Hope Restorative & Cosmetic Dentistry

Will an Immediate Denture Work for Me?

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I lost eight teeth to advanced gum disease, and more are loose. My dentist has a six-month treatment plan for me and recommends an immediate denture if it does not work. My dentist talks fast and seems to be in a hurry. Somehow, he is still kind even though he seems rushed, but I do not understand how an immediate denture would help. – Thank you. Regina

Regina – Thank you for your question. We understand your concerns. Gum disease and tooth loss can create anxiety about what to expect for your long-term oral health.

What Is an Immediate Denture?

An immediate denture is a complete removable denture that a dentist places on the same day as tooth extractions. Still, before agreeing to an immediate denture, we recommend consulting with a periodontist (gum disease specialist).

What Should You Know About Immediate Dentures?

An immediate denture has these pros and cons:

  •  
  • They cause more than traditional dentures.
  • It takes more time to fabricate an immediate denture. You can receive replacement teeth on the same day as tooth removal.
  • A dental lab will make the denture before your mouth and gums heal. After healing, your denture will be loose, and a dentist must refit it—perhaps several times. Relining may help your denture fit again, or you may need a new denture.

How Long Does It Take to Get an Immediate Denture?

Although a dentist places an immediate denture on the same day as tooth removal, it takes four to five visits to take impressions of your mouth, make a denture model, and ensure your final denture will fit well.

Diagram of a snap-on denture from Tulsa, OK dentist Jerome Cha, DDS

An implant-supported denture outlasts a removable denture

Schedule an appointment with your dentist to ensure your treatment options. You may ask your dentist to speak slower, so you understand the options. You can also ask for a referral to a periodontist who specializes in gum disease and may offer more innovative treatment than many general dentists.

Speak with the periodontist about implant-supported dentures if it is likely that you will lose your teeth and need dentures. Replacing individual teeth with implants or an implant-supported bridge may be an alternative if the periodontist can save most of your teeth.

Dr. Jerome Cha, a Tulsa, Oklahoma, accredited cosmetic dentist, sponsors this post.

Dental Implants after Years in Dentures

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I have had dentures for 13 years. I have always hated them, but when I received them, no one told me about the options for dental implants. I approached my dentist about it hoping I could switch, but he said I have been in the dentures too long to get the implants. However, he is the one who didn’t tell me about the implants to begin with and I’ve learned they were around then. Can I trust this dentist? Is it possible I can still get the implants?

Kevin

Dear Kevin,

implant overdentures

I am glad you wrote. First, a word about your dentist. He was under an ethical obligation to give you all your options when he placed you in dentures. The fact that he did not either means he is unethical or he doesn’t know his field well enough to know all his options. Neither one of those is a great option for a dental practitioner. I think it is time to find a new dentist.

As to your ability to get dental implants now, as long as you are in good general health, it is probably possible, but you may need one additional procedure first. When your teeth were removed, your body began to resorb the minerals in your jaw that made up your jawbone. It does this because it recognizes you no longer have teeth there so you don’t need those minerals to keep anything in place. Instead, it transfers those minerals to a different location in your body where it feels those minerals will be of more use. It is a remarkably efficient way to use our body’s resources.

Unfortunately, after somewhere between ten and twenty years, you will no longer have enough jawbone to retain your dentures. This is known as facial collapse. I’m guessing thirteen years into this journey, you have begun to notice your dentures move around more than they have in the past. The solution to this is to have a procedure known as bone grafting done. This will rebuild the missing bone structure.

Once that is done and healed, you will be able to move forward with your dental implants. When you are talking about all of your teeth, it is much more affordable for you to get implant-supported dentures. With this procedure, you will have between four to six dental implants placed and then your dentist will anchor your new dentures to them. It is all the security of dental implants without having to place an implant for each tooth.

I mentioned earlier that you need a new dentist. However, that will be even more important if you decide to go forward with the dental implants. This is an advanced procedure that is not taught in dental school. Instead, your dentist has to take extensive post-doctoral training. Your dentist has obviously NOT done that.

This blog is brought to you by Tulsa Dentist Dr. Jerome Cha.

Am I Condemened to Ugly Teeth because I’m Not Wealthy?

