Extract Remaining Teeth for Dentures? 6 Facts to Help You Decide

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I have advanced tooth decay and gum disease. My two center front teeth are healthy, and after a visit with the periodontist, he says that those two teeth are likely the only ones he can save. I have a cheap bulky partial, and I have an underbite. My dentist thinks that removing the two teeth and getting a complete denture would be healthier than partial dentures. I got a second opinion, and the dentist said that he could do either option, and it’s up to me. I guess that a full denture would look better than a partial. I’m asking a couple of dentists online for their help. My budget is limited, and I’m concerned about that too. But I’ve learned my lesson about neglecting my teeth, so although I’m not too fond of debt, if I need a loan to correct the situation, I’ll apply for financing.  Is it best to have my center front teeth removed or to get partial dentures around them? Thanks. Timothy from Huntsville, AL

Timothy,

For an accurate diagnosis and treatment options, Dr. Brooksher would need to examine your teeth personally and do x-rays.  We’ll give some principles based on your description of your oral health. But we can give you some principles that might help.

Save Your Teeth or Extract Them for Dentures?

The factors below and talking with your dentist can help you decide if you want to keep your teeth or get full dentures.

1. It’s usually best to save healthy natural teeth

When your natural teeth are healthy and won’t compromise your oral health, it’s usually best to save them. Replacing teeth with a removable appliance—a partial or full denture—has many disadvantages. The denture can move or slide if it’s not anchored, and it won’t be comfortable.

2. When few teeth remain, they are under stress

If you only have two upper teeth that are healthy, the force from your lower teeth when you bite and chew puts stress on the upper teeth. Pressure on the teeth can weaken them internally, even if they appear healthy on the outside.

3. A full upper denture increases comfort

Suction keeps a full upper denture in place, and it moves less than a lower denture. It’s more comfortable than a partial denture, and it’s easier to eat and chew with it.

4. A well-made upper denture is healthy for other teeth

A well-made upper removable denture is gentle on lower teeth. If you have a severe underbite, the force or impact of chewing can put stress on lower teeth.

5. When all your teeth are missing, your jawbone is affected

Teeth stimulate the jawbone, so when all your teeth are missing, the stimulation stops, and your body resorbs the bone. After 10 to 20 years, you’ll lack enough jawbone to support your facial muscles, and your face will sag and make you look older. The missing bone will make it difficult—if not impossible—to keep a lower denture in place. But you will still have some suction for an upper denture.

6. Implant-supported dentures increase function and comfort

Diagram of a snap-on denture. The denture is hovering above the jawbone that has two dental implants in it.

Affordable dental implants will secure your dentures

Your dentist can tell you if you’re a candidate for an implant-supported partial denture or an implant-supported denture. Either option might exceed your budget, but implants stimulate your jawbone to prevent further shrinkage. Your denture won’t slip around, and it will be comfortable to eat and speak with it.

Again, Dr. Brooksher hasn’t completed your oral exam or seen your x-rays, so you’ll have to rely on a local dentist for accurate diagnosis and treatment options.

Steven Brooksher, DDS of Baton Rouge sponsors this post. Dr. Brooksher is an accredited cosmetic dentist and a fellow of the International Congress of Oral Implantologists.

Unsure If You Need Root Canal Treatment? – 4 Clues from the X-ray

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In April 2019, I received a filling in a tooth, and now my new dentist is recommending root canal treatment. I relocated, and in January of this year, I went to a new dentist for my yearly cleaning and exam. I also received x-rays, and the dentist said that the x-ray seems to show some decay beneath the April 2019 filling. She recommended root canal treatment, which I declined at the time. Now that I have time to think about the tooth, which isn’t bothering me, I want to get an online second opinion. If there is decay, I don’t want it to get worse and end up needing an extraction and dental implant. – Thanks, Segura from San Antonio

Segura,

X-ray of an invisor tooth with a filling and a dark spot beneath it

Although there is a dark area near the fillng, the tooth doesn’t need root canal treatment, an extraction, or a dental implant

Thanks for sending us a copy of your x-ray. Maybe dental schools need to give more training in x-ray diagnostics. Although Dr. Brooksher would need to examine your tooth, your x-ray doesn’t show inflammation or any reason that a dentist would disturb it with root canal treatment. But what about the dark area beneath the filling?

