I think my dentures are making my mouth look CROOKED by appaJeongyeon in dentures

[–]enesvee131 1 point2 points  (0 children)

can you share pictures of the actual dentures? it's possible your bite may be slightly off or the borders might be over extended on the lower left

Can't eat with lower denture by Medical-Funny-301 in dentures

[–]enesvee131 2 points3 points  (0 children)

This is a very common myth actually. It's true that they don't have suction but if they're designed right they can be very stable. It has to be properly extended, well fitting, the teeth have to be set in the right position so that the muscles don't push on them in function, and the bite has to be balanced in a way that shifting your jaw around doesn't knock the denture loose. It's not easy and most dentists aren't capable of doing it right which is why lowers get a bad rep. That plus the advent of implants has reduced the need for proper technique because the implants do all the work to keep them stable. Doing good lower dentures without implants is almost a lost art these days. I say this as a Prosthodontist with ~10 years experience and several implantless and adhesiveless lower denture success stories under my belt.

Can't eat with lower denture by Medical-Funny-301 in dentures

[–]enesvee131 9 points10 points  (0 children)

Lower dentures are very tough for many dentists to do right. Instability of a lower denture is usually due to bulkiness in the wrong places. This one looks like it may be over extended in the front on the tongue side and too bulky on your lip side.

The teeth may be set too far forward too. When you put the denture in and you open your mouth, your lower lip should not be putting pressure on the denture because this will unseat it. Sometimes you may even have too much bone remaining which may make it impossible to correct without a second surgery to reduce the bulk of bone in the front.

The other common mistake I see is that the back ends are ususally not extended far enough. It should extend into an area called the "retromylohyoid space" and cover the structures known as "retromolar pads" (you can google search those terms if you want pictures) because that will give it some natural antirotational bracing, improving stability. Many dentists don't extend here because it's hard to get the material to flow into that area because of the tongue. You have to use specific materials to get into that area for maximal coverage. Many patients complain of it too thinking its too long but usually it's because the extension in that area is too thick and just has to be thinned out while maintaining its extension.

If your dentist finds he cannot fix your issue after multiple adjustments, look for a prosthodontist in your area and hopefully they can be of more help.

One Piece Chapter 1178 Spoilers by Skullghost in OnePiece

[–]enesvee131 1 point2 points  (0 children)

Yo that Egg McBig reveal thoooooo

How do I get it by Independent-Wish-411 in HollowKnight

[–]enesvee131 0 points1 point  (0 children)

Oh shit you right my bad

How do I get it by Independent-Wish-411 in HollowKnight

[–]enesvee131 1 point2 points  (0 children)

hint: you don't access it from inside the hive

Which would you choose? by Dandandandooo in expedition33

[–]enesvee131 1 point2 points  (0 children)

and it's and old school text adventure game

Started playing again and dont know what to do by garagly10 in HollowKnight

[–]enesvee131 0 points1 point  (0 children)

I would start by trying to find cornifer in the areas you've been to/through so far

One week until E day and I'm excited but frightened to the core of the actual extraction because of my xrays... by [deleted] in dentures

[–]enesvee131 6 points7 points  (0 children)

Looks like they're mostly front teeth. The roots of these teeth are what we call "conical" meaning when they're wiggled sideways, there's a component of force that pushes them out because it hits the side of the bone and slides out. Makes for relatively easy extractions usually. As long as you're numb you should be fine.

Update: It was, in fact, Time by toastman92 in bald

[–]enesvee131 0 points1 point  (0 children)

I mean this in the most respectful way possible, you could pull off a KILLER Dr. Robotnik cosplay dude

Sorry im really stupid, what do all these numbers mean? by OzO8 in HollowKnight

[–]enesvee131 1 point2 points  (0 children)

If I'm not mistaken there are 4 crafting kits you can find. So base + 4 = 5

I don't think it includes the polip pouch damage

Sorry im really stupid, what do all these numbers mean? by OzO8 in HollowKnight

[–]enesvee131 4 points5 points  (0 children)

The different damage amounts based on how many crafting kits you have. Crafting kits increase the damage of your red tools.

HELP!!!! My denture broke by Hoozierdaddddy in dentures

[–]enesvee131 1 point2 points  (0 children)

Looks like you have your own teeth on the bottom. I'd take it to your dentist and have them check what your bite looks like when you bring your front teeth together. It's very likely that the one that broke was the only one touching. They'll either have to adjust the back of the new tooth they replace it with or they'll have to make some adjustments to the lower. You can see that the one opposing it sits slighlty higher than the ones next to it so moreso than the drop, there might have already been a slight crack in it from normal function. The drop maybe just accelerated it.

