February 2011

Dental Department: Life-changing Dentistry - All-On-4 Technique Offers Pure Freedom From Dentures

Author: Dr. Bonnie Rothwell, DMD, AAACD

Millions of people wear complete dentures or are facing the eventual loss of their teeth. There are many reasons teeth can be lost such as tooth decay, bone loss (periodontal disease), trauma or severe wear. Some people manage to wear complete or partial dentures with no problems or complaints. Others are not so fortunate.

THE DENTURE DILEMMA
Complete dentures can be loose fitting due to the shape of an individual’s bone structure or due to the fact that the bone and tissue change as we age. The dental aisle of any drugstore is filled with a wide variety of denture adhesives which are typically powders or creams meant to remedy that. Sometimes they work and sometimes they don’t.

Trying to eat with a denture (or two) is a juggling act which can decrease the enjoyment of a good meal. When visiting a beautiful buffet, denture wearers are often limited to what they can choose to eat especially in a social situation.

To maintain health of the oral tissues, dentures must be removed for at least four hours per day. For many people, this is the most objectionable part of wearing complete dentures. The idea of putting their teeth in a glass beside the bed or hiding out at home is unacceptable for many people.

To avoid this, the only option is dental implants. Dental implants are titanium posts placed in the jaw bone and left to heal for four-six months. If the goal is to have teeth that do not come in and out, this requires several implants (usually eight or more) and then a porcelain bridge attached to that.

If bone loss has occurred, surgical procedures must be done prior to implant placement such as sinus lifts and bone grafts. These can take nine months or longer to mature in order to place the dental implants.

Not only are these arguably the most expensive procedures in dentistry, but the patient still must deal with removable dentures during the healing phases.

THE ALL-ON-4 SOLUTION
Few procedures in dentistry could be considered “life-changing,” but the All-on-4 technique is just that. Developed by Dr. Paolo Malo in cooperation with the Nobel Biocare Implant Company, the focus was on restoring the mouths of patients who had lost all their teeth and didn’t have much bone left to retain dental implants. The resulting technique is the closest thing to giving a patient back his or her teeth and carefree lifestyle as dentistry offers today. With only four implants, strategically placed at an angle, and the denture permanently attached, this procedure offers patients freedom they may not have enjoyed for years.

With the All-on-4 technique, the denture is fastened to the implants allowing no movement, so patients can enjoy the foods they love. Due to the strategic placement of the implants, the surgeon can use fewer implants (only four) in existing bone, eliminating the need for costly and time-consuming bone grafts.

And here’s the best (life-changing) part: The denture is fixed to the implants at the same time as the surgery! So when the patient wakes up from the anesthesia, the teeth are attached and never have to be removed. These are called fixed/removable dentures, which means the dentist can remove them for cleaning or repairs, but the patient cannot.

After surgery, a soft diet is indicated while the implants are healing (still four-six months); then a new denture with a non-visible titanium base is fabricated by the dentist. At no time is the patient without teeth.

As with all dentistry, just like natural teeth, wear can occur as well as the occasional chip or break. A chipped tooth in a porcelain bridge is a costly procedure to replace. A chipped tooth in a denture is an economical repair. Even if all the teeth are worn, the titanium base can be re-used and new teeth can replace the worn ones economically. Once the initial investment has been made, repairs and upkeep are simple and affordable.

The patient should keep the healing denture which can temporarily be placed again by the dentist in the event repairs need to be made to the permanent denture. Again, at no time does the patient ever need to be without teeth.

THE COSMETIC ADVANTAGE
A good denture should provide support of the jaws and lips to avoid the over-closed, sunken look so often associated with dentures and lessen the appearance of wrinkles around the mouth. High quality teeth are available in a wide variety of sizes, shapes and colors that are as natural looking as beautiful, healthy teeth or fine porcelain veneers.

Implants can also be used to simply clip a denture to. This does help stabilize the denture, but they still need to come in and out for daily cleaning and tissue rest. With the All-on-4 technique, the denture stays in the mouth and is designed so it can be cleaned in place.

I’ve met denture wearers and denture wearers with implants who go to great lengths each day so their spouse or significant others never see them without their teeth. Imagine the freedom of never having to worry about this again.

I’ve met denture wearers who keep their uncomfortable dentures in their pocket and only put them in when they see someone they know. Imagine the freedom of not having to constantly be on the lookout when in public.

Certainly there are many people who are hanging on to bad teeth because they don’t want teeth that come in and out. It is widely accepted that dental infections significantly increase the risk of heart attacks and strokes. Yet they would rather live with this serious health risk than live with complete dentures. The All-on-4 technique could be the answer for all of these people.

The All-on-4 technique is one of the most exciting procedures I’ve come across as far as being able to offer “life-changing” dentistry. In fact, I think they should re-name the procedure “Pure Freedom.”

Dr Bonnie Rothwell has been practicing dentistry on Hilton Head Island for over 13 years and has been specially trained to provide the All-on-4 technique. For more information please call (843) 342-6900.

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