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I am losing my teeth. It can’t be helped and has little to do with my oral health care. My dentist wants me to get dental implants. When he told me the cost per tooth, I almost choked. There is no way I can afford that. I can afford dentures. When I mentioned that to him, he said my smile would not be pretty. What am I to do? Sell a house I don’t even own? Is there any way to get a pretty smile without dental implants.

Karyn

Dear Karyn,

implant overdentures

First, I want to assure you that whether or not you have an attractive smile is more up to the dentist than whether or not you have dentures or dental implants. It’s the skill and artistry of the dentist which makes the biggest difference here. If he’s implying that dental implants are more beautiful than dentures, that is an unfair pressure tactic and speaks more to his investment in doing beautiful work no matter what the procedure than anything else.

The one thing he could be referring to, which is honest, is a rather serious issue that comes with dentures known as facial collapse. When your teeth are removed, your body immediately begins resorbing the minerals in your body to use elsewhere. It does this because it recognizes you no longer have any teeth roots. Without roots, you don’t need that bone to keep your teeth in. So it decides to use the minerals in that bone elsewhere. In as little as ten years, you will no longer have enough jawbone left to keep your dentures in place. Not only that, the shrinking of your jawbone, gives you an aged appearance. This is known in dental circles as facial collapse. It may be what your dentist is referring to by an attractive smile.

Getting dental implants prevents facial collapse because the implants serve as prosthetic teeth roots. This signals to your brain that you still have teeth there and therefore need that jawbone.

Implant Overdentures

implant overdentures

You mentioned the cost per tooth. You may be under the impression that you have to get a dental implant for every single tooth. You don’t. That would be too expensive for just about anyone. Instead, what you would get is four to six dental implants and your dentist will anchor a set of dentures to them.

Doing it this way cuts the cost significantly all while having the same benefits of dental implants. As I mentioned to you in the beginning, the dentures themselves can be beautiful if the dentist knows what they’re doing. You have a two-fold mission now.

First, find a dentist with significant training in dental implant procedures. It’s an advanced procedure, so make certain they received post-doctoral training in them. Second, once you have a list of implant dentists, ask to see their smile gallery so you can get an idea of what type of skill and artistry they have. If you are having trouble finding someone who both can do dental implants and does beautiful restorative work, you can check with the American Academy of Cosmetic Dentistry. Do a search on their website for an AACD accredited dentist. These are in the top 1% of cosmetic dentists in the country. I’m certain you’ll be able to find one who can do your work and give you a smile you are proud to share.

This blog is brought to you by Tulsa Cosmetic Dentist Dr. Jerome Cha.

Antibiotic for a Tooth Infection

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I have a toothache. I’ll be honest and tell you that I am not fond of the dentist even in the best of circumstances. I was kind of relieved when the government shut down dental clinics. It stopped hurting for a bit, but now it’s starting to hurt worse. Which antibiotic is best for this? My doctor will write me a prescription.

Luke

Dear Luke,

man holding his jaw in need of an emergency dentist

You are definitely going to need to see a dentist. Antibiotics will not work for this. They are only a temporary stop measure for dental infections. In your situation, it sounds like the tooth has already died, so it will be even more temporary for you. The tooth feeling better is probably when the infected pulp died, but that doesn’t remove the infection itself, just the pain. Now it has spread past the tooth.

This is considered urgent dental care and therefore, your dentist will be able to treat you. This has been a consistent exception to the COVID-19 quarantine because it is medically necessary. Dental infections have to be physically removed. That is typically done in one of two ways. If the tooth can be saved, a dentist will do a root canal treatment. If the tooth can’t be saved, then an extraction becomes necessary. If that happens, you will want to replace your tooth.

Dealing with Dental Anxiety

I know you are not the most comfortable going to the dentist and hearing the procedure doesn’t have to be postponed because of the quarantine probably increased your anxiety. The good news is, there is a fantastic solution, which could change the way you view dentistry in the future.

I’d like you to see a dentist who offers dental sedation options. Most dentists offer two levels of sedation. Nitrous oxide, which is a gas administered to people with mild anxiety, and oral conscious sedation. This is administered by a pill and is strong enough where you’ll need someone to drive you to and from your appointment.

Dr. Cha offers a third level — I.V. Sedation. This is for patients with such high anxiety that they want to be out. Very few dentists offer this option and it requires special training.

