Doctor Kulaga

“I have lost all confidence in my smile.”

Has this statement ever crossed your mind? If so, you are not alone! In our office, we often see patients who want to regain confidence in their smile and repair the function of their teeth so they can chew even simple foods. A big part of life is enjoying laughter with friends over a good meal, so, when your teeth keep you from socializing due to embarrassment, it now goes beyond just “I can’t eat”. The good news is, we are here to help! We have many options in our office to help our patients and each procedure has its pros and cons. In this article, we go into great detail about what to expect from your transition of broken teeth to a smile you can be proud of!

At White Wolf Dental, we never judge our patients and will do whatever it takes to make you comfortable. We will listen compassionately to your needs, wants, and desires. This article describes the most severe situations: When teeth cannot be saved.

All of our doctors are firm believers that dentistry is second to mother nature and try everything to keep dental work to a minimum. We all believe the best dentistry is preventative or no dentistry at all. Unfortunately, many people have circumstances beyond their control, such as their daily medications, underlying illnesses, or even fear of seeing the dentist, that cause their teeth to fail.

Now, let’s talk about what we can do to repair your smile:

We can do standard dentures for both the top and bottom
We can do implant dentures that are removable but snap into place
We can make a fixed hybrid prosthesis that is screwed down and only removed in office

While there are many options on how to sequence these procedures, we have developed a remarkable formula that gives our patients the most predictable results. I will say this now, in dentistry, slower is sometimes faster and I’ll explain more later.

The most affordable option is to do conventional dentures. The majority of people do very well with their upper denture as it has a lot of surface area to create suction, and very few people require implants on the upper arch to stabilize the denture. The lower denture, however, is much different as people have difficulty with the looseness and sores created. Why is the lower so much harder to deal with? You have a strong tongue, chewing muscles, and less gum to attach to. All of these factors lead to patients not being very satisfied with the bottom denture. Patients will only have approximately 30% chewing function of natural teeth with conventional dentures. Here’s a list of the pros and cons:

Pros: Lowest cost, easily repairable, can be relined to fit better, fastest solution
Cons: May need to use adhesive, feels the largest in the mouth, teeth can wear prematurely from a harder food diet, teeth can crack, teeth may come off, food tastes different with roof of mouth being covered, cannot bite corn on the cob or bite into an apple

Our second option is doing implants with dentures. This is a very popular option as you do not use adhesive, the upper denture does not cover the roof of the mouth, and the lower denture is much more stable. Patients will have approximately 45% chewing function of natural teeth. Here’s a list of the pros and cons of implant dentures:

Pros: Do not need to use adhesive, roof of mouth is not covered, feels less bulky, more comfortable due to smaller size, lower denture does not fall out, stronger denture base with custom metal framework.
Cons: Nylon snaps need to be changed every 12-18 months (usually 6 to change out at around $25 each as of this writing), relines maybe needed at year 5 or so, teeth can wear prematurely from a harder food diet, teeth may come off, lower denture with 2 implants still has a slight forward rocking

The first two options have a similar beginning and processing so we will walk you through what to expect if you choose either of these denture options. I will be frank and honest here and not sugar coat the process as we want all of our patients to make the best decision for themselves. First, you will visit us for xrays, photos and records. At this appointment, you will tell us which option you would like . Since this is a complex procedure, we almost always ask our patients to return for a complimentary consultation to go over costs and time frames. We feel an appropriate plan can not be made in 10-15 minutes while you talk with the Doctor during this initial exam. Following your initial exam, your team of Doctors plan your case together to make the most predictable outcome. We will schedule you to take models, pick the color, shape and size of your teeth and coordinate with our lab to make your new smile. Since we do not have the ability to test-fit your teeth before surgery, your cosmetics and bite may not be perfect, but I would say we get 80% of the way there. Even for your temporary dentures, we use a high quality local laboratory giving you the best possible result. On the day of your surgery, your natural teeth are extracted and we place your prosthesis. We want you to wear your prosthesis for 24 hours. Many people return to work in three days after surgery. For the first week, your dentures will be the most loose as your gums need time to heal before pressure can be applied to them. One week after your surgery, we will place a soft liner to tighten up your dentures. Week two is when things start to get better and you begin to learn how to use your new teeth. During the first three weeks, you will likely need the most adjustments for sore spots. In our office we never charge for denture adjustments as we want you to wear them and be comfortable. If we see you 3 times in a month or 20, it’s okay! Everyone is different and healing can be variable. This is also something to take into consideration when thinking about the overall cost of your denture. In some practices, not all the costs are upfront costs. By week four, things are usually smooth sailing.

In our office we usually make two sets of teeth, your temps which were described above, and a final set. Why two sets? Since we did not have the ability to try in your teeth before surgery, the cosmetics and size of the denture is not ideal. With the second set, we are able to customize the teeth to a more ideal form and fit. We usually start making the second set around month four and we will take what is called a final impression on month six. I know what you are thinking: Why do you wait six months for a final set when other offices do it all in a day or six weeks? We have found if you move too quickly, the patients need a hard reline of their denture within a year because we have not allowed the bone and gum to adequately heal. Hard relines can be a costly and unexpected expense that we try to get in front of. This is where slower is faster! By allowing you to heal more, your final denture fits much better and the risk of relining your new denture is minimized. Sometimes, the patients are so happy with their temporary dentures and do not have the budget for a second set, we can turn the temporary dentures into your final dentures by doing a hard reline at month six instead.

If you want to achieve results most like your natural teeth, our teeth in just a day procedure will be the best option. The name, “ teeth in just a day”, is slightly deceiving because, while you do get a new set of teeth on the day of surgery, these will be your temporary teeth. We usually complete the process with your final set around month six. Again, we want to make sure your bone is stable, your gums are stable, and your implants have achieved osteointegration (your body has attached to the implants)with no bone loss. Your final set of teeth will be made from a zirconia with a layered porcelain which has a 3 year warranty or a monolithic zirconia that has a 6 year warranty. We no longer offer weaker plastic or composite teeth, however, the higher quality teeth we do offer are priced very similar to them. Please read our blog with Ms. Smith story to see the “teeth in just a day” transformation from start to finish. With “teeth in just a day”, you get strength, beauty, confidence, and 95% function of your natural teeth. Here’s a list of the pros and cons of “teeth in just a day”:

Pros: It is screwed in place, can brush and eat like normal teeth, minimal chance of failure, minimal chance of teeth wearing out, you can bite into an apple and corn on the cob, smallest fitting of all three and closest to natural teeth, get cleanings every 4 months like natural teeth, at least a 15 year lifespan
Cons: Difficult to repair, must be removed every 18 months to clean underneath, can sound loud if you bite too hard, most expensive option

Wow! I know that was a lot of information but, believe it or not, there is still more we could cover. We hope this helps you make the best choice, whether it’s with our office or another. I’m sure you have more questions so remember, we always offer a complimentary consultation to speak with us in person to discuss your dental needs further. During this complimentary consultation, we will talk about what may be best for your smile and, after visually examining your mouth, the Doctor will determine if you are a candidate for the proposed procedure. If you need, or want, a more detailed examination, we have a $95 charge for xrays, 3D scan, and photos, however, we will always credit this back to you when you start treatment at our office. There is no pressure to take xrays during our complimentary consultation and you can take them whenever you are ready. If you bring xrays, there is no cost at all. At White Wolf Dental, we are here to help and will do whatever it takes for you to be happy, be confident, and smile again!

~Dr. K