth, and are self-removable in the unlikely incident when it becomes uncomfortable.

Almost everyone with natural teeth can benefit from tooth whitening! However, there are cases where treatment may not be effective. A Denturist will determine if you are a viable candidate following a thorough examination. The tooth-whitening system is ideal for people who have healthy, unrestored teeth and would like to have a whiter, brighter smile. The whitening process is most effective on mildly discolored teeth. Darker stains, such as those caused by antibiotics, take longer to respond to treatment. The degree of whiteness will vary from person to person, depending on the structure of the teeth and how long the system is used. Results are usually seen following the first night. The best results generally occur when the process is continued for 10 to 14 nights. Teeth will always be lighter than they were. However, some patients may need periodic re-whitening for one or two nights, every four to six months.

 

Other/Incidental services:

Similar to all other members of health-associated professions, Denturists must practice safely, ethically and effectively for the promotion of oral-health and well being of the public. Apart from after-delivery services to assure good fit and denture satisfaction, Denturists also provide education to denture wearers on how to clean and care for their dentures and mouth cleaning-procedures. Similarly denture wearers need to understand the reaction of their oral tissues to new dentures, how to deal with denture related complications and how to accommodate allergic reactions. 

            

Competing professions have an obligation to the community by reinforcing and supporting all other Health professionals’ roles. The Denturist works independently with the denture wearer, and collaboratively with other health care providers where necessary or appropriate. This working relationship provides the development of mutual acceptance. Elsewhere positive assertive collaboration between Denturists and Dentists has proved to assure the oral well being of the public.

 

 

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