Category: dentistry

Dentures that don’t fit well anymore

Recently, television the air waves have been filled with commercials for denture adhesives to secure those loose fitting dentures and now those loose fitting partial dentures. So, what’s that all about. Well anyone with dentures know that even if they had a lot of suction when the dentist delivered them brand new to you, dentures over time loose that suction, “that tight feeling”. This is because dentures always move more than our teeth, no matter how good we make them, and because they move against our tissues, we loose boney support over time. The bone just melts away forming small and some time large gaps under the denture. This helps to break the seal (the suction) and produce a “looser” fit. Then more movement, more loss of boney support and so on. Those adhesives work for a time, but then again you have to put more and more in every day. The solution is to get a “reline” to your denture. So what’s a reline. We take a new impression of the voids inside your existing denture, send it to the lab and later that day, after the lab has put new denture material inside, we deliver the “new” denture back to you. A new fit and the suction is restored. In our practice, we use a very old time tested technique and an impression material that is “mucostatic”,...

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Crowns, why they break

Ever look at that new crown put in less than 5 years ago and see that half of it is missing? This is especially true in the back of the mouth (posterior) where the forces that you bite with can sometimes overcome the strength of the materials used. This is often true of the “full ceramic” crowns, and the new “Zirconia” crowns. In a study presented at the recent American Association of Dental Research it was reported that after just 2 years almost 40% of this type of crown failed usually splitting in half and necessitating complete replacement. It’s generally due to surface cracks that grow (that’s called crack propagation), connect and then the crown fails. The cracks are from the manufacturing of the crown by the lab or when we have to make adjustments before seating the crown in your mouth. In our practice we use a metal re-enforced crown called a PFM (porcelain fused to metal) which helps avoid these cracks and fractures. Any porcelain can crack and fail, but generally PFMs last longer in the back potions of the mouth. We tend to want to use the conservative method, the PFM, in our practice but always want to give options and respect the wishes of our...

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Why did this new filling break?

Why did this new “white filling” break is a question I hear more and more in my practice. A new patient comes in for an exam and has a “new” filling that has been done within the last 2 years, sometimes within the last year, and it has already failed. Normally I tell the patient that it most likely was the filling material the dentist used or the bonding agent that was used. Both are critical in achieving a restoration that does not fail too early. Research is telling of controlled clinical studies that show the new “nano” fills are failing within the first 2 years at rates we have not seen since the late 1980’s. In my practice, based on my knowledge of materials, my research I have done and continue to do at the UTHSCSA Dental School, and the published research, we use a composite first manufactured in the mid 1990’s and a bonding agent first used in 1990. Why? Because they work, have long term clinical trials that say they work and in our practice normally last more than the American Dental Association’s average of 3-5 years. We want them to last more than 10 years and that’s the reason we are conservative in what we use to restore teeth to their vibrant form and...

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So, How did I get this Broken Tooth?

We get patients from time to time who say, “I was eating breakfast this morning, oatmeal, and suddenly there was something crunchy and half my tooth is missing.  How did that happen?”  Well it is pretty simple.  Teeth are brittle and a property of brittle materials is that they are subject to fracture.  It’s like the windshield of your car.  You get a small nick or crack from a rock, and the crack grows until, if you don’t replace the windshield first, the windshield will break.  This is called crack propagation, or simply the crack grows.  In the mouth we sometimes chew things that crunch and when they do crunch can place a great deal of force on the teeth.  Things like chewing on ice, the un-popped popcorn kernels in the bottom of the bowl, or the last little pea size bit of candy left over when you suck on a jaw breaker or atomic fireball.  When we chew, we compress our food between our teeth and stress builds up and if what we are compressing is exceptionally hard, all the stress built up will release all at once and the teeth will actually slam together.  This will produce sometimes a flaw or crack in the enamel of the tooth, the outside hard material called the crown.  As we chew and force is applied daily, the cusp of the...

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Are All Dentures The Same?

Not all dentures are made the same way.  Many new materials have been developed to make dentures stronger and to make them look better longer.  That’s good for everyone, but for most people, they just want a great fit; they want to be able to eat better.  They want the denture to stay put on their ridges and not wobble around. In our practice, we have taken a page out of the past in many respects.  We do things a little bit different.  Whether like the “immediate” denture described below or one made after healing has been allowed or even for the next pair of dentures made after the old pair has worn out.  It’s how we take impressions.  I am old school.  I use a technique and an impression material that is well over 50 years old.  Well the impression material is not 50 years old, but this impression material was developed first over 50 years ago.  Most dentists will use “stock” trays; they fit anyone!  We use custom trays made from an initial impression.  We use “green stick” compound to develop the boarders of the denture to fit your mouth and only your mouth.  Then we use the special ingredient.   We use the only muco-static impression material ever marketed, zinc oxide paste.  Muco-static is a big word for the material does not displace or move the soft...

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