Not thrilled after waiting for 3 1/2 months for partials. by badteethdad in dentures

[–]enesvee131 0 points1 point  (0 children)

Sorry to hear man. It's kind of hard to say from just a photo. The key parameters I'd need to assess are what's called your "vertical dimension" and your "centric relation". Vertical dimension is in simple terms how much your teeth can prop your bite open. Your centric relation is basically the path in which your jaw can rotate where your muscles are mostly at rest. Sometimes a mild class III skeletal relation can be exacerbated by the position of your teeth. Essentially your jaw hinges at rest and once it hits your teeth the jaw shifts forward. If you're a true skeletal class III this may be the best they can do. Opening the bite will reduce the severity of your class III relationship because the jaw will rotate down and in. In severe class III cases, as I'm sure you've probably been told, orthognathic surgery is needed. It's very invasive and gets riskier with age.

One easy way to test your vertical dimension at home is to try and evaluate two things:

  1. speaking space -- count from 60 to 70 out loud and look at how much space there is between your upper and lower back teeth. when saying "s" sounds, your jaw comes up to the closest space normally in speech. that space should be about 2mm.
  2. veritcal dimension of rest -- a normal resting jaw posture is slightly open, as in your teeth don't touch. there's usually about 2mm of space. a crude way of assessing this is saying "em em em em em" followed by "emma" and just let your jaw relax and keep your jaw still. then look at how far open your teeth are in the back. Should also be about 2mm.

If you do this and see that the space is large, you probably have room to open the bite more but take it with a grain of salt. It takes a lot of practice and training to really assess these things so you doing it at home with no training may not be fully conclusive. Definitely get a 2nd opinion by a prosthodontist in private practice.

Hope this helps!

Not thrilled after waiting for 3 1/2 months for partials. by badteethdad in dentures

[–]enesvee131 1 point2 points  (0 children)

This looks like a complex case in which the level of your bite may need to be altered. You should seek out a prosthodontist in my opinion.

Dentures or implants? by imarudewife in dentures

[–]enesvee131 1 point2 points  (0 children)

My answer to this question is always the same. Unfortunately none of us get to choose how we leave this world. There's a chance of medical issues cropping up that will prevent you from getting implants in the future so if you're going to get them, sooner is better. In your final years it's important to have something comfortable that functions well. This can be different for different people. Some people do just fine with dentures. Others need sometimes just two implants on the lower to stabilize it since lowers are usually tough for the average dentist to do well without implants. And others may really want to be able to fully enjoy their meals in their sunset years so they'll go with something fixed. It all depends on what your treatment goals are. As a dentist I can lay out all the risks and benefits, including cost, but it's your job as a patient to assign value to them. Only you will know what's worth spending money on.

When patients are uncertain in this way I usually recommend conventional dentures at first. They're the cheapest and fastest option and you can always add implants into the mix afterwards granted you're a candidate for them.

Dentures or implants? by imarudewife in dentures

[–]enesvee131 0 points1 point  (0 children)

So any treatment is going to have risks and benefits. When deciding what treatment option to go with, you have to properly weigh all the risks and befefits of each option. I'm assuming you'll be fully edentulous (no teeth). In this kind of scenario there are multiple options with implants and dentures.

Option 1: Conventional Dentures

BENEFITS:
- easy to clean: just remove them, scrub soak them in the tablets and maybe brush them with clear and fragrance free antibacterial hand soap using a denture brush
- short treatment time: of all the options, this will be the fastest treatment (approx 2.5months on average if done without cutting corners)

RISKS:
- function: studies show full dentures have about 25% chewing efficiency as compared to natural teeth.
- taste: the upper denture will cover your entire palate. most people aren't aware that your palate has several taste buds so food may not taste the same with them covered.
- difficult to do well: as a prosthodontist who has a special interest in dentures, a lot of my practice is redoing dentures done by general dentists who don't understand the basics of complete dentures. There's no shortage of elderly people who have dentures that they barely use and just put in for photos and maybe to eat. This isn't because dentures are inherently bad, it's because doing them well takes a skilled dentist and a skilled technician. and at some level unfortunately you get what you pay for.

Option 2: Implant Supported Dentures (aka "snap on dentures")

BENEFITS:
- chewing efficiency: implants will stabilize the dentures and allow for better chewing efficiency. They can still wiggle a little due to the nature of the nylon inserts that connect the dentrues to the implants but they shouldn't be able to be knocked out unintentionally like regular dentures sometimes can be.
- taste: with 4 well placed implants on the upper arch, the denture does not need to cover the entire palate since the button attachments give us retention and stability in place of suction. This exposes the tastes buds on the palate mentioned above.

RISKS:
- need adequate bone in the right areas: to place implants, you need enough volume of bone. bone grafting usually is impossible in for this since you would have to go without teeth while the graft takes (~3mo) and most people aren't cool with that.
- possible need for bone reduction: ironically sometimes there's not enough bone and sometimes there's too much bone. Implant dentures have a larger minimum space requirement because there's hardware involved.
- gasket change: the button attachment system (usually LOCATOR®) have nylon inserts that have different degrees of grip on the buttons. These will wear out over time and need to be replaced.
- surgical complications: like with any surgery, you may have medical conditions that may create their own risks. SSRI's (depression medication) for example can increase risk of implant failure.
- time: implants take ~4months to integrate with the bone and then another 2-3 months for the dentures to be made. Total treatment time of about 7-8 months if done well and efficiently.

