I really surprised by the number of patients asking this question especially that we make tooth caps to strength and support teeth. Before we start our discussion about this question we have to know first what is teeth caps and the indications of using it.

Teeth caps and dental bridges are artificial porcelain or metal  covers that covers the tooth crown. As we said it is usually made of metals or special ceramics with a thickness ranging from 0.75 mm- 2 mm. It is usually indicated in case of very extensive caries that destructing most of the tooth crown(so using fillings only won’t be enough ) or after root canal as the tooth becomes really fragile. On the other hand teeth bridges are false teeth that used to replace extracted tooth.

Before manufacturing a tooth cap or dental bridge the dentist have to grind the tooth or simply remove a thin layer from the  natural crown to allow a space for the artificial tooth cap, The tooth reduction should be exactly to the same thickness of the cap (1-2 mm as we said before) or the tooth will become very bulky and may interfere with the normal occlusion. This tooth reduction is the cause that some patients think that their natural tooth is weakened. But this is completely wrong as we will discuss later.

In case of badly destructed teeth with a very large filling the tooth is already weakened and there is a very high incidence of filling fracture or falling,  so covering the fragile tooth with a metallic cover will prevent crown fracture for sure.

In case of  root canal treated tooth the tooth usually  have a very large filling,  and also the tooth becomes very fragile after root canal treatment due to dehydration and loos of nutrition. So covering the tooth with a strong tooth cap will be a very good choice.

Also we have to say that most of the materials we use to fabricate tooth caps are usually stronger that the natural tooth material . This is not meaning that we like to grind the natural enamel for no reason but if the case is indicated and the crown in fabricated properly there will be no harm but there will be an added protection to the weakened tooth.

In case of dental bridge the decision making is a little more harder as the teeth we grind is healthy and may be completely sound,  We just want to grind it because we want to replace the neighboring extracted tooth. So the idea of grinding healthy teeth is annoying to many patients.  And as a dentist i have to say that if you can afford dental implants you should use it instead of bridges as the neighboring teeth is not affected. But the problem that many patients won’t afford the high coast of the implants . So if you left the empty space untreated you will start to avoid the side of extraction in chewing which will result tartar accumulation and gum problems that may lead to more extraction in the non-functional side. So it will be much better to restore the lost tooth with bridge rather than leaving it untreated.

My final advice :if you can afford dental implants it will be the perfect choice but if you can’t so go ahead and have a dental bridge it will be great.

hello,

This is my first post about dental implants (or teeth implants like patients like to call) so you can consider it as introduction till i prepare a deeper articles.

We can consider these days as the era of dental implants in dentistry. And i have to say that it really deserve it’s reputation as dental implants really offered a solution to replace extracted teeth that was beyond our imagination. As a result of the proved  success of this technology many researchers are trying to get the best from it and today it is almost used in almost all the aspects of dental treatment. Some times  it is used to support orthodontic appliances , Fix loose dentures, Replaces single  extracted tooth or even support a dental bridge .

Teeth implants in the most simple form is an porcelain  artificial or false teeth that is supported and fixed in place by a titanium post that is screwed to the jaw bones.  The word screwing may be not scientific as bone is a living tissue not just a piece of metal so it have to be integrated with the new artificial post not to refuse it which will lead to case failure. So a different materials tried to favor the bone healing and integration around the implant and titanium is proved to be the best. Also a specific surface treatment is done in order to maximize the bi compatibility, retention and mechanical load distribution over the surface.

So who can get benefit from teeth implants simply any patient who lost one or more of his teeth. Single extracted tooth, multiple neighboring extracted teeth or even completely edentulus patient as we mentioned before teeth implants can be used to fix complete dentures .

Like any medical treatment teeth implants are contraindicated in some cases. I will mention some of the relative contraindications of using dental implants here AND take care that i say relative as there is many difference in scientific research results concerning this issue and also the list of contraindication become shorter  every day as the research continue.

first thing  some times the bone diameters like height or width is not enough to host the appropriate size post usually this happens as a result of delaying for years after extraction. Also sometimes a vital structures like nasal cavity, nasal sinus ao important nerves lying in the place that suppose to carry the implant. For sure the problems we mentioned here can be corrected efficiently with surgical repair, bone grafting or sinus lifting surgery but the coast will jump here a lot.

