Frequently Asked Questions

All About Prosthodontics

  1. What is Prosthodontics?
  2. Why do I need a Prosthodontist? Can’t a dentist do the crowns or restore my
    implants?
  3. Where can I find a Prosthodontist?
  4. What training does a Prosthodontist receive?
  5. Is a Prosthodontist different from a “Cosmetic Dentist”
  6. Will the Prosthodontist complete all of my required treatment?
  7. Why is Treatment Expensive?

Crowns, Bridges and porcelain veneers

  1. What is a Crown?
  2. Why are Crowns more expensive than fillings?
  3. What is a Bridge?

Dental Implants

  1. What is a Dental Implant?
  2. How long does treatment take?
  3. Why Dental Implants?
  4. Why do Implants fail?

Dentures

  1. What is a denture?
  2. Who needs a denture?
  3. How long will my denture last?
  4. What happens if I don’t replace my dentures?
  5. Should I wear my dentures at night?
  6. How must I take care for my dentures?
  7. What can you expect from new dentures?
  8. How will dentures affect my eating?
  9. Will dentures affect my speech?
  10. Why are my dentures becoming loose?
  11. Why do I need my mouth checked regularly if I don’t have any teeth?
  12. I have only lost a few teeth. Is it really important having a partial denture?
  13. How do I know it is time for a new denture?

All About Prosthodontics

What is Prosthodontics?

It is a dental specialist that uses prosthetic devices (e.g. dentures and crowns) to restore and replace teeth. The specialty actually involves much more than this, as prosthodontists are also trained to do root canal treatment, treat jaw joint and muscle problems, restore dental implants and construct prostheses for patients with facial deficiencies (e.g. glass eyes and prosthetic noses).

Why do I need a Prosthodontist? Can’t a dentist do the crowns or restore my
implants?

Only prosthodontists receive training at accredited institutions to restore problems that involve more than three problematic teeth. In some cases even a single tooth restoration can be very difficult or complicated, so you should discuss this with your dentist so that you can understand the complexity of your problem and be referred if it is agreed upon.

Where can I find a Prosthodontist?

You can find a list of Prosthodontists by clicking here

What training does a Prosthodontist receive?

Graduate programs in prosthodontics are university-based full-time courses of up to four years in duration. The training includes lectures, seminars, laboratory and clinical training in aesthetics/cosmetics, crowns, bridges, veneers, inlays, complete and partial dentures, dental implants, Temporomandibular joint disorders, traumatic injuries to the teeth and surrounding oral structures, congenital or birth anomalies to the teeth, snoring and sleep disorders, and oral cancer reconstruction and continuing care. Prosthodontists are masters of complete oral rehabilitation.

Is a Prosthodontist different from a “Cosmetic Dentist”

Prosthodontics is one of the six recognised and accredited dental specialties. Cosmetic dentistry is NOT recognised as a dental specialty. Prosthodontists receive extensive training and experience in dental aesthetics and cosmetic during their ful-time graduate programs. Many cosmetic dentists receive their training during weekend or week-long seminars and/or courses.

Will the Prosthodontist complete all of my required treatment?

The prosthodontist is best viewed as the “architect” of your dental treatment. He/she has the vision of the final outcome of your treatment, both the aesthetics of your smile and the improved function of your bite. Often other dental specialists may participate in your treatment to help establish a solid foundation for your restorations. Every prosthodontist develops a treatment plan customised for each individual patient, and he/she will determine if adjunctive procedures by another doctor are necessary and at what stage of your treatment they will occur.

Why is Treatment expensive?

There is a premium on our knowledge and treatment, as we spend an extra four years at university. Treatment plans are very often comprehensive, technically difficult and a lot of time is spent on making sure the final result will be aesthetically and functionally well integrated. The treatment therefore is expensive.

Crowns, Bridges and porcelain veneers

What is a Crown?

Dental crowns (also sometimes referred to as ‘dental caps’ or ‘tooth caps’) cover over and encase the tooth on which they are cemented. Dentists use crowns when rebuilding broken or decayed teeth, as a way to strengthen teeth and and as method to improve the cosmetic appearance of a tooth. Crowns are made in a dental laboratory by a dental technician who uses moulds of your teeth made by your dentist.