Facts About a Dark Area Beneath a Filling

  1. Dark areas – Not all dark areas on a tooth x-ray are a result of tooth decay. Decay, a gap in the filling, or a radiolucent material beneath the filling will appear dark on the x-ray.
  2. Location of darkness – The dark area on your x-ray is on the surface of your tooth. In this case, your dentist can use an explorer and poke the area. If it’s soft, there is decay.
  3. Effect on tooth pulp – Tooth pulp includes the living tissue and nerves inside the tooth. Root canal treatment removes infected pulp. When the dark area on your x-ray isn’t near the pulp, you don’t need root canal treatment. On an x-ray, it might seem that the dark area is between the filling and tooth pulp. You can resolve the illusion while looking at the x-ray: Cover the white filling with your finger and look at the remaining tooth structure. You can see the dark area and the distance from the pulp.
  4. Comparison with adjacent tooth – The lamina dura is a thin white line around the tooth root. An infection will break the line around the root tip or pull it away from the tooth. Look at the x-ray on this page. The tooth with the filling, and the canine tooth next to it, has a lamina dura that intact. Both teeth are healthy. You won’t need root canal treatment. And you surely don’t need an extraction and dental implant.

If you still have reservations about the health of your tooth, consider scheduling an appointment for a second opinion. You can take your x-ray with you for a dentist to examine it in person.

 

Steven Brooksher, DDS practices in Baton Rouge, LA. Dr. Brooksher is one of ten dentists in Louisiana accredited by the American Academy of Cosmetic Dentistry.

3 Secrets for a Successful Smile Makeover Even Without Digital Design

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Digital smile makeovers are becoming increasingly popular. It’s exciting to see a digital version of your current smile as it’s progressively becoming exactly what you’ve envisioned. But what if your dentist doesn’t offer digital smile makeovers? How do you know what to expect?

Advanced cosmetic dentists have created beautiful smiles for decades—even without digital smile technology. Did you know? –  Even if a dentist uses digital technology, there are specific steps advanced cosmetic dentists take to achieve a predictable outcome and a smile makeover you’ll gladly show off.

Secrets of a Success Smile Makeover

Your feedback, the opportunity to wear a temporary version of your new smile, and a final try-in are crucial factors to being confident about your smile makeover. Here’s why.

1. Your Feedback

An advanced cosmetic dentist isn’t simply concerned about giving you a beautiful smile makeover. He or she personalizes your smile so well that it looks like it’s always belonged to you. Throughout the process, your cosmetic dentist will carefully listen as you describe your ideal smile, and he or she will ensure the details are there.

2. Trial Smile Makeover

Skilled cosmetic dentists make a wax model of your new smile design.

  • You’ll snap it in over your teeth as a preview of your smile makeover.
  • You’ll be able to examine it closely and let friends and family see it.
  • If you want changes to the way it looks or feels, your dentist will make the changes to align with the smile you envisioned.

This phase is not complete without your approval. When you give your dentist the okay, your permanent smile makeover will be crafted by a master ceramist.

3. It’s Final When You Say So

Your dentist will temporarily attach your final smile makeover to your teeth. This is another opportunity for you to smile with approval or to explain any hesitation you have. If you’ve chosen a dentist who is an artist, the smile design is only acceptable to your dentist if you also love it.

Smile Makeover Satisfaction with or without a Virtual Model

Even if your dentist offers virtual or digital smile makeovers, your feedback, the trial smile, and a final try-in are phases that must be included to ensure you get the smile you love. If you’re left out of the process, you’ll likely end up with a smile that you’ll want to leave behind in the office. And that’s a waste of time and money.

Before-and-after smile makeover patient photos from Dentistry by Brooksher in Baton Rouge, LA.

Dr. Brooksher gave this patient a smile makeover that is healthy and natural-looking

Accredited cosmetic dentists consistently provide stunning smile makeovers. Are there accredited cosmetic dentists in your area or within driving distance?

  • Visit their websites
  • Check their credentials and accomplishments
  • Look at their smile gallery of actual patient photos

Select your dentist carefully—digital design or not—and you’ll get a smile makeover you love.

Steven Brooksher, DDS, an accredited cosmetic dentist in Baton Rouge, LA, sponsors this post.

4 Gummy-Smile Makeover Options that Get Stunning Results

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Have your gums taken over your teeth and your smile? A smile makeover can make a life-changing difference that boosts your confidence. But the options for beautifully transforming your smile require the skill and talent of an artistic cosmetic dentist.

Treatment Options for Your Smile Makeover

Gum Contouring

Expert cosmetic dentists use gingivectomy, or a gum lift, to remove excess gum tissue around your teeth. Removing the tissue will make your teeth look longer.

  • No needles or scalpels are involved.
  • Your cosmetic dentist provides painless treatment with a laser that gently removes excess gum tissue.
  • Sometimes additional cosmetic work is needed to lengthen tooth structure and complete your smile makeover.