Also any general condition that affects bone healing will diminish the success of the cases or even prevent the surgeon from even thinking in using teeth implants like osteoporosis, uncontrolled diabetes heavy smoking history of radio or chemo therapy and even very bad oral hygiene without a strong motor to change.

last thing is the coast factor as many patients can’t afford it’s high coast and try to choose more affordable  solutions .

bye bye, come later to read more

dr ahmed galal

practicing dentist

Most patients with new dentures expect too much. They expect from the dentist to offer a denture that as comfortable and functional as their lost natural teeth and this is simply impossible in most cases.

Coping with new dentures :

1-You have to know that wearing new denture is difficult in the beginning and you will need time to get used to wearing it so relax we are not in a hurry and you can accommodate to it  gradually. You should also know that many patients spend a horrible time in the beginning and they think that they will never be able to wear it then gradually use their dentures perfectly.

2-If you have no problems in wearing your new denture you should wear it as much as possible, but if you have problems like gagging you can start first with one jaw only until you used to it  then wear the two jaws  and increase the wearing time day after day.

3-You shouldn’t wear your denture at night keep it in a water glass or denture storing solutions.

4-How to eat with your new denture:

• At the beginning you should cut food into small pieces.
• Also you should chew your food on both sides in the same time this will help you to stabilize the denture in the beginning.
• Try to avoid hard food that needs an effort to chew till you get used to your denture.
• also sticky food food should be avoided till you become an expert.

5-Looseness of new dentures:

at first dentures can be loose a little until the patient adapt it. Also dentures usually need 10-30 minutes to become fixed when first inserted. Normally looseness will be disappeared gradually if the denture is manufactured properly

6-Cleaning new dentures: food debris sometimes accumulated under the denture or even if no food debris is accumulated the denture should be cleaned at least twice daily to be sure that there is no plaque or bacteria is adhering to the denture.

there is so many denture cleaners available and we will discuss this subject later in a separate post but at least dental brush and tooth paste should be used till you buy denture cleaner.

7-Discomfort, pain or ulcers:

it is quite normal that patient will feel discomfort in the few days after wearing new dentures . If the symptoms don’t relieve in a few days you should see your dentist.if you have ulcers or wounds stop wearing your denture and see your dentist directly.

Denture adhesives refer to a category of commercial products that used to increase the retention and stability of  different types of complete dentures. Denture adhesives are usually introduced in the form of powder, glow or adhesive  tapes.

Denture stability  is the first requirement needed to gain the patient satisfaction, No one wants to wear a denture that is not fixed in place or even fall during speaking or eating, It can be really embarrassing and can lead to denture phobia.

Dentures don’t need adhesives  if the patient has enough ridge height and healthy salivation . But sometimes the patient spend much time eating on he toothless ridge which may cause ridge bone  loss. Also there are many other causes  that can prevent  denture stability, In these cases may be you will need the assistance of denture adhesives.

Denture adhesives types and forms :

Denture adhesive  is a bio-compatible glow that used to keep the denture in place during function. There are many types and forms available today like powder, paste and tape.

So what is the best type for you??

Lets say that we can not favor one of the previous forms for every case,  it depends on the case. Some people like the paste form as it gives a good retention while the others hate it because the excess paste is spilled in the mouth and need to be cleaned. Many patients like the powder form as the excess powder is not a  problem because it is very easy to be cleaned, But we have to mention that some patients find it “Not retentive enough”.

So you should try some of the available brands until you discover the one that can give you the best results,  sure consulting your dentist will shorten the road.

Do i need denture adhesives:

First we have to concentrate on a very important point “Adhesives are not the solution for ill fitted rocking denture “.  It is very important for you to know that adhesives should only be used with properly manufactured, good fitting  and non rocking dentures. If you have a new denture and it is not fitting, rocking or cause sores and ulcers then you should  see your dentist quickly to fix it. If you neglected the problem and tried to use adhesives the jaw bone will shrink  which will be very hard for the dentist to repair and sometimes you will need to make a new denture that can be worse than the first one.

What if you have an old denture that was retentive and stable then after 2-5 years  it becomes loose, falling or rock during speaking or eating. Unfortunately denture adhesives are not the solution here this old denture needs what we call “relining”. Relining is needed when the dimension of the jaw bone under the denture shrinks  as a response to the mastication force falling on it.  In this case you have to see your dentist to take a new impression  to add a thin layer compensating the lost bone.

So it is indicated to use adhesives only when you have a properly manufactured denture, that accurately fits your gum but has a bad retention due to insufficient height of ridge bone or insufficient salivation.

