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Post Link Posted: Tue Apr 05 2005 7:08 am
Post subject: Only four top teeth left. What to do?
Reply to roy1953uk Reply with quote





Hi all,

I am 52, wear a partial upper and have only the four incisors left in
my upper jaw after just having a cracked canine tooth removed. (My
lower teeth have quite old bridgework, but are OK.) Several dentists
had told me that if the canine comes out, I will have to have the
incisors out too and start wearing a full denture, as incisors are too
weak to support a partial denture on their own for any length of time.
Now that the cacnine tooth is out, my dentist seemed to have changed
his mind and says the incisors are OK for now, and the gums are alo
fine, so I needn't go for a full denture. The lateral incisor and
central incisor on one side have had root canal treatments and are
splinted together with a connected pair of crowns. The other central
incisor and lateral incisor are "virgin teeth". All four incisors are
apparently in good condition. Excluding implants, which are too costly
for me, what would you suggest: (a) Continuing with the same partial,
which has had the canine tooth added, (b) root-canal plus splinting for
the other pair of incisors as was done with the first two, (c) full
denture, or some other treatment? How long could any of these
treatments delay the need for a full denture? Also, will I find a full
denture much more difficult to use than my current partial or am I
worrying unduly about having to start wearing a full denture. Also, how
likely is it that my face will age very quickly after moving to a full
denture? I don't think I will have a gagging problem but I am most
worried about my speech changing and about the denture falling out in
public.
Also, if I leave things as they are (keep my current partial) is it
likely that one of the incisors could suddenly fail (crack or whatever)
needing it to be extracted urgently, and I will then be unable to wear
a partial because there is not enough support, while it would take a
few weeks to prepare a full denture, meaning that that I would end up
going around with only three teeth for a few weeks. (I'd rather start
the preparations for a full denture now, while I still have a partial
denture solution, than find I can only wear a full denture after
another tooth comes out and I can't wear a partial any more while I
wait for the full denture.)
I should mention that I have been perfectly satisfied with my partial
and can eat and speak without any problems. I don't know if this is any
indication of how I'll be with a full upper denture.

Roy





teeth left top
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Post Link Posted: Tue Apr 05 2005 7:29 am
Post subject: Re: Only four top teeth left. What to do?
Reply to Joel M. Eichen Reply with quote



"roy1953uk" <roy1953uk@excite.com> wrote in message
news:1112702930.750838.271830@g14g2000cwa.googlegroups.com...

Quote:
Hi all,

I am 52, wear a partial upper and have only the four incisors left in
my upper jaw after just having a cracked canine tooth removed. (My
lower teeth have quite old bridgework, but are OK.) Several dentists
had told me that if the canine comes out, I will have to have the
incisors out too and start wearing a full denture, as incisors are too
weak to support a partial denture on their own for any length of time.
Now that the cacnine tooth is out, my dentist seemed to have changed
his mind and says the incisors are OK for now, and the gums are alo
fine, so I needn't go for a full denture. The lateral incisor and
central incisor on one side have had root canal treatments and are
splinted together with a connected pair of crowns. The other central
incisor and lateral incisor are "virgin teeth". All four incisors are
apparently in good condition. Excluding implants, which are too costly
for me, what would you suggest: (a) Continuing with the same partial,
which has had the canine tooth added, (b) root-canal plus splinting for
the other pair of incisors as was done with the first two, (c) full
denture, or some other treatment? How long could any of these
treatments delay the need for a full denture? Also, will I find a full
denture much more difficult to use than my current partial or am I
worrying unduly about having to start wearing a full denture. Also, how
likely is it that my face will age very quickly after moving to a full
denture? I don't think I will have a gagging problem but I am most
worried about my speech changing and about the denture falling out in
public.
Also, if I leave things as they are (keep my current partial) is it
likely that one of the incisors could suddenly fail (crack or whatever)
needing it to be extracted urgently, and I will then be unable to wear
a partial because there is not enough support, while it would take a
few weeks to prepare a full denture, meaning that that I would end up
going around with only three teeth for a few weeks. (I'd rather start
the preparations for a full denture now, while I still have a partial
denture solution, than find I can only wear a full denture after
another tooth comes out and I can't wear a partial any more while I
wait for the full denture.)
I should mention that I have been perfectly satisfied with my partial
and can eat and speak without any problems. I don't know if this is any
indication of how I'll be with a full upper denture.


R E P L Y

Generally true, however a Valplast partial
may prove to be useful without the normal supply of anchor teeth ......


