Archives for October 2023

Should I Try to Keep My Last Two Upper Teeth?

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I have most of my bottom teeth, but on the upper arch I only have the two front teeth. I can eat with them and they are still healthy. I wear a partial denture for the rest of the teeth, but really hate it because it is uncomfortable and hard to eat with. I also have an underbite. The bottom teeth are in okay condition. I am having a hard time dealing with the partial and at this point only wear them when I am going out for a social situation. I had one dentist tell me that I would be happier if I removed these last two teeth and got a denture. I was always under the impression that you wanted to keep natural teeth for as long as possible. Am I incorrect about that?

Bradley

Dear Bradley,

implant overdentures

While you are correct that it is best to keep natural teeth for as long as possible, you are in a unique situation. However, let me give a disclaimer that I have not examined you and there might be some information that an exam and x-ray would provide that would change what I’m about to say.

Eating on just those two teeth is placing a lot of stress on them. Plus, they will be butting against your lower teeth which causes further stress. The very best solution for a situation like yours is to replace the missing upper teeth with dental implant supported partial dentures. Then, you’d have secure tooth replacements on either side of your natural teeth. This would take some of the pressures off your front teeth.

You didn’t mention your budget, which is always a consideration when it comes to any type of dental care. If you cannot afford the dental implants, I believe you would be better off getting a complete denture. I would not say this if it were your lower teeth.

Your upper dentures are held in by suction. However, dentures for the lower arch rest on the bone ridge. When your teeth are removed, your body immediately begins resorbing the minerals in your jawbone to use elsewhere in your body. After ten or so years, you will no longer have enough jawbone left to retain your dentures. This is known as facial collapse. In the case of bottom teeth, I would save as many as possible. If they are lost, do everything you can to replace them with dental implants, which prevents the loss of the jawbone.

This blog is brought to you by Lexington Cosmetic Dentist Dr. Fred Arnold.

A Cavity on a Porcelain Veneer

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I have six porcelain veneers and one of them has a cavity. My dentist wants to remove the veneer, treat the cavity, and then replace it with a dental crown. I am not too keen on the idea of a crown. Is that the standard procedure for dealing with a cavity on a veneer or do I have another option?

Cathy

Dear Cathy,

A porcelain veneer being placed on a tooth

You did not mention how big the cavity is, but for a tooth to require a dental crown you would need at least 20% of the tooth decayed. Unless that is the case, my instinct is to tell you to get a second opinion on this. When you do get this second opinion, you need to see an expert cosmetic dentist. Only about 2% of dentists are able to do the procedure you need and you don’t want someone saying get the crown simply because they are not skilled in porcelain veneers.

There are patients who go to an expert cosmetic dentist to get their cosmetic work done and then return to their family dentist for regular dental work. That is fine. However, when there is maintenance to be done on the veneers, it is safer to excuse yourself from that dentist to have the maintenance done by someone with expertise.

It is possible to have a cavity treated and then replaced with a porcelain veneer. You are not stuck with a crown, with the exception of when the decay is significant as I mentioned in the first paragraph. You will just need to have an expert cosmetic dentist to do the work. Your best bet is to go to an AACD accredited dentist.

Preventing Decay with Porcelain Veneers

The place where your porcelain veneers are the most vulnerable are at the margins. This is where the porcelain veneer meets the tooth. Fortunately, it is very easy to prevent this. Flossing regularly, limiting snacks, and making sure special attention is given to that area in your cleaning appointments.

It is important that your dentist and hygienist avoid a couple of things during your regular cleanings. First, is a power prophy jet. This will remove the protective glaze from your porcelain veneers and cause them to pick up stains very quickly. A second thing to avoid is acidulated fluoride. This will etch your teeth and will also cause damage to the veneers.

This blog is brought to you by Lexington, KY Dentist Dr. Fred Arnold.

Arnold Dental
699 Perimeter Drive, Suite 200
Lexington, KY 40517
Phone: 859-269-1000
Email: info@lexingtonsmiles.com
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