1. Is it necessary to replace any missing teeth?
Any missing teeth, even a single one, should be restored as soon after the time of loss as possible. The loss of even one tooth may lead to negative consequences within the whole masticatory system, such as migration of the adjacent teeth (inclination, rotation) and “elongation” of the corresponding opposite tooth that strives to make contact. Other complications include temporomandibular joint disorders that manifest themselves as morning muscular pain within the temple areas, as well as alimentary tract disorders. The other problem is aesthetic defects, such as an incomplete smile, shortening of the lower face, collapsing lips and increased wrinkles around the mouth.
2. What does the choice of the prosthetic restoration depend on?
The choice of prosthetic restoration being suitable for a given patient depends on many factors, such as:
- number of missing teeth;
- number and quality of remaining teeth;
- localisation of the tooth loss;
- condition of bone base, gums and mucous membrane;
- features of occlusion (bite);
- patient’s age;
- patient’s preferences;
- patient’s financial situation.
3. What options for the replacement of missing teeth are available in the case of complete toothlessness?
For many years the generally used solution in such a case has been a full denture. The advantages of such a solution include its availability, low price and satisfactory aesthetic effect. On the other hand, its disadvantage is low comfort in use. The denture simulates the masticatory function only to a small extent, and significant surface area of its plate covering the palate compromises the sensation of taste. Implant-based prosthetic restoration provides an alternative option that replaces missing teeth much more efficiently; such restoration includes:
- overdentures supported on 2-4 implants in the upper and lower jaw;
- bridges supported on at least 6 implants in the upper jaw and 5 implants in the lower one.
4. How are hygienic principles modified in the case of permanent dentures?
To prolong the durability of permanent denture to the maximum extent, special hygienic procedures have to be implemented which involve the use of additional hygienic tools apart from the toothbrush. The perigingival area of crowns and bridges requires special attention due to the tendency of build-up of bacterial plaque which is difficult to remove. Recommended equipment includes:
- super floss, rigid dental floss with a foamy thickened segment; the rigid portion is to be pulled under the cleaned denture element, and then the element is to be cleaned with the foamy portion;
- dental irrigator, a device producing a water stream that massages gums and cleans spaces which are difficult to reach.
5. How are hygienic principles modified in the case of removable dentures?
In the case of removable dentures, the denture itself should receive particular attention, apart from conventional care of the remaining teeth. A removable denture should be cleaned after each meal (at least twice a day). When the denture is removed from the patient’s mouth, it should be cleaned with a soft toothbrush and toothpaste, liquid soap or special cleaning agent. Special two-sided denture brushes are preferable, as the special shape of their bristle allows cleaning of even those places of the denture which are the most difficult to reach. Moreover, there are various cleaning agents, such as powder or tablets which dissolve in water, creating a liquid for denture cleaning. Such agents are particularly recommended to individuals with some physical disability.
6. What are the dietary requirements for patients under prosthetics treatment?
In general the diet of patients having permanent dentures is not changed, contrary to patients with removable ones. Patients who start using removable dentures, in particular full sets, should eat only liquid and semi-liquid food in the initial period and gradually introduce to more solid meals. Patients should eat smaller portions and avoid very hard and sticky food. In general, the meal time is significantly prolonged.
7. Is it possible to repair a prosthetic restoration by oneself?
Independent repair or correction of denture by the patient is not allowed; such an approach may destroy the restoration and lead to injury to the oral tissues. If the denture causes any discomfort, the patient should visit the dentist immediately.
8. Is the use of denture adhesive beneficial?
Agents which improve denture fixation are usually available in the form of powder that forms a sticky mass when mixed with the saliva. Such products may be periodically used in the initial period of getting used to the denture, and also by singers or actors during a show. In all other cases the use of denture adhesive is not advisable, as it may conceal possible imperfection of the denture, which should be detected and corrected in the surgery.