Getting dentures or not?

[trabian]

Hello, I am 56 yo and have been living with bad teeth all my life. I was a neglected child and was never taught to brush properly (among many other things). I had my first checkup at 5 and my milk teeth were so bad that they had to put me into general anesthesia and surgically remove some of the teeth. Between 6 and 8, my front permanent teeth began to stick out outside my milk teeth, especially the upper ones. These milk teeth were later extracted instead of falling out naturally, but had already caused a severe overbite. Practically all my teeth already had caries and fillings by the time I was 12. I'm trying to understand how this all came to be without any plan of intervention to try to salvage some of the damage, and it was probably a combination of neglect from my parents and the fact that my parents kept moving to another city or country every 1 or 2 years. When my wisdom teeth came out, things got even worse because they pushed my front teeth into a jumble. I simply got by with it. I have very thick lips and my mouth was always slightly open at rest, and my lips were always dry and cracked.

About 10 years ago a dentist suggested I had my premolars removed. I was stupid enough to not get a second opinion, because I was very afraid of going to another dentist. After the extractions and the orthodontic treatment I could at least close my mouth properly, but now when I smile you can't really see my teeth if I'm not grinning very broadly.

I've been very unhappy and self-conscious about smiling ever since. I was recommended another dentist who studied the situation, and I got braces to try to pull the teeth forward and maybe have new premolar implants on the lower row. I was in treatment for 18 months and finally got my money back because they hadn't really managed any result. I later went to a supposedly even better dentist, but she said that even with new implants it wouldn't be possible to get my teeth forward significantly, to make them "show" as with a normal set of teeth.

The situation today is that I'm starting to lose molars, many have enormous fillings that are starting to fail after so many years and the teeth crack from top to bottom. I had two extracted last year and probably one more will go soon. The enamel of my teeth is also very deteriorated, and just a couple of days after a cleaning by the dentist they're dark and spotty again from drinking tea and coffee.

Today I still brush and floss and go to checkups, but it's as if my teeth don't exist, I've given up, I'm not sentimentally attached to them and would gladly pull them all out. I'd very much like to be able to smile and see my teeth in a photo with other people, but right now it's like an empty hole between my lips. My fear is that my gums and bones underneath won't permit a set of dentures to look "normal"...

Has anyone had a similar experience, or is there a professional here that has treated a similar case successfully? Any response would be appreciated.

 

[Dr M]

Good day

It is difficult to give an opinion without knowing the exact state or condition your remaining teeth are in. It is important to note however that with aging, you lose the natural elasticity in your face. This means showing less and less teeth as you get older. For an opinion of exactly what can be done, we would need to do a full clinical examination , to evaluate the condition of the remaining the teeth. the condition of the supporting structures of the mouth, such as your alveolar bone and gum tissues.

 

[trabian]

Good day

It is difficult to give an opinion without knowing the exact state or condition your remaining teeth are in. It is important to note however that with aging, you lose the natural elasticity in your face. This means showing less and less teeth as you get older. For an opinion of exactly what can be done, we would need to do a full clinical examination , to evaluate the condition of the remaining the teeth. the condition of the supporting structures of the mouth, such as your alveolar bone and gum tissues.

Thank you for your reply, Dr M. I am aware that an examination is necessary for a qualified opinion. Maybe what I'd like to hear here are simply examples of similar cases or others' personal experiences, because I feel very lost right now. Also, perhaps you or other professionals may have some general thoughts about the following:

1. How many teeth do people usually lose before a full denture is considered? I don't like the thought of partial dentures or just filling the gaps with implants since the state of my remaining teeth is so bad and in 10-15 years they're probably going to fail anyway. At the same time it seems a bit radical to pull everything out, because my teeth are largely functional at this time although I have some gaps in the back.
   
   
2. Can dentures work well even though they're not exactly aligned with the original gums and the bones underneath? I mean, in order to correct a large overbite?
   
   
3. Do people of my age (56) generally get implants or dentures, when everything is removed? I'm trying to think pragmatically: costs, maintenance, general satisfaction etc. I do have some resources tucked away for this, but spending more than a sports car's worth on the treatment (like Iggy Pop) seems extravagant to me.

Regards,
Trabian

 

[Dr M]

To answer your questions :

1) It depends. I was taught that if you have at least 8 occluding teeth, this should be enough to function. But this differs from person to person and where these teeth are located.

2) If you decide to go the denture route, you will most likely be looking at what we call immediate dentures. This is where the dentures are manufactured and then all the teeth are extracted upon delivery of the denture. This is usually what I like to call a " guesstimate ", because the teeth are set up in such a way to provide optimal function, but not always optimal aesthetics, since you can't have a try in visit to see how they would look like, while you still have teeth in your mouth. You can still have some improvement on the overbite you mentioned.
After the teeth has been extracted, your alveolar bone remodels. This can sometimes take a year. After this, a new set can be planned out and made to suit your specific functional and aesthetic requirements.

It is important to note that removable dentures will never ever be as comfortable as your own teeth. Since it is REMOVABLE.

3) You can get either implants or dentures at your age. This choice is only dictated by your available tooth supporting structures as mentioned previously and finances. For an estimate you will have to go for a consult first, with your dentist or treating specialist.

 

[trabian]

Thank you again for your professional opinion, Dr M. What you say about the guesstimate worries me since I'm very concerned about the aesthetics, in fact it's the main reason I'm considering dentures right now since my remaining teeth are at least functional. A denture with teeth in the same position as now would still be invisible when I smile, however white and perfect they are.

Btw I've now read a bit about fixed dentures, wouldn't that be a good option if one removes all the existing teeth?

I would still like to hear from someone that has gone through something like this, from a patient's view.

 

[Dr M]

For fixed prosthesis, you will need an evaluation from a dentist or dental specialist, in order to see the quantity and quality of bone you have to work with. Fixed dentures are attached to implants. This process can be expensive