[ono8ono]

Hi Bryanna,

I had my lower right first molar #19 extracted last December 23, 2014 and now my gum is completely healed. I decide to have a denture for that space. My dentist told me he has to drill, sand down or something so that the denture could attach firmly. I wonder exactly what he will do to accomplish this task. My #18 molar is healthy, no cavity filling. My #20 had a small cavity filling. I do not have any root canal teeth. I'm 58.

Also what would happen if I don't fill the space with a denture. Are my other teeth going to shift? I kind of notice #21, 22, 23 is shifting.
Thank you very much.

[razzle51]

it wont be a denture . It will either be a fixed bridge or removalable bridge ...there will be a fake tooth attached to the tooth in front and tooth in back.

[Bryanna]

Hi ono8ono,

I think you need some clarification from your dentist about what type of "replacement" he is proposing to do. The term "denture" can signify a few different things.

A full denture is a removable set of teeth that replaces a full arch of missing teeth..... this is for someone who is edentulous.

A partial denture is also removable but can replace one to several missing teeth in the same arch but it requires some teeth to be used an anchor teeth to help hold it in place. Partial dentures can be made with or without precision. Meaning a precision partial denture is made to actually fit snug by snapping into ridges that are made in the anchor teeth. That would require that the anchor teeth been slightly drilled into to make these ridges. The partial denture would have small metal wings that fit and snap into the ridges on the teeth. A regular partial denture that is not precision looks and acts similar to a precision partial but it does not have that precise fit.

A nesbit is a tiny removable partial denture and it replaces 1-2 teeth that are missing next to each other. This can be made as a precision or as a conventional fitting partial as I described above.

Some people refer to a permanent bridge as a denture. So I am not sure if you know the difference so I will explain. A permanent bridge replaces missing teeth but it is not removable, it is cemented onto the anchor teeth. This replacement requires that any anchor teeth be drilled down and crowned as they become a part of the bridge. So if you are missing one tooth, say #19, then tooth #18 and #20 are the anchor teeth and they are significantly drilled down and then covered with crowns that attach to a fake crown. So you would have #18 crown, #19 pontic (fake crown) and #20 crown all soldered together and cemented on.

If you do not replace tooth #19, then it is likely that the teeth adjacent to the space will shift towards the space. Also your opposing tooth in your upper arch could drift downward as it no longer has #19 to hold it in place. This drifting would depend on how much that upper tooth is occluding (meeting) against your existing lower teeth as they may help hold it in place.

If you need further clarification, let me know.

I would suggest that you get a clear understanding of what your dentist has planned for you before you tell him to go ahead.

[ono8ono]

Razzle51: thanks for your info.

Bryanna: Thanks for your reply and detailed explanation. Really really appreciated.

Now I remember my dentist told me he is going to make a partial removable denture to replace #19 but it requires some drilling on #20 & #18 (probably to make ridges) to be used as anchor teeth to hold #19 in place. I don't know he is going to make it with or without precision. This I have to find out from him.

Regardless, I just wonder whether the drilling would weaken or cause significant structural damage to #18 and #20? My #18 is a healthy tooth, #20 has a small cavity filling. I'm really scared of any dental work after I went thru my #19 ordeal.

Originally Posted by Bryanna

Hi ono8ono,

I think you need some clarification from your dentist about what type of "replacement" he is proposing to do. The term "denture" can signify a few different things.

A full denture is a removable set of teeth that replaces a full arch of missing teeth..... this is for someone who is edentulous.

A partial denture is also removable but can replace one to several missing teeth in the same arch but it requires some teeth to be used an anchor teeth to help hold it in place. Partial dentures can be made with or without precision. Meaning a precision partial denture is made to actually fit snug by snapping into ridges that are made in the anchor teeth. That would require that the anchor teeth been slightly drilled into to make these ridges. The partial denture would have small metal wings that fit and snap into the ridges on the teeth. A regular partial denture that is not precision looks and acts similar to a precision partial but it does not have that precise fit.

A nesbit is a tiny removable partial denture and it replaces 1-2 teeth that are missing next to each other. This can be made as a precision or as a conventional fitting partial as I described above.

