Call Us! 610-621-2099

Dentures Partials

DENTURES, PARTIALS, BRIDGES:  Tooth replacement can be accomplished a variety
of ways.  If you have a tooth on either side of a space created by an extraction, a “fixed” or
glued in tooth can be attached to the adjacent teeth using a porcelain covered metal frame.
The teeth on either side of the space are prepared for crowns or caps by reducing the tooth
by 1-2 mm all around.  The two caps support a fake tooth in between like a bridge spans
a river.  Though this is less desirable than an implant, which you can floss normally around,
but it offers a solid solution to replacing a missing tooth that you don’t have to soak in a cup
at night.  You can floss around a bridge,  but it just takes a bit more effort and time.

A Partial denture is used when don’t have teeth on the back end of a span of missing teeth,
or the span is too great to restore the strength due to too many extractions.  You need to have
equal or greater amount of root surface to support the root surface you are replacing.  This
often requires capping three teeth to replace two extractions.  It can be a costly solution, and
a partial denture offers a more economical solution.  Many people wear partial dentures and
function quite comfortably.  Nothing is as good as your own teeth, and the more teeth you
need to replace, the more debilitated your bite and function becomes.

Partial dentures use clasps to hold the appliance in place.  It is preferable to cap the abutment
or clasped teeth with a permanent restoration such as a crown (30+ years) because a partial
denture uses a cast titanium frame.  If you need to change a filling on a tooth that is used for
retention or support of the partial… you can never precisely mimic the shape of the original
restoration, and your custom cast partial may not fit as it once did when it was originally
fabricated.  It is better to build a house on stone than on sand as the parable states.

When considering a partial, the clasps can sometimes be seen when you smile.  The alternative
is precision or internal attachments that replace the clasps with a hidden retention device built
within the crown and the partial.  Imagine a basketball hoop made on the bottom side of a
crown near the gum.  Inside the plastic of the partial is a male part that clicks into the hoop.
Precision partials provide for a more sturdy attachment with optimal esthetics where needed.

Other partial denture designs are made of a special flexible acrylic (Valplast) that uses no clasps
and locks into the undercuts of your remaining teeth. This has limited use depending upon
which teeth you are replacing and have an added drawback of not being able to add another
tooth (if one is lost) to the partial once fabricated because of the type of plastic used.  Some
dentists use an all acrylic partial without an underlying supportive metal framework.  This may
work when replacing a single tooth (called a “Flipper”) but rarely is a permanent solution.
Sometimes wrought wire or custom cast clasps (only) are incorporated into the plastic.  These
are inexpensive “fixes” that are not as ideal as a cast framed partial built upon a solid foundation
or permanently restored teeth.  We sometimes use these designs if the patient has had a recent
(or is having an) extraction.  This is called a transitional partial.  It’s less expensive and provides
for temporary tooth replacement while the bone is healing (and changing shape) until a cast
partial can be fabrication.

Overdentures are a step between full dentures that require suction to stay in place and partials.
Sometimes a few select teeth can be saved and used for retention of a full denture.  Sometimes
we have one or two teeth fit through a denture with pink rubber gaskets to hold the denture in.
Sometimes we can use teeth that are root canaled and place a post with a ball on the end that
fits into an O ring fabricated into the denture.  Two supports are good.  Four supports are great.
(Ever sit in a chair with two legs?)  Implants can also be placed under a denture and used
as an attachment.  This is a great adjunct for lower dentures, which aren’t held in by suction,
but by the muscles on the side of your tongue.  A few retentive techniques can make a world
of difference… you will even wear them for more than just family photos!

Dentures… the final frontier.  We rarely suggest that you have all of your teeth removed, unless
you have severe periodontal (gum) disease.  Anytime you remove a tooth, your bite becomes
less functional and more debilitated.  You loose 60% of your effective chewing with dentures,
and that’s if they fit you well.  Over time, some people forget or ignore the fact that bone changes
and the inside of the denture needs to be relined to fit the current shape of the bone.  If you don’t,
the areas that are not being supported are not triggered to be strong, and therefore recede even
more.  The American Dental Association suggests that dentures should be replaced every 5 years
to prevent accumulation of bacteria in the acrylic.  It’s also important to replace the bite on the
opposing side.  We often see folks who have a full set of upper dentures, and only the lower
front natural teeth.  five or ten years go by (I was gonna git them lower partialz), and you see the
back of the top denture tilting down.  The impact of the lower teeth creates a suction that actually
sucks the back ridge on the top down.  This is very weak bone due to the location of the sinus,
and often provides for complications that may lead to surgery.  Another problem often seen is
the bone in the front of the top jaw resorbs from the trauma, and you’ll get hyperplastic flabby
gums for a ridge.  This extra tissue must be removed prior to making new dentures so you can
stop this condition and prevent further destruction of the bone.

When we make dentures, we used the rule that if we are replacing teeth against natural teeth,
we use porcelain replacement teeth to prevent wear.  If we used plastic teeth against natural
teeth, they would eventual wear down and your natural skeletal bite will be off and you may
experience joint pain or a skin condition on the corners of your mouth.  I call this the “Popeye
syndrome”, where eventual your lower jaw protrudes  from a decrease in the natural vertical
dimension.  You get more facial wrinkles as well.  Maintaining or re-establishing what the
god Lord gave you is extremely important.  After all you can’t expect to remove a spark plug
from your car and expect it to run correctly, now can you?!