Issue 9.10

The lower denture is like a little horseshoe floating on a sea of saliva with the big tongue pushing it all around.  It’s not stable and chewing with it can be quite a difficult and an embarrassing balancing act.  Thank goodness for titanium posts (implants), that dentures can be attached to, to hold them in place.  There is a great variety of implants and ways to attach them to people’s dentures.  I have chosen to use a system that you might compare to a trailer hitch.  On the end of the implant is a round ball that fits into the bottom of the denture which has a housing (keeper cap) that fits over and holds onto that ball.  This keeper cap has a little rubber O ring that snugs down onto the ball for retention.  Snapping on is not a good description of this type of retention.  The “snap on” types of attachments are, in my opinion, like riding in a car with no shock absorbers.  The ride is jarring and rough.  With a rubber O ring the ride is cushioned and resembles the small give of tissue and so the bite feels more natural while still being retentive, and less stressful on the implant.  

For stability and balance the use of four or more implants is better.  A teeter-totter is comparable to a denture with only two implants for retention.  It rocks from the front to the back of the mouth on the implants.  My preference is to place four implants as far apart as possible avoiding the nerves in the jaw bone.  This distributes the pressures of chewing.  The types of titanium implants I use are called mini implants.  I can use four and get the greater stability for less money than the two wide body implants with the “snap on” feature (the rough ride type) 

Phillip Hall is a practicing general dentist in St. George.  He is also head of the St. George Craniofacial Treatment Center, and operates St. George Dental Careers, a successful dental assisting school.  Appointments for general dentistry or dentures call 656-1111.  For sleep apnea appliances or TMJ problems call 634-8338

Issue 5.10

In past articles I have extolled the many advantages for seniors and their overall physical health to be able to eat properly when they are battling the aging process.  There is enjoyment and satisfaction being able to enjoy a meal alone or with friends and family without pain or embarrassment.  My hat is off to the many that have made good decisions about dental care along the way.  Seniors need to place value and priority on getting and maintaining the best dental health they you can.  What is it worth?  Is it too much to spend one thousand, ten thousand, and twenty thousand dollars?  How much do people spend on cars, vacations, animals, four wheelers and other recreational desires?  Is dental health a budgeted, planned expense?  Or do you spend money on dentistry only if it’s an emergency when a tooth hurts or is broken? 

I frequently hear “I’m on a fixed budget…I have no dental insurance…I’m not going to live that long…I don’t care about how my teeth look, etc.”  I’m a realist and know there are limits that vary with personal budgets.  I’m not saying that every last tooth should be saved at all costs.  Sometimes the best solution has to be tooth extraction or dentures.  My plea is do something about your dental condition that will sustain or improve it while you have choices.  I see difficult and physically dangerous situations that I have to take care of due to prior procrastination, non-treatment, or having chosen in the past the cheapest and quickest fix.  Misery and suffering from dental neglect is costly both financially and emotionally.  Dentists are caring individuals who are concerned about their patient’s well-being.  I feel great satisfaction when I am successful at motivating people to make lasting choices for their dental health.          

Phillip Hall is a practicing general dentist in St. George.  He is also head of the St. George Craniofacial Treatment Center, and operates St. George Dental Careers, a successful dental assisting school.  Appointments for general dentistry or dentures call 656-1111.  For sleep apnea appliances or TMJ problems call 634-8338

Issue 49.09

Have you ever looked at someone and said “That sure looks like a denture smile?”  When people lose teeth and get them replaced with false teeth it happens in stages.  The back teeth are lost first.  Partial dentures are made to fit the opposing teeth.  With time, other teeth are lost and so the partial denture is added to, or an upper denture is placed and the natural teeth are removed.  In the process of all these changes the proper relationship of the top teeth to the bottom teeth is lost and this is when the “denture look” creeps in.  There are certain harmonious relationships and curves to the dental arch that need to be considered. 

Patients often say their upper denture fits well and want me to make a lower denture and place the mini implants I’m known for, to hold it in better.  Sometimes I can, but often I need to tell them no.  In order for their dentures to work well I need to correct their bite and have it balanced carefully to accommodate implants.  The smile line, length, and color of teeth are important.  The fullness of the lip, the midline of the smile, and many more things all contribute to either a natural looking smile or the “denture look.”  To make only one denture to relate to a poorly constructed old opposing denture just insures that the old mistakes will be passed on to the new denture.  As ridges resorbe the vertical dimension (the distance between the dental arches) collapses and the denture wearer over closes and again, the dreaded “denture look” appears.  