Some people refer to a permanent bridge as a denture. So I am not sure if you know the difference so I will explain. A permanent bridge replaces missing teeth but it is not removable, it is cemented onto the anchor teeth. This replacement requires that any anchor teeth be drilled down and crowned as they become a part of the bridge. So if you are missing one tooth, say #19, then tooth #18 and #20 are the anchor teeth and they are significantly drilled down and then covered with crowns that attach to a fake crown. So you would have #18 crown, #19 pontic (fake crown) and #20 crown all soldered together and cemented on.

If you do not replace tooth #19, then it is likely that the teeth adjacent to the space will shift towards the space. Also your opposing tooth in your upper arch could drift downward as it no longer has #19 to hold it in place. This drifting would depend on how much that upper tooth is occluding (meeting) against your existing lower teeth as they may help hold it in place.

If you need further clarification, let me know.

I would suggest that you get a clear understanding of what your dentist has planned for you before you tell him to go ahead.

[ono8ono]

also I wonder how deep is the cut to make the ridges. Thank you.

[Bryanna]

Ono8ono,

I still think you need some clarification from your dentist as to what he has in mind because you are talking about 2 different things.

A removable partial denture replaces one or more missing teeth in an arch. The "anchor" teeth are not necessarily the teeth next to the missing one. They can be further back in the arch. A removable partial denture is usually not a small appliance, meaning the framework will extend beyond the adjacent missing tooth.

A nesbit appliance, which is a one tooth removable partial is smaller than a partial denture as it is made to snap into just the area of the missing tooth. The framework of the appliance does not extend beyond the adjacent teeth.

The notches or ridges that are drilled into the teeth for a precision fit are small as the intention is to give the clasps of the appliance a place to fit into without ruining the integrity of those teeth.

I may have given this to you before, but here is an excellent page that shows you the different removable partial options. Hope this helps....

http://doctorspiller.com/partial_dentures.htm

[ono8ono]

Thank you very much for the link. That really helps.

My dentist told me he can't do nesbit on molar tooth #19 because #19 do a lot of chewing. Is it true? Thank you.

Originally Posted by Bryanna

Ono8ono,

I still think you need some clarification from your dentist as to what he has in mind because you are talking about 2 different things.

A removable partial denture replaces one or more missing teeth in an arch. The "anchor" teeth are not necessarily the teeth next to the missing one. They can be further back in the arch. A removable partial denture is usually not a small appliance, meaning the framework will extend beyond the adjacent missing tooth.

A nesbit appliance, which is a one tooth removable partial is smaller than a partial denture as it is made to snap into just the area of the missing tooth. The framework of the appliance does not extend beyond the adjacent teeth.

The notches or ridges that are drilled into the teeth for a precision fit are small as the intention is to give the clasps of the appliance a place to fit into without ruining the integrity of those teeth.

I may have given this to you before, but here is an excellent page that shows you the different removable partial options. Hope this helps....

http://doctorspiller.com/partial_dentures.htm

[Bryanna]

Hi ono8ono,

Nesbit appliances are not meant to be worn during chewing irrelevant of where they are in the mouth because they can become dislodged during eating and become a choking hazard. With that said, most of the time Nesbits can be made to replace tooth #19 so long as #18 and 20 are present. They just need to be removed during eating and sleeping.

Your dentist may not feel comfortable making a Nesbit because if you were to wear it while eating and did have a choking episode he would not want to be held liable in any way. Which is totally his prerogative to feel that way and make that decision. Do you agree...?

[ono8ono]

yeah, I'm sure he worry about the choking incident & liability. Now I understand where he is coming from. Thank you for your insight.

Originally Posted by Bryanna

Hi ono8ono,

Nesbit appliances are not meant to be worn during chewing irrelevant of where they are in the mouth because they can become dislodged during eating and become a choking hazard. With that said, most of the time Nesbits can be made to replace tooth #19 so long as #18 and 20 are present. They just need to be removed during eating and sleeping.

Your dentist may not feel comfortable making a Nesbit because if you were to wear it while eating and did have a choking episode he would not want to be held liable in any way. Which is totally his prerogative to feel that way and make that decision. Do you agree...?