The type of crown your dentist recommends will depend on the tooth involved and sometimes on your preference. They include porcelain crowns, porcelain-bonded-to-metal crowns, which combine the appearance of tooth coloured material with the strength of metal, gold alloy crowns and acrylic crowns.

Why are Crowns more expensive than fillings?

A crown is more complicated than a filling. Laboratory fees are incurred in its preparation and the materials used are more expensive than normal filling materials.

Two or three visits are usually required for the dentist to reduce the size of the existing tooth, make a mould, fit a temporary crown and finally adhere the permanent crown in place.

What is a Bridge?

A bridge is an appliance permanently fixed in the mouth to replace missing teeth. It uses remaining teeth to support the new artificial tooth or teeth.

A bridge is made up of two crowns for the teeth on either side of the gap –these two anchoring teeth are called abutment teeth– and a false tooth/teeth rigidly attached in between. The false teeth are called pontics. The bridge can be made from gold, alloys, porcelain or a combination of these materials.

An enamel-bonded bridge uses a metal or porcelain framework to which the artificial teeth are attached, and then resin bonded to supporting teeth.

Dental Implants

What is a Dental Implant?

A dental implant can be thought of as an artificial tooth root that is submerged into the jawbone. When dental work such as a crown, fixed bridge or a full set of dentures is added, one or more missing teeth can be replaced. A dental implant is fabricated from a very strong, biocompatible material placed in a simple procedure that, generally, is as convenient as a tooth extraction. After an initial healing period, during which the implant is buried in bone and left undisturbed under gum tissue, it is uncovered and connected to a small metal post that secures and supports the artificial tooth.

How long does treatment take?

It depends on the type of bone, and where the implant is placed into your jaw. It can range from a few months to over 9 months. Generally, implants in the front lower jaw need around 3 months; the back upper jaw needs around 6 months and elsewhere in the mouth around 6 months. These times may need to be lengthened if bone needs to be grown or grafting has taken place.

Why Dental Implants?

A dental implant is the closest thing to a natural tooth your dentist can give you. They feel much more natural and secure than traditional removable dentures, especially if these are loose fitting because of extensive bone loss. If several adjacent teeth are missing, a fixed bridge may be attached to dental implants as an alternative to a removable partial denture plate. Dental implants allow for the replacement of a missing tooth without modifying adjacent teeth. Your dentist will be happy to discuss alternatives for restoring your dental function with you.

Why do Implants fail?

Failure of a dental implant is often related to failure to osseointegrate correctly. A dental implant is considered to be a failure if it is lost, mobile or shows peri-implant (around the implant) bone loss of greater than 1.0 mm in the first year and greater than 0.2mm a year after.
Dental implants are not susceptible to dental caries but they can develop a condition called peri-implantitis. This is an inflammatory condition of the mucosa and/or bone around the implant which may result in bone loss and eventual loss of the implant. Peri-implantitis is more likely to occur in heavy smokers, patients with diabetes, patients with poor oral hygiene and cases where the mucosa around the implant is thin.

Risk of failure is increased in smokers. For this reason implants are frequently placed only after a patient has stopped smoking as the treatment is very expensive. More rarely, an implant may fail because of poor positioning at the time of surgery, or may be overloaded initially causing failure to integrate. If smoking and positioning problems exist prior to implant surgery, clinicians often advise patients that a bridge or partial denture rather than an implant may be a better solution.

Dentures

What is a denture?

A denture is a removable artificial appliance used to imitate the function and appearance as a replacement for missing teeth. Dentures are normally made of acrylic, sometimes in combination with various metal substructures and components. The teeth itself is also made of different colours of layered acrylic, shaped and stained to look like natural teeth. Complete dentures replace all the teeth, while a partial denture fills the spaces created by missing teeth and prevents the remaining natural teeth from drifting out of their position.

Who needs a denture?

Candidates for complete dentures have lost most or all of their teeth. A partial denture is suitable for those who have some natural teeth remaining. A denture enlarges the range of foods that is included in your diet by improving your ability to chew.   A denture enhances pronunciation and speech, and provides support for facial muscles. It will greatly enhance your facial appearance and smile and is a recognized factor that can boost your self-esteem.

How long will my denture last?