In my office, I take great care to insure that a natural and balanced set of dentures is the final result.  See my ad for an example of a natural look vs. the “denture look.”

Phillip Hall is a practicing general dentist in St. George.  He is also head of the St. George Craniofacial Treatment Center, and operates St. George Dental Careers, a successful dental assisting school.  Appointments for general dentistry or dentures call 656-1111.  For sleep apnea appliances or TMJ problems call 634-8338.

Dental implant therapy has been one of the most significant advances in dentistry in the past 25 years.  Thousands of grateful patients bear witness to the benefits derived from the opportunity to obtain a replacement for lost teeth that restores their smiles and confidence.  Many different types of implants are available.  The computer and medical worlds are working to develop smaller components.  In similar fashion, a smaller version of the dental implant has been successfully utilized in many denture cases.

These mini implants consist of a miniature titanium implant that acts like the root of your tooth and a retaining piece that is incorporated into the base of your denture.  The head of the implant is shaped like a ball, and the retaining piece acts like a socket that contains a rubber O-ring.  The O-ring snaps over the ball when the denture is seated and holds the denture at a predetermined level of force.  When seated, the denture rests gently on the gum tissue.  The implant retaining pieces allow for micro-mobility while withstanding natural lifting forces. In other words, your denture stays put!

Placement of the implants is accomplished quickly and easily in a process performed in the dentist’s office with local anesthesia.  Using a precise controlled, minimally invasive technique, mini implants are placed into the jawbone.  The heads of the implants protrude from the gum tissue and provide a strong, solid foundation for securing your dentures.  This one-step procedure does not involve sutures or the typical months of healing associated with surgical procedures.

The cost of these mini implants is roughly the 1/4^th the cost of a traditional implant and more cost effective than years and years of denture adhesive.  Our patients come back with smiles on their faces and great stories of being able to enjoy eating again.

Phillip Hall is a practicing general dentist in St. George.  He is also head of the St. George Craniofacial Treatment Center, and operates St. George Dental Careers, a successful dental assisting school.  Appointments for general dentistry or dentures call 656-1111.  For sleep apnea appliances or TMJ problems call 634-8338

Neuropahtic Orofacial pain disorders…now that’s a mouth full.  Unfortunately, arthritic aches and pains come with aging.  However, there are also many associated neurological types of pain.  Too often people just put up with many of these until they become severe before they get help.  There are neuritic pains due to injury that can also be called peripheral pain.  There are also different types of pain that come from dysfunction (things not working right) in our central nervous system (tumors, multiple sclerosis, etc.).  Many of the pains from dysfunction manifest themselves with pain or problems that you should be aware of.  Here is a list of unusual types of pain that you should be on the lookout for. 1) Short duration, fleeting electric-like shooting pains, or pains that are sharp or burning in nature,  2) Pains associated with numbness, itchy, uncomfortable or exaggerated feelings when you lightly touch an area of your skin or in your mouth. 3) Pains associated with headaches that are different than you have ever felt or pains that persist.  Muscle pains are usually dull and aching and of longer duration.

If you are just putting up with these types of uncomfortable pains you should seriously consider getting a proper medical diagnosis.  You may need to see a neurologist, or other medical specialty.  Many pains are associated with the tissues of the mouth & teeth or the muscles and structures (TMJ) we use for chewing.  A dentist who is familiar with the many manifestations of pain from these areas should be seen.  There are more and more physicians and dentists who focus on these pain issues.  Sorting out things like trigeminal neuralgia from glossopharyngela/superior laryngeal neuralgia (tongue/throat pains), occipital neuralgia (neck back of head pain with or without association with the TMJ), Eagle’s syndrome or styloid-stylohyoid syndrome, burning mouth syndrome, myofascial pains of the head and neck (persistent muscle type pains that refer pain all over the head and neck.), neurofascular toothache, maxillary sinusitis, odontogenic (tooth) toothache, non-odontogenic toothache, neuralgia-inducing cavitational osteonecrosis.   I could go on and on, but suffice it to say that there are many, many, sources of pain associated with the head and neck and some are more treatable than others.

