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DENTURES DISCUSSED

We would like to discuss the advantages and disadvantages of dentures

      So many patients considering dentures feel that dentures would:

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make their life easier

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that they will have fewer problems 

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they would not have to take care of their oral health again. 

     The reduced chewing efficiency accompanying tooth loss can compromise nutritional status, plus put you at higher risk for chronic illness like diabetes, cancer, hypertension and heart disease.*

      So we hope this discussion will give you a more truthful view of the realities of life with dentures.

Learn more about the facts before you choose dentures. "You want to what!..............now?"

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ADVANTAGES OF DENTURES DISADVANTAGES OF DENTURES OVER KEEPING YOUR OWN TEETH
Replace badly decayed, broken or lost teeth Loss of facial structure
Replace missing teeth You can misplace them and they will have to be replaced, you can not misplace your own teeth
If you have no teeth:

       A. They will give you the ability to speak clearer.

        

Chewing is different-it takes about two to six months to learn how to eat with them
       B. Eat a wider variety of foods. Your taste will be affected.  ADA reports that "people with dentures have a perceived improvement in chewing efficiency yet no substantial improvement in dietary patterns"*
       C. Improve your appearance Possible change in diet to softer foods
        D. Mortality rate of those without teeth and did not wear dentures is TWICE as high 63% as those with 20 or more teeth... death rate was only 32%. Possible future of adjustments, due to natural changes,  to keep their fit
  Develop denture sores due to changes in your gum tissue because our mouths were not designed for us to wear hard plastic against soft gum tissue
  You will need new dentures every 5 to 7 years
  Bone loss to the point where you may need implants to keep your dentures anchored in place.  This usually involves six implants at the cost of around $2,000.00 an implant
  Higher incidence of yeast infections at the corners of your mouth and inside the mouth
  Dentures cause dry mouth
  Dentures, when not worn,  shorten your life span due to dietary and health changes
  With time they look like "false teeth"
  Speech adjustments
  It is unromantic to be toothless
  Gum tissue breakdown
  Daily care of your "teeth"  will still be necessary
  Natural teeth help you chew foods better and easier than you can with dentures
  There is still the expense for items for home care of your dentures
  Because gum tissue is constantly changing your denture will need relining 
  Tongue must adjust to the restrictions that a denture places on it.
  The average person exerts 125-150 pounds of pressure when biting or chewing, denture wearers may only exert 15-17 pounds of pressure.
  Pulling teeth may affect memory.
  They don't "last forever" like natural teeth

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Friends who tell you how easy it is to get use to dentures and how they could eat anything, probably don't remember what it was like to adjust to dentures and may have started with great bone and gum support.

Surgeon General's Report states: 20 years ago 46% of older adults aged 65 and older were edentulous (without their natural teeth) however only 30% are edentulous today.

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Updates

Study links Tooth Loss, Heart Disease

A new study shows a progressive association between tooth loss and cardiovascular disease, even among nonsmokers.  According to  December 2005 American Journal of Preventive Medicine, researchers analyzed data from more than 40,000 responders ages 40-79 in the 1999-2002 Behavioral Risk Factor Surveillance System Study.

Heart disease was found in 4.7 % of the respondents without tooth loss, 5.7% of those missing 1-5 teeth, 7.5% missing 6-31 teeth and 8.5% with total tooth loss.  The finding after adjusting for sex, race and ethnicity, education, marital status, diabetes, smoking status, alcohol consumption, high blood pressure, high blood cholesterol and body mass index and the correlation between tooth loss and hart disease heal when smoking status was considered.  Smoking has strong relationships to both tooth loss and heart disease.  Nonetheless, when this study stratified by age group and smoking status, a significant association remained between tooth loss and heart disease among respondents aged 40-59 years who have never smoked.  These results are consistent with previous studies that link gum disease and tooth loss to an increased risk of atherosclerosis and heart disease. ADA News pg 15, 1/06.

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Does Tooth Loss Affect Dietary Intake?

Since the primary function of teeth is mastication, tooth loss can reduce chewing ability that leads to detrimental changes in food selection. This, in turn, may increase the risk of particular systemic diseases since diet and certain health states, such as cardiovascular health, are linked. For example, an increase in dietary cholesterol and saturated fat, and a decrease in fiber have been shown to elevate the risk of heart disease. Since a large portion of the population has missing teeth, the effect on health risks due to tooth loss may have a significant impact.

In what is, no doubt, one of the largest studies investigating a relationship between tooth loss and diet, data were collected on dental status, and food and nutrient intake from over 49,000 male professionals.  After adjusting for age, smoking, exercise and profession, it was found that intake of vegetables, dietary fiber , crude fiber, and carotene was significantly lower, while intake of total calories, cholesterol  and fat  was significantly higher  in edentulous participants compared to participants with 25 teeth or more.

In a follow-up study with the same cohort of professional men, longitudinal analyses between tooth loss and consumption of specific foods and nutrients were performed. It was found that over an eight-year period, participants without any tooth loss had greater reductions in daily intake of saturated fat, cholesterol and vitamin B12, and greater increases in daily intake of fiber, carotene and fruits compared to participants with tooth loss. In addition, subjects who lost five or more teeth were significantly more likely to stop eating apples, pears and carrots compared to subjects who lost four teeth or less. These studies provide the best evidence to date for an association between tooth loss and a change in food intake, and suggest that it is advisable to incorporate dietary evaluation and nutrition recommendations into dental visits for patients with tooth loss to avoid the health risks of a poor diet.


References

1. Hung HC, Willett W, Ascherio A, Rosner BA, Rimm E, Joshipura KJ.
Tooth loss and dietary intake. JADA 2003;134(9):1185-1192.

2. Joshipura KJ, Willett WC, Douglass CW. The impact of
edentulousness on food and nutrient intake. JADA 1996;127(4):459-467.

3. Willett WC. Diet and health: What should we eat? Science 1994;264
(5158):532-537.

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Quality of life = health, wealth…and teeth! 

 While having life's cake and being able to eat it comfortably is a goal we all share, how much does losing teeth change the quality of life? Can we manage with fewer teeth? Unstable prostheses? Loose dentures? For that matter, how do dentures impact on lives? The hypothesis that adults with teeth had a better oral health-related quality of life than did adults without teeth.   All denture wearers expressed similar dissatisfaction with their dentures when they first sought treatment. Their complaints included looseness, pain beneath the dentures, and difficulty eating with unstable dentures. Most complained about mandibular dentures but not about their maxillary dentures. While complaints by denture wearers may be similar relative to their dental problems, their psychological makeup and needs are quite different.  Regardless of treatment, patients with their own teeth reported the best quality of life-outcomes. Patients who choose to replace dentures with implants have a poor oral health-related quality of life and that some of these issues remain post-treatment. These issues may continue post-treatment, but to a lesser extent.  *Allen PF and McMillan AS: A longitudinal study of the quality of life outcomes in older adults requesting implant prostheses and complete removable dentures. Clin Oral Impl Res 14:173-179, 2003.

* ADA Updates Sept 2001 "New findings call for more studies, new treatments."
**Journal of Canadian Dental Association 2002;68(3): 182-187

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