Saturday, 27 September 2014

How immediate are immediate dentures?

By Daniel Subbotin BSc, BA, DD

Immediate dentures are one of the most exciting and innovative dental techniques of the last century. Simply put, immediate denture is a dental procedure where a denture is created prior to removal of teeth and inserted immediate after teeth are extracted. This is a procedure with obvious advantages as well as some factors that must be considered.

Immediate partial dentures replace several but not all teeth in the patient’s mouth.  Complete immediate dentures replace all teeth.  To make the explanation comprehensive, immediate complete dentures can also be part of a dental treatment leading to a complete removable denture or implant treatment.

The most obvious advantage of immediate dentures is the availability of dentures immediately after “hopeless” teeth are extracted. In these cases, the ability to chew, swallow and speak is immediately restored. 

Any patients who are considering immediate dentures must also be presented with their inherent difficulties.  To begin, no adjustment period is available. Dentures are immediately introduced and may pose difficulties with eating, speaking or swallowing but a few post-operative adjustments can easily fix this.  Immediate dentures also occupy more space in the mouth than natural teeth.  Consequently, the new denture material now impacts tissues that did not previously have pressure on them.  

Introducing immediate dentures does not allow for bone shrinkage that occurs with time. Mouth changes necessitate significant denture adjustments and reline appointments that create additional costs.  In some cases, these changes will require subsequent new dentures.

The immediate denture process will typically consist of four stages.  These are initial evaluation, immediate denture fabrication, surgical procedure and denture delivery and maintenance. When implants are the ultimate denture solution, immediate dentures constitute the final prosthesis prior to implants.

Additional procedures may also be necessary when patient jawbones need to be adjusted for maximum denture comfort. Tissue conditioning or “soft reline” is the placement of a soft, temporary liner inside the denture while a “hard reline” consists of resurfacing the denture base with a new hard material.

Your immediate dentures will be composed of specially designed plastics or dental polymers. The gum portion or denture base is designed to resemble natural gum tissue and teeth are available in a number of colours.

Some patients will be ineligible for this type of treatment. These are usually those patients whose medical conditions will not tolerate oral surgery or have jaw anatomy that will not allow for this procedure. Additionally, patients with a “gag reflex” or dexterity problems will be excluded from immediate denture options. And only on rare occasions, patients with allergies to denture compound materials will require alternative treatments.

In those instances where patients are eligible for the immediate denture alternative, this is an excellent method for eliminating the disruption of normal lifestyles. Patients are able to eat, swallow, drink and talk without interruption. Many patients report minimal pain that is quickly dissipated.  Adaptation is immediate and often without significant challenges.

Whether immediate dentures are a permanent component of your denture program or part of a complete dental treatment, they should be carefully evaluated and understood.  Prepare for the convenience of your dentures becoming an instantly available addition to your everyday habits.  At the same time, you will need to prepare for the adjustments that will be necessary, the requirement for immediate adaptation and the possibility of discomfort.

Net gains are likely to outweigh the disadvantages.  With the assistance of a competent dentist and denturist and realistic expectations, it is very likely that you will determine that immediate dentures are an excellent solution to be embraced. 

You may well decide that the ability to eliminate the time that would ordinarily be required between teeth extraction and new dentures is well worth any disadvantages. Ultimately, your dental professional will make the decision as to eligibility.  But clearly, your smile, state of mind and overall disposition are priorities to the immediate denture option that are simply unavailable with any other alternative.

For more information about immediate dentures please feel free to contact EPICITI Mobile Dental Care. House call mobile denture clinic services are available for seniors in nursing homes, retirement homes and hospitals. Home care denture services are available for residents in Toronto and surrounding area, including Mississauga, Oakville, Burlington, Scarborough, Oshawa, Brampton, Markham, Richmond Hill, Aurora and Newmarket. Feel free to get in touch if you have any questions.

Wednesday, 10 September 2014

Let's help granny keep her teeth! Senior oral hygiene is key to care-giving.

