Does It Make Sense to Keep Weak Teeth and Get a Partial Denture?

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Face of a woman relaxed during dental treatment for information on sedation dentistry from Dr. Brooksher of Baton RougeMy dentist told me that I needed a five-unit bridge in early February. I asked for a partial denture, but my dentist says I have so much bone loss that a partial denture would put too much pressure on the teeth for the partial to hook onto them. The teeth are weak from gum disease. The cost estimate for the bridge is $5600. I think it’s easier to get all my teeth extracted and get a complete set of dentures. Does it make sense to keep weak teeth?  – Dwight from Kansas City, MO

Dwight,

Dr. Brooksher would need to examine your teeth, digital x-rays, and dental records to give you an accurate diagnosis. But we can say that if most of your remaining teeth are healthy, you should not ask a dentist to extract all your teeth in exchange for complete removable dentures. It will create more problems that will affect your quality of life.

Dental Bridge or Removable Partial Denture?

How do a dental bridge and a removable partial denture compare? We will explain and briefly discuss an alternative.

Dental bridge

The cost your dentist quoted you for a dental bridge is reasonable. But we are not sure why he suggests a dental bridge instead of a removable partial denture. A dental bridge requires your dentist to shave down the teeth that anchor the denture. Shaving your teeth down and using them as anchors for a bridge will further weaken them.

Removable partial denture

A removable partial denture attaches to the tooth on either side of the missing one. The clasp can be metal or gum colored.

Implant-supported bridge

If your teeth are weak and in danger of declining, an implant-supported bridge may be an option for replacing your missing teeth and anchoring a dental bridge. Dental implants would support the ends of the bridge with replacement teeth in the middle. Speak with your dentist about this option.

Treat Gum Disease Before Restoring Teeth

If you are still battling gum disease and bone loss, your dentist needs to treat your gum disease and ensure it is stable before restoring your teeth. You may also need a bone graft to build up bone and protect your oral health.

Get a Second Opinion

We recommend that you see another dentist for a second opinion. Bring your dental records with you so the dentist can use them to give you an accurate diagnosis and treatment. Also, speak with the dentist about options for relieving your anxiety during the procedure.

Dr. Steven Brooker, a Baton Rouge Fellow of implant dentistry, sponsors this post. Dr. Brooksher is accredited by the International Congress of Oral Implantologists.

My Dental Crown Feels Weird When I Chew

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My dentist placed a crown on an upper left molar three weeks ago. The tooth touches the opposite bottom molar tooth when I chew, but it feels off. I think the crown needs deeper grooves so the other tooth will match it when I chew. If I ask my dentist to drill down some of the crown’s surface, will it damage it? Although I will need laughing gas or another sedation to cope with my anxiety and get through this, I want it resolved. I already told my dentist about the discomfort, and she said that I need time to get used to my bite. How long will that take? Thanks. Randall from Memphis

Randall,

Your dentist’s request to give your concerns more time means that she does not know what to do. Brooksher would need to examine your tooth and crown to determine what is causing the disharmony when you chew. But the situation could be challenging to correct, or your dentist’s lack of knowledge might be the problem.

Your bite should be perfectly comfortable when you receive a new crown or onlay. But the motions involved in chewing make the occlusion—how the upper and lower teeth fit together—complex. And many dentists lack the training and skill to resolve the issue.

Post-graduate institutes, including the Las Vegas Institute for Advanced Dental Studies, the Texas Center for Occlusal Studies, the Dawson Academy, the Pankey Institute, and others, train dentists in the science of occlusion. Many cosmetic dentists attend the institutes or receive courses from other organizations that teach the same principles. Still, many other dentists feel that basic dental school education is enough, and they do not need occlusion training. Although dentists who bypass additional training might complete single crowns or onlays, they may not be qualified to complete a full-mouth reconstruction with a balanced bite. So, as a patient, a dentist may tell you that it takes time to get used to your bite.

What Is Malocclusion and What Problems Can It Cause?

Malocclusion is the term for disharmony in how your upper and lower teeth line up. The shape, size, or position of your jaw or teeth may cause malocclusion, or misaligned teeth. The shape and size of a dental crown can affect your bite. Although you might adjust to how your bite feels, it does not mean it is aligned correctly. And malocclusion can lead to other issues.

  • Unusual stress on teeth – The stress can lead to bone loss around the affected teeth.
  • TMJ disorder – You might experience symptoms or signs related to TMJ, including jaw, facial, or neck pain, and headaches or earaches.

Face of a woman relaxed during dental treatment for information on sedation dentistry from Dr. Brooksher of Baton RougeMany dentists adjust a new crown or onlay by asking you to bite on bite registration paper. The paper leaves marks where the crown or onlay makes contact prematurely. The dentist will grind down the crown in those places. Your dentist has completed that essential step, and your crown is not high.

The issue with your bite is more subtle. But a dentist—perhaps not your dentist—can adjust the crown to make it comfortable without damaging it. If your dentist does not know how to correct it, you can wait a few months to see if the tooth begins to feel better with your bite. Or you can get a second opinion from an advanced cosmetic dentist. Look on a few dentists’ websites for information about post-graduate training in occlusion from one of the institutes mentioned on this page. You can talk to the dentist about your anxiety and discuss sedation options during your consultation.

Baton Rouge dentist Dr. Steven Brooksher sponsors this post.