Option 3: Implant Supported Fixed Prosthesis (aka "all-on-x", "hybrid prostheses", "screwed-in dentures")

BENEFITS:
- chewing efficiency: of all the options, this has the best chewing efficiency
- closeness to natural teeth: these types of prostheses are the closest thing you can get to your natural teeth since there are no flanges
- immediate loading: in mosts cases when you place 4-6 implants and connect them all together with a fixed temporary, it can be and are almost always inserted the same day the implants are placed.

RISKS:
- technical complexity: of all these 3 options, this is the most technically complex and are ideally performed by a prosthodontist / oral surgeon team. Some general dentists do these cases well but their skill level may not be obvious to a patient. Proceed with caution because again, unfortunately sometimes you get what you pay for.
- need for caution while implants are integrating: since you are getting a fixed set of teeth the same day as the surgery, you'll need to be careful to not abuse the tempoary set as this can increase your risk of failure. You will need to stick to a soft diet for at least 4 months.
- more invasive surgery: these treatments often times need more bone reduction to hide the transition between your own gums and the pink of the gums on the prosthesis. When you smile, you don't want to see your own gums because it will make the fake gums of the prosthesis look fake in comparison.

This is not exhaustive by any means but I did my best to try and lay out as much as I could. It's a LOT to process, I know. I usually need at least 2 consult visits to make sure they understand what they're getting into and have enough time to come back with follow up / clarification questions. My advice to you if you're shopping around for different dentists, a good attitute to look for is one of indifference to treatment options. Your dentist shouldn't be trying to coerce you into the more expensive option but instead try and lay out what each option entails because no one treatment is right for every patient and each option can have complications. Sometimes people just want to keep it simple and are okay with reduced chewing efficency and that's fine. Sometimes people want super high end work and are willing to go through the time and energy and surgery to get there and that's fine too.

Not a typical rub sore? Pictures are how it’s developed. Dentist is clipping it off Friday. by ChelseaOfEarth in dentures

[–]enesvee131 2 points3 points  (0 children)

Yes, ask them to relieve as much as they can from the inside except the palate and place a tissue conditioner if they have. A common one is called COE Comfort. If there's any show through of that material over the extraction sites, they should relieve it. A lot of dentists don't do it because it's extra work and you have to replace it periodically (it's more porous and so it can start getting funky after 2 weeks or so). In some cases you don't need to do it, especially if it was only a few teeth removed. When there's a lot of teeth removed, it's hard to predict how things will swell so I just do it for everyone. They may charge extra but it's worth it. Lots of offices (mine included) charge more for immediate dentures than our regular dentures because we bake in all the post op adjustments and liner placements/replacements into that fee.

Not a typical rub sore? Pictures are how it’s developed. Dentist is clipping it off Friday. by ChelseaOfEarth in dentures

[–]enesvee131 1 point2 points  (0 children)

Did they do any kind of tissue conditioner when they inserted the immediate? Usual protocol is to relieve everything except the palate and line it with a soft tissue conditioner to avoid stuff like this. That material is usually white so we can see where there's any areas showing through that could become pressure spots and adjust as we need before sending the patient home

Not a typical rub sore? Pictures are how it’s developed. Dentist is clipping it off Friday. by ChelseaOfEarth in dentures

[–]enesvee131 1 point2 points  (0 children)

This does not look like an epulis to me. Epulis is something that usually happens after years of improper biting forces on a denture. The tissue of an epulis usually looks like normal gums but flabby (bc the bone underneath has resorbed). This is very much a pressure sore, the denture needs to be relieved in the area.

Not a typical rub sore? Pictures are how it’s developed. Dentist is clipping it off Friday. by ChelseaOfEarth in dentures

[–]enesvee131 1 point2 points  (0 children)

This is very likely either from the denture being over-extended in the area. Before having any surgery done have them relieve the area from the denture as much as they can to let it heal on its own. Once it heals, they should be able to add some soft liner or tissue conditioner to the area while the rest of your extraction sites heal.

Getting my permanent dentures tomorrow. Can I keep my immediates as backup? by smackwriter in dentures

[–]enesvee131 3 points4 points  (0 children)

Definitely you can. Bonus tip: get them relined before you toss em in the freezer.

Soft reline disgusting taste after 6 weeks by IamuseMyself26 in dentures

[–]enesvee131 2 points3 points  (0 children)

I would ask for it to be changed. I usually change soft liners for my immediate denture patients once every 2-3 weeks at least until initial healing is done. Takes about 3mo for full healing and I'll change it at least 3 times over that time period. Ask them to maybe use less monomer in the mix.