By Daniel Subbotin BSc, BA, DD

Those who dedicate their time and energies to the responsibilities of caring for the senior population are acutely aware of the challenges inherent to those tasks. With advancing age, the senior population is faced with difficulties in such basic functions as mobility, eating, bathing, dressing and simply surviving.

One of the most important concerns, however, is often overlooked. Seniors who are frequently without dental insurance and opportunities to visit dental professionals are subject to numerous problems associated with inadequate dental care.

What are the causes for increased dental problems with the senior population?  Regrettably, they are numerous. Seniors are subject to effects associated with numerous medications that are administered for such conditions as diabetes, heart disease, stroke and Alzheimer’s.  Mouths change with age and nerves shrink as part of that aging process.

Very often, seniors will have no dental insurance to provide assistance. Mouth soreness can lead to inadequate nutrition and declining health. Dry mouth will often lead to cavities and gum disease. 

Most importantly, seniors very often have no transportation to dental professionals.  This is most recently mitigated by the availability of mobile dental care.  But the size of the problem and lack of financial assistance for seniors result in poor oral health leading to more serious health issues.

Caregivers can be instrumental in reducing the likelihood of periodontal disease, loss of teeth and untreated decay. With routine attention to dental hygiene, either at home or within a residential care facility, we can reduce seniors’ exposure to the numerous conditions frequently associated with aging.

Dry mouth is one of the most significant signs of compromised oral health. Over 400 prescribed medications have dry mouth as one of the side effects. This condition can be treated with simple solutions such as increased hydration, sucking on sugar-free hard candies or chewing sugar-free gum. Ice chips or popsicles can also improve seniors’ dry mouth discomfort.

Improving nutrition will also improve dental health. Be certain that seniors minimize intake of sodas, juices and energy drinks as well as sticky, sugary candies. Coffee and alcohol also contribute to dry mouth.

The solutions are both internal and external. With improved nutrition (substantial water, fruits and vegetables, lean proteins and low-fat dairy foods), we can substantially impact dental health. Various diseases have direct impact on dental health, especially in the cases of diabetes and heart disease, primarily because of the medications prescribed.  Introducing proper diet will make a terrific difference.

On the external side, it is important to make it possible for seniors to maintain routine care and have access to dental professional services. Whether it be in the home or care facility, seniors must have appropriate tools to contribute to dental health.

In those cases where seniors have mental faculties and are capable of understanding, gentle reminders of the need for routine brushing, flossing and rinsing will be powerful. Make certain that your senior has the toothbrush appropriate to natural teeth or dentures and the corresponding toothpaste or cleaner.

Flossing is always important and should be done after every meal.  Many seniors will benefit from a mouthwash as the final component of oral hygiene, particularly if it contains fluoride with its anti-bacterial effects.

The same rules apply for dementia patients but another level of care will be required. Show the senior how to brush by brushing your own teeth and having him or her imitate your actions. If the patient is incapable of the brushing process, do it for him or her, making certain to be firm but gentle with potentially sore teeth and gums.  Finish with a pleasant, good-tasting rinse that will punctuate the entire cleaning experience as an enjoyable one.

Our aging population is suffering from numerous hardships that include reduced income and mobility, compromised comprehension and a litany of undesirable health conditions.  Caregivers have an implied and specific imperative for attending to the complex dental issues that our seniors face.

Never lose sight of the dignity to which our elderly citizens are entitled. With clean teeth, a happy smile and a lack of dental pain, our seniors will benefit immeasurably from our having completed these important steps on their behalf.

To learn more about how you can help assist a senior with their oral health, or if you have any questions regarding the details of this article, please feel free to contact EPICITI Mobile Dental Care. They provide onsite mobile dental house call services to seniors in nursing homes, retirement homes, long-term care centres, hospitals, and private residences. Serviceable areas for mobile denture clinic services and house call mobile dental cleaning services include the Greater Toronto Area, Scarborough, Mississauga, Oakville, Burlington, Brampton, Aurora, Richmond Hill and Newmarket.