Joel



Quote:

Roy












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Post Link Posted: Tue Apr 05 2005 10:10 am
Post subject: Re: Only four top teeth left. What to do?
Reply to W_B Reply with quote



On 5 Apr 2005 05:08:50 -0700, "roy1953uk" <roy1953uk@excite.com> wrote:


Quote:
(a) Continuing with the same partial,
which has had the canine tooth added, (b) root-canal plus splinting for
the other pair of incisors as was done with the first two, (c) full
denture, or some other treatment? How long could any of these
treatments delay the need for a full denture? Also, will I find a full
denture much more difficult to use than my current partial or am I
worrying unduly about having to start wearing a full denture.



You may consider having a 'transitional' partial made.

Perhaps Roy will weigh in on this case.
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com












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Post Link Posted: Tue Apr 05 2005 10:20 am
Post subject: Re: Only four top teeth left. What to do?
Reply to roy1953uk Reply with quote



W_B:

1. From my skimming through posts on this site I can see that (the
other) Roy is the expert denturist? Yes, it will be interesting to see
what he has to say.

2. By a transitional partial, do you mean an acrylic-only partial
covering the whole palate and still connected to the remaining four
front teeth, but which can easily be converted to a full immediate
denture by removing the clasps and adding the four teeth?

Thanks,

Roy












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Post Link Posted: Tue Apr 05 2005 10:51 am
Post subject: Re: Only four top teeth left. What to do?
Reply to W_B Reply with quote



On 5 Apr 2005 08:20:25 -0700, "roy1953uk" <roy1953uk@excite.com> wrote:


Quote:
W_B:

1. From my skimming through posts on this site I can see that (the
other) Roy is the expert denturist? Yes, it will be interesting to see
what he has to say.


Yes, exactly.


Quote:

2. By a transitional partial, do you mean an acrylic-only partial
covering the whole palate and still connected to the remaining four
front teeth, but which can easily be converted to a full immediate
denture by removing the clasps and adding the four teeth?



Right again.


Quote:
Thanks,

Roy


--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com












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Post Link Posted: Tue Apr 05 2005 6:09 pm
Post subject: Re: Only four top teeth left. What to do?
Reply to Charlie  Oster via MedKB. Reply with quote



Excellent posts. I've been treating scores of denture patients for 30
years. Keep the teeth.

--
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Post Link Posted: Tue Apr 05 2005 6:13 pm
Post subject: Re: Only four top teeth left. What to do?
Reply to Charlie  Oster via MedKB. Reply with quote



And, I gotta say this, any DDS who tells you the incisors have to come out
'cause they "can't support a partial" is either misguided or ignorant.

Cu-sil type denture might be an option too if you get down to a couple
isolated teeth.

--
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Post Link Posted: Thu Apr 07 2005 11:00 pm
Post subject: Re: Only four top teeth left. What to do?
Reply to Roy Brown Reply with quote



"W_B" <no_one@nowhere.net> wrote in message
news:21j7515ffqlpmrdhde2m1i80bod6uocnk1@4ax.com...
| On 5 Apr 2005 05:08:50 -0700, "roy1953uk" <roy1953uk@excite.com> wrote:
|
| >(a) Continuing with the same partial,
| >which has had the canine tooth added, (b) root-canal plus splinting for
| >the other pair of incisors as was done with the first two, (c) full
| >denture, or some other treatment? How long could any of these
| >treatments delay the need for a full denture? Also, will I find a full
| >denture much more difficult to use than my current partial or am I
| >worrying unduly about having to start wearing a full denture.
|
|
| You may consider having a 'transitional' partial made.
|
| Perhaps Roy will weigh in on this case.
| --
|
| W_B
| Take out the G'RBAGE
| wubbabubbazG@RBAGEyahoo.com

I will respond to the original post.












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Post Link Posted: Thu Apr 07 2005 11:57 pm
Post subject: Re: Only four top teeth left. What to do?
Reply to Roy Brown Reply with quote



Comments in text below.
--
Roy
rem NADA to reply



"roy1953uk" <roy1953uk@excite.com> wrote in message
news:1112702930.750838.271830@g14g2000cwa.googlegroups.com...
| Hi all,
|
| I am 52, wear a partial upper and have only the four incisors left in
| my upper jaw after just having a cracked canine tooth removed. (My
| lower teeth have quite old bridgework, but are OK.) Several dentists
| had told me that if the canine comes out, I will have to have the
| incisors out too and start wearing a full denture, as incisors are too
| weak to support a partial denture on their own for any length of time.