The purpose of my article today is to educate seniors that the quality of your life, if compromised by these types of pains, can in many cases be greatly improved with careful consideration of all your symptoms, history and physical examination leading to treatment.  There is always the chance that some of these issues are life threatening but with most everything, early detection and treatment increases the possibility of an acceptable outcome.  Don’t just put up with the pain; get something done about it.

Phillip Hall is a practicing general dentist in St. George.  He is also head of the St. George Craniofacial Treatment Center, and operates St. George Dental Careers, a successful dental assisting school.  Appointments for general dentistry or dentures call 656-1111.  For sleep apnea appliances or TMJ problems call 634-8338.

A sad trend that I see is the loss of permanent teeth in children because parents haven’t either taken their children to the dentist until it’s too late to save a tooth, or they have no money to spend on the necessary repairs their children need.  The most often quoted excuse parents give is that they don’t have dental insurance.  Besides lack of insurance, the problem is the order of priorities in spending.  Almost ten times more money is spent on recreation today than 50 years ago.  The whole country is reeling because of financial uncertainty and poor decisions.

What I am suggesting is that general dental needs a positive recommendation from a wiser generation.  As a grandparent myself I do realize that our children don’t always take all our suggestions.  We can help however by a word of reminder and encouragement.  Promote maintaining dental health by good oral hygiene habits and reasonably often visits to the dentist.  Encourage a family fund or budget for dental health.  Holiday or special occasions where gifts are given might even include a tooth brush or a prepaid dental check up for that special grandchild.  Help with obtaining or maintaining good dental health can be an important often over looked way to significantly help a young person’s life.  Self esteem among young teenagers can be greatly affected for the negative if one is ashamed of their smile.  The amount of suffering by children and young people due to unaddressed tooth ache by many parents of all levels of financial ability is surprisingly common.  Next time you see your grandchildren take the time to be a little nosey and ask about their teeth.  You might be surprised.  Give advise, counsel, and support if you can to promote healthy teeth and you’ll make a difference in the lives of your grand children.    

Phillip Hall is a practicing general dentist in St. George.  He is also head of the St. George Craniofacial Treatment Center, and operates St. George Dental Careers, a successful dental assisting school.  Appointments for general dentistry or dentures call 656-1111.  For sleep apnea appliances or TMJ problems call 634-8338.

Snoring occurs in approximately 40% of all adults over age 40.  Of these, 9% of men and 4% of women have signs of sleep apnea on testing.  Sleep apnea is as prevalent as diabetes or asthma.  If you have restless sleep and your partner says your snore with intermittent pauses; if you have excessive daytime sleepiness; if you awaken due to gasping or choking; if you feel that your memory is poor and your intellect clouded; if your partner seems to think your personality is changing or your have a decreased sex drive; if you have morning headaches, then you have a very high probability of having OSA (Obstructive Sleep Apnea).

Sleep Apnea can lead to daytime sleepiness and increased chance for car accidents by 3 to 7 times.  Sleep Apnea patients have 5 times greater incidence of heart attack.  Chronic snoring triples your risk of dying during sleep.  Weight gain is also more prevalent with people who have sleep apnea. 

The definitive diagnosis of Sleep Apnea is usually made after a Polysomnogram (Sleep Study) ordered and examined by a physician.  Specially trained dentists knowledgeable of this medical condition play a supportive role to the physician by providing properly fitted dental orthotics (sleep appliances) which are worn by the patient at night to keep the airway open and greatly lessen apnic events (not breathing for periods lasting longer than 10 seconds).   The effectiveness of these appliances for mild to moderate cases of sleep apnea has been documented in the medical world.

As a dentist and member of the American Academy of Dental Sleep Medicine, I often refer patients with the tell-tell signs of sleep apnea and reported snoring to physicians.  Many of these patients end up using C-PAP breathing machines at night while some are referred back to me for oral appliances as an alternative treatment.  By the way, they usually stop snoring! 

Phillip Hall is a practicing general dentist in St. George.  He is also head of the St. George Craniofacial Treatment Center, and operates St. George Dental Careers, a successful dental assisting school.  Appointments for general dentistry or dentures call 656-1111.  For sleep apnea appliances or TMJ problems call 634-8338.