There is not a removable prosthesis made for the mouth that is permanent, it is only an artificial substitute, made from acrylic! The tissues of the mouth are undergoing continual change so that the dentures will have to be adjusted, rebased or remade from time to time. The average life expectancy of a denture is 5-8 years (or possibly 10 years) depending on the amount of wear on the teeth and the shrinkage of your gums. Although the denture is likely to last considerably longer than this, it eventually gets loose and worn. An older denture can harbor bacteria that may cause oral health problems.

Even when your dentures feel comfortable they should be examined regularly to ensure no permanent damage is being done to the mouth. If ever a sore spot or growth is discovered you should immediately seek advice. These areas may be quite harmless and only require minor adjustment to the denture but only a professional can evaluate and rectify the situation.

If a partial denture fits poorly, it may damage the supporting gums and even your natural teeth as well. A poor fit may cause bleeding, soreness or swelling and consequently you should seek further attention if this occurs.

What happens if I don’t replace my dentures?

Studies have proven that it is not good for your overall health to wear your dentures beyond five to eight years because bacteria and other viruses live on and in the acrylic of your denture.  The reality of a “worn-out” denture can have devastating effects that are often invisible and imperceptible to the denture wearer.
Here is a short list of harmful possible effects suffered by wearers of dentures more than five years old:

• Headaches, ear aches, neck pain and joint problems
• Dietary problems including colon problems
• More laborious chewing and more difficult digestion; which can lead to colon problems
• Softening of the gum
• Painful, irritated gum

Should I wear my dentures at night?

You may be advised to wear your denture almost constantly during the first two weeks, even while you sleep. If you find that your jaws or the muscles of your face ache by over-closing your jaw without your dentures, leave them in. Some denture wearers are apprehensive to be seen by a spouse without their dentures and choose not to remove them when going to sleep. There is little evidence that this practice is inherently harmful.

It is however, considered best to remove your dentures at night, under normal circumstances. Research has shown that removing the denture for at least eight hours during either the day or night, allows the gum tissue to rest and may be beneficial to allow normal stimulation and cleansing by the tongue and saliva. This promotes better long-term health of the gums

How must I take care for my dentures?

Special attention must be paid to cleanliness in order to remove bacteria, food debris and various stains that arise from some foods and smoking. Food debris and tartar accumulate on your dentures just as they do on normal teeth so therefore they should be cleaned after each meal. If you are not careful about this, the gums may become inflamed and bad breath may develop. A daily routine of brushing and soaking is a highly effective way to look after dentures, ideally use soap and water. This combination of methods, using non-abrasive products, will ensure dentures stay clean, fresh and in top condition.

Avoid using tooth paste or denture cream on your dentures (tooth pastes and denture creams contain abrasives). Avoid putting your dentures in hot water; damage to the denture may occur. If a partial denture is in place, remove it before brushing your natural teeth. Once removed, soak the dentures in a proper cleansing solution mixed with water for a period of at least three hours in each twenty-four hour day. It is important that your dentures at all times be kept in a safe place, out of reach of children and pets.

Dentures should be removed before cleaning. Firstly, every surface and part of the denture should be brushed with a denture toothbrush to remove loose food particles. Hold the denture over a basin containing a little water in the bottom. It is a good idea to put a face cloth in the basin too, so that if the denture does slip from your hand, it will cushion the fall and prevent breaking on impact. You may use soap and water, but if you prefer to use a paste, a specially designed denture-paste should be used as conventional toothpastes can be too abrasive.

What can you expect from new dentures?

Dentures are an artificial substitute for healthy natural teeth, but if you have been unfortunate to lose some or all of your teeth, then a partial or full denture will enable you to maintain your facial appearance and satisfactorily chew food.

You may encounter difficulties getting used to your new dentures at first and have difficulty controlling them while eating, swallowing or speaking. With a lower denture there is often a tendency at first for the tongue and lower jaw muscles to displace it. In time you will however overcome these difficulties and adjust to your new dentures. The secret lies in perseverance.

How will dentures affect my eating?

Adjustment takes time and patience but don’t be discouraged. You have only to learn to bite and chew in a slightly different way. When biting food with natural teeth, the tendency is to pull forward. Instead of pulling out as you bite, push the food forward a little and bite completely through it. Start with small portions of food and eat slowly. Biting into an apple and eating corn on the cob are probably things you will want to postpone, but you will be able to enjoy these foods later when you have mastered the art.