This blog is brought to you by Tulsa Dentist Dr. Jerome Cha.

Can a Smile Be Pretty After Dentures?

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About 30 years ago, I received full dentures. They have always looked fake. Now, as I’m aging, I’m having a hard time keeping them in. Is it too late for me to have a pretty smile? Are there other options for me instead of dentures?

Lucy

Dear Lucy,

Mature couple posing and smiling

No matter what your circumstances, you can have a beautiful smile.

It makes me incredibly sad that you’ve gone this many years embarrassed by your smile, through no fault of your own. Patients don’t always know the options available to them. There are many dentists, Dr. Cha included, who are trying to change that. First, I want to address why you are having trouble keeping your dentures in at the moment.

When your teeth were removed, your body began resorbing the minerals in your jawbone. Within the first three years, you lose up to 60% of your jawbone. After those initial years, the rate of resorption slows down significantly. However, you’ve been missing teeth for 30 years. That is more than long enough to have facial collapse set in. This means you’ve lost so much jawbone, there isn’t enough left to retain your dentures properly.

When this happens, you have to build back up the bone in order to have properly functioning teeth again. This can be done with bone grafting.

Dentures or Dental Implants

After you have built the bone back up, you have a couple of choices. The first is to get dentures again. The biggest downside to that is you will again begin the bone resorption. This leads me to your second option. You can get implant overdentures. These use four to six dental implants to secure your dentures to your jaw.

Having those implants have quite a few advantages:

  • It prevents bone loss.
  • It keeps your dentures completely secure.
  • It greatly improves your quality of life, including your chewing capacity.

Getting a Beautiful Smile

The key to getting a gorgeous smile is the dentist who creates your dentures. Cosmetic dentistry isn’t really taught in dental schools. Because of that, you need to find a dentist who is not only skilled with dental implants (if you decide to go that route), but invested significant time in cosmetic training. The top of the line cosmetic dentists are AACD accredited. That’s different from just membership. Accredited dentists have passed stringent exams on their technical knowledge and presented a large number of specific cases, they’ve personally done, to prove their artistry.

This blog is brought to you by Tulsa Cosmetic Dentist Dr. Jerome Cha.

My Tooth Fell Out

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I used to have nightmares about my front teeth falling out. Well today one of my back teeth fell out. I’m not sure what happened. It had been hurting for a while, but then stopped. I’m worried this can happen to the rest of my teeth. The problem is I’m terrified of the dentist. Is there anything I can do from home to help this.

Brandon

Dear Brandon,

hockey player with a knoced out tooth

In general, there are two reasons that will cause your teeth to suddenly fall out. One is trauma. This is what likely happened to the hockey player above. When a tooth gets knocked out, it is imperative you get to the dentists withing 30 minutes. This gives the dentist the best chance of saving your tooth. You’ll want to hold the tooth by the crown and not the root. Be sure to keep it moist, either by keeping it between your cheek and gums or by placing it in a cup of milk. Hopefully, the dentist can reattach it. If not, then the dentist can help you understand your tooth replacement options.

The second reason for losing a tooth suddenly can be more serious and I suspect this may be what you are facing. It is the result of advanced gum disease. This causes bone loss and gum recession, leading to your teeth coming out. This will require interventive treatment to keep more teeth from falling out. Once you’ve got that under control, then you’ll be able to begin replacing the teeth you’ve lost. The best tooth replacement option is dental implants. You won’t be a good candidate for that until you have your gum disease completely under control.

When You Have Dental Anxiety

I know you were hoping for treatment you could do at home and avoid the dentist. Unfortunately, there is no way to treat either of these issues from home. The good news is, I have a way for you to have anxiety-free appointments. I want you to see a dentist who offers dental sedation.

There are varying levels of sedation available. The lightest range is nitrous oxide. This is sometimes called laughing gas. It will help relax you and enable the local anesthetic to work more efficiently. I suspect, because of your level of anxiety, you will require the next level of sedation— Oral conscious sedation. This is administered with a simple pill. However, it is so strong that you’ll need someone to drive you to and from your appointment. You’ll likely even sleep through the whole thing.

This blog is brought to you by Tulsa Dentist Dr. Jerome Cha.

