I really enjoy these questions. It was just yesterday that a patient came in with that very situation. Let me share with you some of the things that we discussed. My goal for years has been to keep as many teeth as possible in the mouth and keep my patients away from a denture. If we need to make a denture, I go to all lengths to spend all the time that I need, not try to use any shortcuts and make the best denture possible. Again, that is when all else is not possible or does not work well.
Today, everyone is in a rush to remove the last two teeth and make a full denture. I am not an advocate or a fan of this approach. Even if one has been wearing a partial the transition to a full denture is enormous and the function goes down tremendously. So I try to avoid this whenever I can.
There are two ways to allow a set of teeth to grab in someone’s mouth. The first technique is very much in style and those of you who follow this column, know that I have written about it extensively. That treatment involves removing the last two teeth and placing dental implants for denture anchorage and stability. I am not going to talk about that today. I want to focus on keeping the teeth and using those for anchorage.
One of the simplest way to stay in a partial denture with only two teeth left involves capping or crowning the teeth. A partial denture requires a smooth off and on motion. While the teeth are in place, we want the partial to not flop or bounce around a lot. Designing a partial denture on natural teeth does not always allow these things to happen. Natural teeth may be tilted or turned making those qualities difficult to achieve. When we crown those 2 remaining teeth, we can make make them parallel for ease of removal and placement. At the same time we can design spots for the partial denture to rest upon and grab those teeth snugly. This snugness will give us retention and more stability. In addition to that we now have the teeth with an extra layer of protection against decay by virtue of the crowns. This will extend the life of these teeth.
So one way to keep teeth to hold a partial denture is to crown those two teeth and then make a partial to take advantage of the custom crown shape. The other way to use the two remaining teeth as if they are dental implants. The teeth are shortened and the same type of connector that is used with implants can be used with natural teeth. This method has been around for many years. Many dentists don’t even know that this option exists, because all of the current training focuses on implants.
I have used this technique for years and it can be more cost efficient than dental implants. Assuredly, it reduces the time frame for treatment by a significant amount. These teeth can be used as the only anchors for a partial or in conjunction with some other teeth or dental implants.
If you would like to find out more about your choices and the possibilities that exist for treatment that is customized to your particular situation, please call me at 440.951.7856. I am always happy to speak with you