Don't know what your original partial looks like, but if you have or switch to
full palatal coverage, there is more denture support and retention provided from
the roof of the mouth which puts less of a load on the remaining teeth which
extends their life. You want to keep the teeth to prevent bone resorption that
will occur when you lose them.

| Now that the cacnine tooth is out, my dentist seemed to have changed
| his mind and says the incisors are OK for now, and the gums are alo
| fine, so I needn't go for a full denture. The lateral incisor and
| central incisor on one side have had root canal treatments and are
| splinted together with a connected pair of crowns. The other central
| incisor and lateral incisor are "virgin teeth". All four incisors are
| apparently in good condition. Excluding implants, which are too costly
| for me, what would you suggest: (a) Continuing with the same partial,
| which has had the canine tooth added,

Good option for 6 months or so while the initial rapid stage of bone resorption
occurs. Then have a new partial made that gives full palatal coverage

|(b) root-canal plus splinting for
| the other pair of incisors as was done with the first two,

I assume by splinting you mean having crowns made. Not a good option since the
teeth are "virgin" and healthy. If one was concerned about the lateral incisor
taking too much of a load, it could be "splinted" or tied to the central using a
fine wire or mesh ribbon type material and some composite material without
cutting into the teeth. One could even bond a set of "Maryland" type wings to
the lingual surface.

|(c) full denture, or some other treatment?

Full denture, not recommended. You might get away with 2 implants in the canine
region and some attachments but 4 or more implants are usually recommended on
the upper. The latter most likely being the recommended treatment of choice for
someone in your situation. That is because you will have decreased bone loss
using implants and less of a load on the remaining teeth.

|How long could any of these
| treatments delay the need for a full denture? Also, will I find a full
| denture much more difficult to use than my current partial or am I
| worrying unduly about having to start wearing a full denture.

Most people that tolerate a partial are accepting of a full denture. You are
worrying unduly.

|Also, how
| likely is it that my face will age very quickly after moving to a full
| denture?

"Face aging" is usually due to a lack of maintenance. Reline or rebase the
denture when loose (usually about every 3-4 yearsfor an upper). Replace when
teeth are showing wear.

|I don't think I will have a gagging problem but I am most
| worried about my speech changing and about the denture falling out in
| public.

If you could tolerate the impressions for the partial or already wear a it is
highly unlikely you will gag. A well made, well maintained complete denture is
less likely to come loose than the partial you will wear.

| Also, if I leave things as they are (keep my current partial) is it
| likely that one of the incisors could suddenly fail (crack or whatever)
| needing it to be extracted urgently, and I will then be unable to wear
| a partial because there is not enough support, while it would take a
| few weeks to prepare a full denture, meaning that that I would end up
| going around with only three teeth for a few weeks. (I'd rather start
| the preparations for a full denture now, while I still have a partial
| denture solution, than find I can only wear a full denture after
| another tooth comes out and I can't wear a partial any more while I
| wait for the full denture.)

You are worrying unduly. Unless you live in a remote area. One could add a
tooth, clasp and convert a partial to a full palate in the same day, sometimes
next day depending when you start. Either before or after your tooth was
extracted. Done before the denture acts like a bandaid. It is possible to go in
first thing in the morning. have the impressions taken. Make the necessary
alterations to the denture and have it ready to wear when the tooth is extracted
at the end of the day. How long did it take to add the canine you just lost?

| I should mention that I have been perfectly satisfied with my partial
| and can eat and speak without any problems. I don't know if this is any
| indication of how I'll be with a full upper denture.

A very good indication of success. With one caveat. That being - if your email
addy is any indication you are located in the UK and you are receiving treatment
via the NHS, the generally accepted dental principles I've provided may not
necessarily apply.

BTW, thanks for signing for me.

|
| Roy
|












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Post Link Posted: Fri Apr 08 2005 1:53 pm
Post subject: Re: Only four top teeth left. What to do?
Reply to roy1953uk Reply with quote



Hello Roy,

I am very grateful for your detailed comments. Here are some further
remarks.


Quote:
Don't know what your original partial looks like


Metal framework - covers about half my palate. An open part of the
framework rests against the lingual side of my incisors and there are
clasps conmecting it to each of my lateral incisors. The clasp on the
side of my denture that has just had a canine tooth added to it is made
of very thin wire and looks as if it could easily become detached after
a while by slipping out of the acrylic area. The partial is very
retentive indeed, and actually needs a bit of effort to remove, and
some manipulation (rotation while inserting) to replace in my mouth.

, but if you have or switch to

Quote:
full palatal coverage, there is more denture support and retention
provided from
the roof of the mouth which puts less of a load on the remaining
teeth which
extends their life.


You mean I should have my present partial replaced by an acrylic
partial that covers all of my palate like a full denture, but is still
connected o my incisors with clasps? This will help prolong the
transition to a full denture? Roughly how long can I expect to be able
to stay with my front teeth if I keep my present partial, and how long
could this be extended by migrating to a full-palate partial?


Quote:
You want to keep the teeth to prevent bone resorption that
will occur when you lose them.


I realize that bone resorption will take place once the incisors come
out, but is this more of a problem than with the rest of my teeth that
I have lost? Doesn't it just mean that I will need to have my full
denture relined or rebased from time to time? If I am going to need a
full denture within a few years (is this a correct guess) anyway, then
will it make a big difference to postpone it for that length of time?