Some times the denture is  fixed in place but you just need more confidence that it will not fall during speaking or eating. This fear is common among new denture wearers so it is OK to use it but you have to concentrate more in training your self to stabilize the denture in place as the muscles coordination has a great role in denture fixation.

How to use denture adhesives:

1-First clean your denture with tooth brush or denture brush.

2- If you will use powder adhesive keep the fitting surface a little wet then shake the powder container lightly to spread the powder to the fitting surface then wear your denture. Don’t eat for the next 15-30 min.

In case of paste adhesive apply a separate pea sized pieces  from the tube to the fitting surface and keep the adhesive away from the denture base periphery not  to expel the excess in your mouth. Then put the denture in place. Using too much adhesive won’t be useful and will be hard to clean .

With the tape adhesive you will just adheres the tape to the denture base and put it in your mouth after customizing it and cutting the excess.

Generally use the least amount of the adhesive first then gradually increase the amount every day till you reach the best sufficient amount needed to stabilize your denture.

Some adhesives may cause some kind of allergy that is usually presented as gum burning or redness,  in that case stop using it and call your dentist to prescribe you a different brand .

There are many denture adhesive brands  in the market. Cushion grip, Equate Firm grip, Super poli grip, Fixodent, Sea bond and Ends lip. The selection is yours you can use any of them according to your preference. The prices range from 3$ to 25&.

Many dental patients asking about the cheapest type of false teeth to replace an extracted teeth. Lets say that the good academic replacements available are porcelain bridges, Metal + porcelain tooth caps, Full metallic bridges, metal based partial denture and acrylic based temporarily partial dentures. I ordered the solutions available from expensive to cheap.

So the cheapest type of false teeth is full acrylic partial denture. This type is considered temporary academically and in many countries it is un legal to introduce it to the patient as permanent solution. But many patients allover the world even in developed countries use it as permanent prosthetic because it is far cheaper than bridges or metal based partials.

This type of dentures can be functional and perform well on the short term (year or two) but on the long run after years the troubles begin. The problem in this type of false teeth that it concentrate all the force of mastication on the gums covering the place of the extracted tooth and the underlying jaw bone. In case of the more expensive metal based partial dentures the force of mastication is distributed between the gums and the remaining neighboring natural teeth. Something called occlusal rest is used to support or hang the denture partially on teeth during function.

This distribution of force is very important to the long run durability of the partial denture. When the mastication force fall on the jaw bone the bone shrink or resorp as response to stress, By the time after two or three years the bone in the extracted tooth place become concave which will make the construction of bridge very hard because the false teeth will be very long to accommodate the bone concavity.

So it will be better if can pay to more money to avoid this poor type of partial dentures. But if you cant afford the expensive alternatives like metal based partial denture then it will be a good decision to make a cheap temporally full acrylic denture to conserve the lost tooth space till you can pay for permanent solution.

False teeth is a common term used by patients to describe any type of artificial teeth that used to replace a extracted or missed natural tooth. Unfortunately false teeth is not scientific term and it is not describing a definite type of treatment. So the aim of this article is to describe the different types of false teeth, Advantages and disadvantaged of each also which type  is fit best with your needs. So when you search the internet or speak with your dentist you can be more specific in exactly what type  you mean.

Scientifically artificial (or false teeth)  teeth are classified to these categories:

1-Crown(cap) and bridges

2-partial dentures

3-complete dentures

4-Teeth implants

we will discuss each type of false teeth in details

1- complete dentures:

Complete dentures is the form of false teeth that used when the patient had a completely teeth free ( edentulous ) jaw ( upper or lower ).  It is composed of a plate of plastic ( polymer ) or metal. That is accurately fitting the edentulous jaw surface .Mounted on this base a complete set of teeth that made of plastic,  cross linked resin or even porcelain.  Its retention in place is based on the suction between the base plastic or metal plate and the mucosa (mouth mucosa is like the skin in the rest of the body) covering the edentulous jaw bone (like the suction rubber piece that used to hang thing on a glass wall). The success of the denture depend basically on the surface area of the mucosa covering the jaw bone because when there is a large area of healthy mucosa the denture will be more retentive and also the mastication force will be fragmented over a large area which will make the denture live longer without the need to make adjustments.

How will your dentist fabricate your denture false teeth:

first the dentist have to examine you very carefully, extract any remaining teeth or roots .