Porcelain Veneers

Your cosmetic dentist may need to prepare your teeth before giving you a smile makeover with porcelain veneers, by removing a small amount of enamel (0.05 mm or less) from each tooth. Your dentist may also remove some of the bone beneath the gums. He or she will position porcelain veneers over the fronts of your teeth to make them look longer but natural.

Dental Crowns

Dr. Brooksher used gum contouring and dental crowns for this smile makeover.

Depending on your case, your cosmetic dentist might recommend crowns to lengthen your teeth. He or she must taper the entire tooth for a crown to fit over it properly without affecting your bite. Your dentist will explain what you can expect with crowns versus veneers.

Orthodontics

In some cases, your cosmetic dentist will recommend orthodontic treatment to level your teeth and provide a smile makeover that highlights your teeth—not your gums. What can you expect?

  • Your dentist or orthodontist will provide a treatment plan to move your teeth upward, which will also move your gums upward.
  • The vertical position of your teeth will allow your upper lips to hide your gums.
  • Less gum tissue will show when you smile.

Which Option Is Right for You?

You should entrust your smile makeover only to an advanced cosmetic dentist. Look for a nearby accredited cosmetic dentist and schedule a consultation. He or she will examine your teeth and gums and explain your options for saying goodbye to your gummy smile.

Steven Brooksher, DDS, an accredited cosmetic dentist in Baton Rouge, LA, sponsors this post.

5 Facts About Porcelain Veneers and Teeth Grinding

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Bruxism (teeth grinding) can wear down and fracture natural teeth. So if you’re thinking about getting porcelain veneers, there is reason for concern because teeth grinding can fracture veneers.

It’s understandable that you’re interested in porcelain veneers. They are the most natural-looking way to restore teeth that are chipped, discolored, or misaligned. Porcelain mimics the characteristics of natural teeth. But porcelain veneers are costly, and you need to protect your investment in them. So before you ask a dentist for them, there are a few facts to know about veneers and teeth grinding.

1. The Stats

A 2017 study published on the U.S. National Library of Medicine – National Institutes of Health website reveals the following about porcelain veneers and patients with bruxism:

  • Fractures – Fractures in porcelain veneers are more common in patients with bruxism.
  • Debonding – There is a higher incidence in the debonding (loosening or falling off) of porcelain veneers for patients who grind their teeth.
  • Splints/mouthguards – Mouthguards increase the success of porcelain veneers for patients with bruxism. If you grind your teeth but do not wear a mouthguard, your veneers will be eight times more likely to fracture.

2. What’s Causing Your Teeth Grinding?

Before you receive porcelain veneers, your cosmetic dentist will try to determine the cause of your teeth grinding. Treatment can include a custom mouthguard to wear at night or relaxation techniques to reduce stress. Some causes of bruxism include:

  • Stress or anxiety
  • Sleep apnea
  • Misalignment (malocclusion)
  • Certain medical conditions or prescription medications

3. The Exam

Before you receive porcelain veneers, an examination is required. Why?

  • Your teeth and gums will first be examined to determine if they are healthy enough for you to receive porcelain veneers.
  • Teeth that are already damaged by bruxism need to be restored.
  • Your dentist will need to determine if you need treatment for TMJ (temporomandibular joint) disorder.
  • Exercises might be needed to help you restore proper TMJ function and relieve pain or discomfort from the disorder.
  • A custom mouthguard will be recommended to protect your investment in porcelain veneers and prevent fractures.

4. High-Strength Materials Can Help

There are different brands and strengths of porcelain veneers. And a highly skilled cosmetic dentist can determine if high-strength porcelain is right for your case and will achieve the results you desire.

5. Alternatives

Depending on the condition of your teeth and the results you want to achieve, your dentist might recommend alternatives, such as ceramic crowns. If you select an experienced cosmetic dentist, he or she will let you know what to expect with each option.

What’s Next?

We suggest that you schedule consultations for porcelain veneers with at least two different cosmetic dentists. Look for accredited cosmetic dentists in your area, or choose dentists with advanced training and experience in cosmetic dentistry. Check each dentist’s website to learn about his or her training.

Although you grind your teeth, your cosmetic dentist will help you determine if porcelain veneers are the right solution for enhancing your smile. If an alternative treatment is needed, a cosmetic dentist will still provide great results.

Below are photos of one of Dr. Brooksher’s patients. They show how porcelain veneers can beautifully transform your smile.

  • Before porcelain veneers photo of a female patient's smile. Teeth are uneven and the center teeth have a triangle between them.
    BEFORE
  • After porcelain veneers photo of a female patient's smile. Her teeth have been whitened, lengthened, and spaces between them were removed.
    AFTER

This post is sponsored by Baton Rouge award-winning cosmetic dentist Dr. Steven Brooksher.

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