February 1, 2001

Dear Dr. Mady: I saw my dentist the other day and requested that he pull all of my remaining teeth. He did agree that they are not salvageable but wants to keep the roots of a couple of the lower ones so that the new denture will snap over top of them and fit tighter. He said he will get these teeth and the new dentures ready before the teeth are pulled and will insert them at that time. Do you think he is doing the right thing by keeping a couple of roots under my denture? I just don't understand the reason - A confused patient.

Dear confused patient: What your dentist is referring to is known as an overdenture. The word simply means that your new denture will be placed over something to help it stay in better.

An overdenture is a denture that uses precision dental attachments to retain a solid position during wear. This attachment can be placed in the tooth roots of the teeth he wants to keep, or into dental implants which have been placed to receive them. This type of denture derives its support from these abutment teeth by completely enveloping itself over them, beneath the fitting surface.

These abutment teeth usually are treated with root canals so that the roots are filled and are either reduced with or without attachments placed in them, or attached by some sort of a precision bar.

No different in terms of esthetics

In other words the teeth your dentist will leave behind will be specially prepared, but at the same time your denture will appear no different in terms of esthetics than a regular denture. The only difference will be under the denture.

Other advantages of overdentures, in addition to esthetics and retention, are the lack of a need for denture adhesives and creams, and the slowing of the bone loss process that is often experienced with standard complete dentures.

Saving your natural teeth roots will significantly reduce the loss of jawbone height in those areas because extracting promotes bone resorption naturally. The more bone you can retain, the more stable a fit you will have with your dentures.

Facial contour changes

Also, if the bone is preserved it allows your dentures to better control facial contour changes that lead to premature wrinkles and aging and a shrunken-looking face.

I really feel that if you take your dentist's advice that you will also be able to speak more clearly, so there will be less of a chance that your friends and relatives will notice a drastic change in you. If your dentures are placed more firmly, you will chew and break down your food better, and this can only improve your digestion and as a result your overall health.
Because you are going to be a first-time denture wearer, you may experience some temporary problems. The need for some adjustments because of sore spots or an uneven bite is normal, especially during the first four to six weeks.

You may experience increased saliva flow because your mouth is not used to the prostheses and occasional gagging at first can be expected.

Muscles won't adapt immediately

The tongue may feel crowded and your speech may be slightly different initially because your muscles won't adapt immediately.

But as you adjust the problems will go away. All you have to do is put it in your mind prior to this treatment that it is going to work. If you do this, it will make it a much easier task.

The overdenture is an excellent alternative to complete and total extractions of your teeth and these couple of retained roots will provide excellent stability and support for your new denture(s). They will make a world of difference.

This column is reprinted with the permission of the author and The Windsor Star. "Ask the Dentist" is written by Windsor dentist (and ECDS member), Dr. David Mady Jr.. The column appears the first Thursday of each month in the Windsor Star. Readers with questions can write to "Ask The Dentist", c/o The Windsor Star, 167 Ferry St., Windsor Ontario, N9A 4M5



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