Dentist Can’t Get Me Numb

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I need some help. I’ve been to the dentist three different times for an attempted tooth extraction. Each time, he’s given me up to seven shots of anesthetic and I just can’t seem to go numb. I’m in agony with this infected tooth and I’m worried it will only get worse. Have you encountered this before? My dentist can’t figure out why this is happening as he’s never encountered it.

Paul

Dear Paul,

Woma asleep in teh dental chair from sedation

I think I can help you. Many dentists don’t yet recognize the connection between anxiety and Novocain. It is completely normal to be anxious in the dental chair. For some patients, however, that anxiety severely kicks up their metabolism burning off their numbing medication. Once that happens once, it becomes even harder to get numb the next time because of the previous experience.

Fortunately, there is a solution.

What you need is to see a sedation dentist for this tooth extraction. There are generally three levels of dental sedation. The lightest level is nitrous oxide. This is sometimes called laughing gas. It gives you a relaxed floaty feel. It’s biggest benefit is that once your procedure is done, your dentist will switch the gas from nitrous to oxygen and in just a few moments you are back to normal and able to get on with your day. This is most effective for patients with mild dental anxiety.

The next level of dental sedation is called oral conscious sedation. This is for patients with more severe anxiety. It is a simple pill you will take before your appointment. This will completely relax you. In fact, you will need someone to drive you to and from your appointment, as well as stay with you for several hours afterward until you are lucid. This is he sedation I think you’ll be best served by using.

The third level is I.V. sedation. Very few dentists do this level, though Dr. Cha does.

What Should I Look for in a Sedation Dentist?

While sedation is very safe, you still want to find a dentist who has invested in special training for it. For instance, Dr. Cha is both DOCS and ACLS certified so you know he has invested training in all sedation procedures as well as emergency protocols. That is really what you want to look for.

I’m assuming your tooth is too far gone for a root canal treatment or your dentist would have suggested that, but I always feel it is best to save a tooth if at all possible. Once this tooth is extracted you will need to replace it. Don’t wait too long or your other teeth will shift or tip into its place. Talk to your dentist about all your tooth replacement options, but I’d look strongly at getting a dental implant.

This blog is brought to you by Tulsa Dentist Dr. Jerome Cha.

Oral Surgeon or Dentist for an Extraction

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I have pretty severe dental anxiety. That is what has left me in the quandary I’m in now. I had a cavity I was afraid to get filled. Then, it became infected and the pain was so bad I had to go back in. This dentist did a root canal treatment. That was excruciating for me so I chickened out about coming back for the crown. As a result, the tooth got re-infected. Now the dentist says it needs to be extracted. He told me it would be pretty extensive and there would likely be a need to cut into bone. He gave me the choice between doing it with an oral surgeon using anesthesia or having it cost less using him. I don’t want it to cost more but I also don’t want to have a problem because I didn’t want to spend money. What is the right thing to do?

Marina

Dear Marian,

A woman wearing a nose piece for nitrous oxide

It was unfair of your dentist to put you in that position. He made it sound as if you didn’t go to an oral surgeon, the treatment was risky. It’s not. One thing I wonder is whether or not your dentist feels out of his depth and therefore he’s trying to encourage you to go elsewhere for your procedure.

I would ask him how comfortable he is with the procedure and how much experience he has with this type of extraction. If he’s comfortable with it, there is no reason you can’t do it with your dentist. The anxiety issue can be solved in a way where you can have a pain free appointment.

Sedation Dentistry—the Solution to Dental Anxiety

There are dentists who provide sedation in-office. Most offer two levels of sedation: nitrous oxide and oral conscious sedation.

Nitrous Oxide

This is administered with a nosepiece, as you see in the picture above. You breathe in nitrous oxide right before your procedure. It will relax you and help your numbing medicine become more effective. This is most useful for someone with mild dental anxiety.

A benefit of this type of sedation is once the procedure is over the dentist changes the gas to oxygen and you are lucid again in just a few moments and ready to get on with your day as normal.

Oral Conscious Sedation

If your anxiety is a bit more severe or the procedure is extensive, you may want oral conscious sedation. This is a pill you take before your appointment. It will completely relax you. It’s so strong, most patients sleep through the procedure.