Then the dentist will make what we call impression may be one or two impressions for each jaw. Impression aim is to fabricate a accurate hard model of the area that will be covered with the denture to start fabricating the denture false teeth on that hard model. The dentist will put a doughy material in your mouth after minute this doughy material will be transformed  to rubber like form that will act as a template to cast a model on later. sometimes we need another impression with a different material to get accurate results. (1-2 visits)

Later the dentist will register the relation between upper and lower jaws by ordering you to bite on wax blocks fitted on a temporary base plate. or using an appliance called facebow  .(1 visit)

Then you will try the temporary base plate  with the teeth on it.(1 visit )

If the try in was ok you will deliver your denture  in the next visit.

Advantages, disadvantages and options of dentures:

Speaking about advantages and disadvantages of complete denture  is really wasting of time. If you have edentulous jaw then you have to make a denture (unless you are really wealthy and will make a full mouth implants )  or your stomach will be affected by digesting a hard food.  Other choice is very very expensive because you will have to make a full mouth implants witch will coast you a fortune and i don’t think that any insurance company will cover it.

There is also a modified type of denture false teeth that can be really great and function far bitter than the ordinary dentures. It called the implant supported full dentures, In this case we fix the denture to titanium fixtures (posts) that is implanted inside the jaw bones.  The fixation between the denture and the fixture is in the form of pall and socket or any other way of fixation that allow the removal and  replacement of the denture so you can clean the false teeth wash your mouth perfectly and putting the denture back again. This type of dentures is much more retentive than the ordinary dentures but also it is much more expensive simply you pay for extra 4 implants at least.

Materials used to fabricate dentures :

denture base:

is usually fabricated using different types of resin polymers that vary in strength or quality depending on the coast you pay. Also some dentists prefer the use of metallic denture base because it is stronger ,cleaner and if fabricated properly can be more retentive . metallic denture base coast more than plastic ones.

denture  teeth:

teeth are usually made of resins that differ in abrasion resistance, strength and aesthetic  according to the coast the cheap false teeth is abraded by time which cause the denture not to masticate food properly also look bad and unnatural.

sometimes we use porcelain teeth for the sake of aesthetics and durability. But we have to say that it also heavy, produce unpleasant sound  when hit each others and also very expensive.

How to clean and take care of denture false teeth:

1-brush your denture with tooth paste and tooth brush 2-3 times daily

2-If any food came under the denture remove the denture and clean any food remnants to keep your gums healthy.

3-Use specific denture cleaners every 2 days to clean, disinfect and remove the stains from the denture(we use GSK polident eff. tablets here in Egypt ). All you have to do is to put the denture in glass of water and put one cleaning tablet into the water the water will start to bubble and you can take your false teeth after 3 min .

4-After using the denture for a period of time ranging from 1 year to 8-10 years the denture will become loose and will need to be relined by the dentist to maintain its retention. Once you feel that the denture is not fixed and become loose go directly to your dentist and fix it ant delay can cause gum wounds ,discomfort or even bone resorption   that will cause the fixation harder.

5-don’t sleep with your denture you should store it in water or any specialized denture saline overnight till the morning. If you left the denture to dry this will make it cracked and loose its strength.

2- removable partial dentures:

The partial denture is a form of false teeth similar to the complete denture that we explained above. The difference is that the partial denture is used when the patient has remaining healthy teeth along with extracted teeth edentulous spaces. We just add false teeth in the edentulous places and create an openings in the denture base in the places where the natural teeth present.  This type of dentures retention is depending on metallic clasps that present on the healthy teeth which retain the denture in place during function. we use metallic base for this type of false teeth dentures except in the very economic type that have a acrylic base.

How will your dentist fabricate your partial denture false teeth:

The process is similar to the fabrication of the complete denture that we explained above. The only difference is that the dentist sometimes need to make some preparations in the existing natural teeth so the denture can come in place without interference from the natural teeth. Also we have to say that this type of dentures is more retentive and function bitter  than the full dentures so if you can survive 4-5 teeth in each jaw to retain a partial denture it is much more bitter.

Advantages, disadvantages and options of removable partial  denture :

If you have an edentulous space  that extend to the end of the jaw posteriorly or in other words when you have an extracted tooth or teeth with no molars behind them the partial dentures will be the best economic option you have. If you can pay more money you can make implant to restore the extracted teeth but making fixed bridges will not be possible in this case. The bridge should GENERALLY be fixed from both sides. There are types of bridges that can be fixed from one side using non rigid fixation or what we call semi rigid fixation  but this type will coast more and it is not good for every case.