(a) Continuing with the same partial,

Quote:
| which has had the canine tooth added,

Good option for 6 months or so while the initial rapid stage of bone
resorption
occurs. Then have a new partial made that gives full palatal coverage


An acrylic one? Sounds like a good idea as it will get me used to
having my palate completely covered ready for a complete denture.



Quote:
I assume by splinting you mean having crowns made.


Yes, like with the lateral incisor and central incisor on the other
side.


Quote:
Not a good option since the
teeth are "virgin" and healthy. If one was concerned about the
lateral incisor
taking too much of a load, it could be "splinted" or tied to the
central using a
fine wire or mesh ribbon type material and some composite material
without
cutting into the teeth. One could even bond a set of "Maryland" type
wings to
the lingual surface.


OK. Interesting why I've always had root canals and connected crowns
rather than the method you recommend, which sounds so simple and avoids
grinding teeth and taking out the central core, which must make them
weaker (and these ARE the teeth that have always had problems, and end
up cracking or developing caries under the crowns.


Quote:
|(c) full denture, or some other treatment?
Full denture, not recommended.


Why not a full denture? You keep telling me not to be unduly worried
and that I shouldn't expect to have any problems with a full denture.
So why is it not recommended? Especially, if I'm nearly there one way
or the other? If I could delay the process by, say, ten years, then it
makes sense to me, but if it's going to be a year or so anyway, then
what difference does it make.


Quote:
You might get away with 2 implants in the canine
region and some attachments but 4 or more implants are usually
recommended on
the upper. The latter most likely being the recommended treatment of
choice for
someone in your situation. That is because you will have decreased
bone loss
using implants and less of a load on the remaining teeth.


I understand, but I can see that the cost would be very high.


Quote:
|How long could any of these
| treatments delay the need for a full denture? Also, will I find a
full
| denture much more difficult to use than my current partial or am I
| worrying unduly about having to start wearing a full denture.

Most people that tolerate a partial are accepting of a full denture.
You are
worrying unduly.


I'm not unduly worried as I have been told quite a few times that it's
not so different from my partial. I worry that my speech will be
strange for a few weeks and that my lips will jut out or whatever for a
few weeks and give the game away, which does concern me as I'm a bit
embarrassed about people finding out or asking questions. I suppose I
will no longer be able to bite with my front teeth, so uncut apples and
the like are out. But I guess I can get used to that.


Quote:
"Face aging" is usually due to a lack of maintenance. Reline or
rebase the
denture when loose (usually about every 3-4 yearsfor an upper).
Replace when
teeth are showing wear.


Good.


Quote:
If you could tolerate the impressions for the partial or already wear
a it is
highly unlikely you will gag. A well made, well maintained complete
denture is
less likely to come loose than the partial you will wear.


I agree about gagging not being a problem. It's good to hear that a
complete denture won't keep falling out.


Quote:
You are worrying unduly. Unless you live in a remote area. One could
add a
tooth, clasp and convert a partial to a full palate in the same day,
sometimes
next day depending when you start. Either before or after your tooth
was
extracted. Done before the denture acts like a bandaid. It is
possible to go in
first thing in the morning. have the impressions taken. Make the
necessary
alterations to the denture and have it ready to wear when the tooth
is extracted
at the end of the day. How long did it take to add the canine you

just lost?

I got the canine added to my denture within just a few hours. You mean
if I lose one of the four remaining teeth, I could still have it added
to my partial and have only three incisors left without having to go to
a full denture? You also mean that if I have an acrylic partial that
covers my palate completely, this can just as quickly be converted to a
temporary complete denture as adding one tooth? Am I right in believing
that my present metal-framework partial could not be so converted if I
needed a complete denture, so that this is an advantage of switching to
a full-palate acrylic partial?


Quote:

| I should mention that I have been perfectly satisfied with my
partial
| and can eat and speak without any problems. I don't know if this is
any
| indication of how I'll be with a full upper denture.

A very good indication of success. With one caveat. That being - if
your email
addy is any indication you are located in the UK and you are
receiving treatment
via the NHS, the generally accepted dental principles I've provided
may not
necessarily apply.


OK. Actually I am from the UK but currently living in a country where
the dental services are good (no NHS-like service for dental
treatments, only private), but quite expensive. I have dental insurance
which covers quite a lot, but not exotic treatments like attachments,
Valplast and the like, and not of course implants.

Thank you again for taking the time to give me such detailed answers,
which have been quite reassuring. Knowing what to expect takes the
worry out of the whole thing. I think my greatest worry is having
people ask me why I'm not speaking normally during the initial period
of wearing a complete denture. Apart from that, I am not very
concerned.

Roy












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