Because of its strength, you will need someone to drive you to and from your appointment as well as stay with you for several hours afterward until you are clear-headed and steady on your feet.

You are likely to find that this helps you with your anxiety and helps you get to the dentist more often. This will help prevent any further dental emergencies as well.

Make sure you replace the extracted tooth. Without a good replacement, like dental implants, the adjacent teeth will drift or tip into the open space. This will lead to TMJ Disorder.

This blog is brought to you by Tulsa dentist Dr. Jerome Cha.

Husband Can’t Wear His Dentures

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I’m worried about my husband. He got dentures, but he can’t wear them. We’ve been back several times for refittings, yet nothing seems to work. I don’t know how to help him. He’s miserable and can barely eat without his bottom teeth. Do you have any advice?

Carolyn

Dear Carolyn,

illustration of dentures beside a dental implant

It sounds like your husband is really suffering. It is not uncommon for patients to have an adjustment period to dentures. For some, it’s quite difficult. Usually making adjustments helps. Others never adjust. This is a chance to evaluate what his next steps are.

If he’s determined to stick with dentures, he could go to a different dentist to try someone else’s hand at refitting his dentures. Another option is a prosthodontist. They have more experience than some of your local dentists, depending on where you live.

An Alternative to Dentures

If he just can’t adjust, he has another option. Dental implants are a fantastic tooth replacement option. These put prosthetic tooth roots into his teeth. He will no longer be in pain. It’s more like having healthy, natural teeth back.

However, there is an even better reason to get them. When his teeth were removed, his body started slowly leeching the minerals out of his jawbone to use elsewhere in his body. It does that to be efficient. This is causing his jawbone to slowly shrink. Eventually, there won’t be enough jawbone left for his denture to stay in place. Dentists call this facial collapse.

Getting dental implants prevents this from happening. Because the prosthetic root is placed in his jawbone, his body interprets this as him having teeth and needing his jawbone. This will change his life. He’ll be able to eat again. In fact, he can eat anything he wants, even steak.

If you decide to go the implant route, make sure your husband sees an experienced and qualified implant dentist. It’s an advanced procedure and requires significant post-doctoral training. For instance, Dr. Cha took every course on it the Misch Institute offered and is a Fellow at the International Congress of Oral Implantologists (ICOI).

I wish you both the best.
This blog is brought to you by Tulsa Dentist Dr. Jerome Cha.

Do I Need a Special Dentist for Implants?

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My husband wants to get two dental implants. I think he needs a specialist and he said regular dentists do it. Because we’re talking about surgery, I just want to make sure he gets the best care possible. What’s the right type of caregiver for this?

Cindy

Dear Cindy,

Illustration of dental implants in three parts

I don’t blame you for wanting the best dentist possible for your husband’s care. In fact, it’s not just the sign of a loving wife, but a wise one as well. To answer your question, there isn’t a dental implant specialty, but there is a distinction in what type of dentist your husband should see for his implant procedure.

Finding the Best Dentist for Dental Implants

The first thing you want to look for is a dentist who is well-trained in the dental implant procedure. When I say well-trained, I’m not referring to a good dental school. This procedure is so advanced it requires significant post-doctoral training.

For instance, Dr. Cha completed every course at the famed Misch International Implant Institute. Not only that, he’s done so many successful implant cases he’s now a fellow at the International Congress of Oral Implantologists (ICOI). This puts him among the top implant dentists in the world.

The second thing you’ll look for is a dentist who can do the surgery himself. Many dentists who say they do dental implants actually only do the crown portion and farm out the surgery to another practice. While that can work, often communication issues arise which means the dental implant isn’t placed in the exact position the dentist needs.

Oral surgeons may be good at surgery, but they don’t always understand the science behind how teeth should properly meet with each other. This can lead to biting or aesthetic issues. If you have a dentist trained in the surgery, there’s no chance of bad placement through miscommunication.

Finally, you’ll want a dentist who is skilled in cosmetic work. You want the porcelain crown used for the tooth to look both beautiful and natural, blending in perfectly with your natural teeth. Ideally, you’d find a dentist who is not only highly qualified in dental implants but is also accredited with the American Academy of Cosmetic Dentistry (AACD).

This blog is brought to you by Tulsa Dentist Dr. Jerome Cha.

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