What if you have natural teeth present behind the edentulous space here you got many options that i can list fixed bridges, implants and partial dentures, so how can you choose between them?? If i want to restore an extracted tooth for my self i would prefer implant because the neighboring teeth won’t be reduced and i don’t have the burden of removing and cleaning a partial denture false teeth , if i cant pay for implant or don’t like the surgery solutions then good looking porcelain fixed bridge can be a satisfactory solution for me here after a short period you won’t feel that it is a false teeth you will just feel like your teeth. The only disadvantage of the fixed bridge solution is that the neighboring teeth have to be trimmed ( about 1-2 mm from each side) with the risk of harming one of them.

What if can’t pay even for the bridge, I don’t want my healthy neighboring teeth to be trimmed or i don’t like the dentist working for a long time inside my mouth then  the last good solution is making a partial denture. It is cheap, no reduction of teeth,no surgery and also function well and can be good looking.

We also have to say that in many cases your dentist decide for you, May be some of the previous solutions are not possible you or the case favor one of them over the other. For example if the teeth crowns are very short you can’t make a fixed bridge false teeth or you may need a preoperative surgery that you may refuse , If you have a uncontrolled diabetes or osteoporosis the implant will probably fail, The oral hygiene also is  determining  factor  etc

Materials used to fabricate partial denture :

here we use almost the same materials that i explained above with the complete denture except we generally use metallic denture base with this type of false teeth instead of the acrylics we use usually with the complete dentures. We have to say that some patient ask for a very economic partial dentures and in this cases we use full acrylic partial denture which is really inferior in performance and biocompatibility.

How to clean and take care of denture false teeth:

The same rules that we explained before will fit here.We will just add a very important tip

The natural teeth that is located near the clasps of the partial denture has a very high susceptibility to decay so the patient have to give extra care to clean natural teeth present beside the removable denture (sure after removing the false teeth )

3-False teeth in the form of fixed bridges and teeth caps :

The fixed bridge is a form of false teeth that is bounded to the neighboring teeth that present beside the missed tooth or teeth. There is many types of dental bridges but generally teeth bridges is formed of metals, ceramics or both together (a metal frame covered by a tooth colored ceramic to look like a natural tooth ) . let’s say that we have tooth need to be restored with a false teeth. The final fabricated crown will be in the form of three unites, A cap to cover the tooth anterior to the missing another cap to cover the posteriors tooth  to the missing and the false tooth that will replace the missing one in the middle. Three unites are casted together without soldering to give the highest accuracy and strength . The neighboring teeth should be healthy enough to carry the extra load  with good formed roots healthy gums also not very short to guarantee the success of this form of false teeth

How will your dentist fabricate your fixed bridge false teeth:

There is many types and techniques in fixed dentures fabrication we will discuss here the most classic type sure there is ton of new advances in this industry so the steps will vary from clinic to clinic

1-Fist you will examined carefully may be an x-ray will be taken to check on the tooth roots and pulp.

2-May be Primary impression well  be done to send it to the lap to fabricate a temporarily crowns( or cap) to cover the teeth after trimming till the lab finish the bridge final false teeth (some dentists prefer to perform this step in the clinic without impression using special materials).

3-then in the next visit the dentist start to trim or prepare the neighboring teeth after anesthesia. THE teeth will become very small don’t panic it is normal once you decided to make a bridge the final result is the most important.

4-Then the final impression is made,  the dentist choose the color of the new false teeth , register your bite and finally cement the temp crowns and send the impression back to the lap to fabricate the final false teeth bridge.

5-in the last visit the dentist will replace the temp crowns with the new final bridge.

some high level dentists will use a system called cad cam which is a computerized system. this system will finish the whole process in a single short visit.

Advantages, disadvantages and options of fixed bridges:

read the previous section in the partial denture we explained this before.

Materials used to fabricate fixed bridge :

full Metal false teeth , full ceramic false teeth or combination of both in the form of metal body covered with a ceramic  layer to give the natural shape of the tooth

Full metallic is the strongest, cheapest but bad looking(sliver color).It can be used in posterior teeth.

Ceramic fused to metal has a medium strength medium coast and also medium aesthetics(can be acceptable in many conditions)

Full ceramic has the greatest aesthetic, the most expensive and the least strength.  (the new types of full ceramics is really strong )

How to clean and take care of fixed bridge:

Here is the great part of the story .Just treat it as any normal tooth brush regularly, use mouth wash from time to time, don’t bite on hard objects and that’s all last thing when you feel anything call your dentist.