Will dentures affect my speech?

At first you may notice minor differences in your speech. Lisping is not unusual. Don’t be concerned. Soon your tongue, lips and cheeks will become accustomed to the slight alteration in the shape and contours of your mouth. Reading aloud to yourself is an excellent exercise which will more quickly restore your normal speech.

Why are my dentures becoming loose?

If your dentures are over 5 years old and if they have not been relined every 2 years, you are likely to have some problems with the fit of your dentures. Your denture needs regular servicing if it is to function at its best. Throughout life the jawbones change in shape. Once the natural teeth have been removed there is no more stimulation-transfer of the mastication powers to the surrounding bone. The bone ridges tend to resorb (shrink), which results in an alteration of the bite-relationship between the upper and lower jaws.

This results in an over-closure of the mouth which causes a loss of chewing efficiency, loosening of the denture, change in appearance, and general discomfort of the mouth.
These changes can be rectified, but if it is left for too long, rehabilitation becomes complicated and very difficult. The rate of change varies from person to person, and depends on age, health, the time lapsed since the last natural teeth were extracted, and many other factors.

Why do I need my mouth checked regularly if I don’t have any teeth?

Oral health means more than just an attractive smile, even for denture wearers. More than 90% of all systemic diseases have oral manifestations. For that reason, your Oral Clinician may be the first health care provider to recognize a health problem. All Oral Health Care providers have an important responsibility as gatekeepers of oral health and oral manifestations of other health conditions that needs urgent attention.

Poor oral hygiene may be a contributing factor to the incidence of oral cancer. In many Western countries oral cancer takes more lives annually than cervical or skin cancer. Rampant infections in the mouth can also affect major organs including the heart and heart valves. In addition, poor oral health affects the digestive process. This may lead to intestinal failure, Irritable Bowel Syndrome and other problems. Many diseases can be diagnosed in their early stages through an oral examination. These diseases may be characterized by swollen gums, mouth ulcers, dry mouth and/or excessive gum problems. Some of these diseases include diabetes, leukemia, cancer, heart disease and kidney disease.

An old or ill-fitting denture can also exacerbate the natural process of resorbtion. When teeth are removed, our body assumes there is no need for the bone that supported the teeth. Over time the bone slowly, yet progressively diminishes. This process, called resorbtion, occurs at a more rapid rate if all teeth in the jaw are missing. Left untreated, the loss of jawbone can progress so far that even the best quality denture will no longer function satisfactorily

I have only lost a few teeth. Is it really important having a partial denture?

Yes. A well-fitting partial denture will prevent your natural teeth from moving to close some of the spaces. Without a partial denture, these teeth could drift and end up being crooked, rotated or tilted. An imbalanced bite could result and damage more of your natural teeth.

How do I know it is time for a new denture?

When dentures are first inserted they fit the gum snugly. There is no substitute for a well fitted denture, and to make sure that you have no problems always have your dentures checked regularly. Most dentures will function satisfactorily for 5-8 years or even 10 years if checked and adjusted at least annually. During this time it may be necessary to “reline ” a denture, which involves processing of a new fitting surface to improve the fit, and “eases ” may be necessary to ensure optimal comfort.

Artificial teeth are generally not as strong as natural teeth and will wear with age. The better the quality of the tooth, the longer the life expectancy. Worn artificial teeth cannot be fixed or rebuilt. If your denture is worn to the point where is it interfering with function you will need to replace it.

From an oral health perspective it is also necessary to replace your denture often. Bacteria builds up even in the most carefully cleaned denture. It is also important to have an oral examination annually, even if you have no natural teeth of your own. The incidence of oral cancer rivals cervical and skin cancer and denture wearers must be vigilant.

Over time shrinkage occurs in the gum that supports your dentures or dentures are worn down, the lower jaw can move out of its correct position with the upper jaw. This can sometimes lead to a number of problems. The facial muscles can virtually collapse giving the appearance of premature aging. If you experience any of the following it may be time for a new denture:

• Difficulty eating with your denture
• Cheek biting
• Speech difficulties
• Red or inflamed tissues
• Clicking noises
• Discomfort when wearing your denture
• Cracked corners of your mouth