Dentures: Where Your Natural Teeth Used To Be

Well-fitting Dentures

When teeth are removed, our jawbone begins a continuous, lifelong process of resorption, or shrinkage.  The pressure from dentures on gum tissues contribute to the shrinkage, since gum tissues were never intended to withstand chewing forces.  High quality, well-fitting dentures restore your youthful appearance, allow you to eat most of the foods that you love, helps you feel better about yourself, eliminates embarrassment, enables you to speak more clearly and even helps with digestion.

Loose Dentures

If you've worn the same set of dentures for a long time, your ridges have shrunk.  As a result, your bite has become closed down, and your lips and cheeks have less support from the teeth than they once did.  Since a set of dentures is made to fit the shape of your oral anatomy at the time they are made, often you don't notice the gradual shrinkage as gums and bone recede.  Your dentures become looser and more unstable, affecting speaking and chewing.  The collapsed "denture look" develops, when before nobody knew you were wearing dentures.

If this is you, it's time to get your smile back with a new set of dentures.  The new set will make you look better and feel younger, speak more clearly and enhance your chewing ability.

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

How To Care For Dentures

Dentures Care

Careful daily removal of the bacterial and fungal biofilm present in the mouth and on complete dentures is important to minimize denture inflammation (stomatitis) and to help contribute to good oral and general health.  The latest evidence in the literature recommends that patients who wear dentures should do the following:

1. Daily cleansing by soaking is superior to denture creams and pastes and less abrasive
2. Denture cleansers should be used only outside the mouth
3. Dentures should be thoroughly rinsed after cleaning before reinsertion into the mouth
4. Dentures should never be placed in boiling water, because they will warp
5. Dentures can be soaked in diluted bleach solutions but only for 10 minutes or less

Your local Board Certified Prosthodontist (denture specialist) can help you with your dentures.

Source: evidence-based guidelines from the American College of Prosthodontists as commissioned by the American Dental Association.

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

Denture Wearers: The Bubble Gum Trick

Prosthodontists come up with some novel techniques:

If you wear dentures, one of the ways to keep your gums healthy, is to massage them to maintain generous circulation, and "toughen" them at the same time.

Try this:  get old fashioned bubble gum and put a few squares in your mouth, at the same time, with your dentures out.  When the gum has reached its softened stage, chew the big ball of gum all around your mouth.  The gum will provide the benefit of the massaging, and you'll also feel like a kid again!

Robert G. Tupac, DDS, FACP, Inc.
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave. #170
Bakersfield, CA 93309

Why Denture Wearers Want Implants

Reasons denture wearers want implants:

• they miss eating their favorite foods
• they want to order from the intire menu
• they are tired of worrying whether their teeth will pop out
• they are sick and tired of adhesives
• they want to appear younger and have better facial structure
• they want more functional teeth
• they want the self-confidence from knowing their teeth are secure
• they want to preserve their jawbone from further shrinkage

Eat everything.  Feel great.  Look younger.  Feel better about yourself.  Dental implants!
 
Robert G. Tupac, DDS, FACP, Inc.
 Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170
 Bakersfield, CA 93309

Experts Agree: Standard of Care for a Lower Denture Is Two Implants for Retention

The standard of care for the edentulous mandible (no lower teeth) should be the two-implant retained mandibular over-denture (IRMOD).

A survey of U. S. prosthodontic academic experts determined the following opinions:

• Consensus that the IRMOD was superior in 9 of 10 parameters assessed:  retention, stability, speech, chewing efficiency, comfort while eating soft foods and hard foods, confidence in intimate situations, satisfaction and self esteem. 

Conclusions:  An implant retained mandibular overdenture vs. a complete denture only is the first choice of care when restoring an edentulous mandible of a healthy patient or a patient with mild systemic disease.  

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics
5060 California Ave., #170
Bakersfield, CA 93309
(661) 325-1275 |

Tooth Position and Lip Support

When this patient was wearing removable dentures, her upper lip was flat and the corners of her mouth were wrinkled.  This is a typical consequence of tooth loss and bone shrinkage, and a denture that couldn't properly support facial musculature.

With All-on-4 implant bridges we designed and fabricated in our own in-office laboratory, her teeth are now bone supported instead of tissue supported.  As a result, the teeth can be positioned to give her the same lip support she enjoyed with her natural teeth--fully contoured lips with sharply defined edges.  The sunken in "denture look" no longer exists.

Robert G. Tupac, DDS, FACP, Inc.
Diplomate, American Board of Prosthodontics
(661) 325-1275
5060 California Ave., #170,
Bakersfield, CA 93309

Look Better And Younger With Dentures From Your Board Certified Prosthodontist

When teeth are removed, our jawbone begins a continuous, lifelong process of resorption, or shrinkage.  As a result, there is a collapse of facial support, less height in the lower third of the face and weakening of chewing muscles.  A well made set of dentures from your Board Certified Prosthodontist can recapture much of what is lost cosmetically, but not functionally.  The evidence is that dentures can generate only 15-25 lbs. of chewing force, compared to the 125 lbs. of force that natural teeth can.  That's why fibrous foods like meats, fresh vegetables, lettuce and unpeeled fruit, which take up to 60-70 lbs. of force to chew through, are so difficult to manage.

A set of dentures is not meant to last forever because your denture was made to fit the original shape of your oral anatomy and that shape changes as the gums and bone underneath recede.  Often you don't notice the gradual shrinkage that causes them to loosen and become unstable, affecting you in a number of different ways.

New Set of Dentures

With bone loss, the denture slips and moves.  Lips, cheeks and tongue struggle to compensate and form words.  Shrinkage also affects the alignment and balance of the upper and lower dentures and creates chewing insufficiency.  Denture wearers are more prone to dietary inadequacies as a result.  If you're developing wrinkles and that sunken "denture look" of closing too far, it may be time for a new set of dentures.

With a new set of dentures, you'll look better and younger with the lip and facial support that you need, and have a smile with a more natural appearance.  You'll speak clearly again, chew better, and best of all, will feel better about yourself.
  
Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

Eat What You Want With Dental Implants

Dentures Vs. Dental Implants

Dentures are not a substitute for natural teeth; they are a substitute for having no teeth at all.

Gums were never intended to withstand chewing forces--people with dentures can generate only 15-25 lbs. of chewing force, compared to the 125 lbs. of chewing force that natural teeth can.  That's why fibrous foods, like meats, fresh vegetables, lettuce and unpeeled fruit, which take up to 60-70 lbs. of force to chew through, are so difficult to manage with dentures.

With dental implants holding your teeth in, you can order from the entire menu!

Robert G. Tupac, DDS, FACP, Inc.,
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309

Smile More With Dental Implants

Dental Implants Restore Patient Confidence with a New Smile

The denture patient said:  "It takes so much effort to use my tongue and lips to hold my dentures in place, I avoid smiling."

Full Dentures Move

Since full dentures sit on soft tissues, which are compressible, they move.  Since full dentures are surrounded by things that are always moving--lips, cheeks, tongue, floor of the mouth--they move.
Dental implants hold teeth in place, preventing that movement.  They make you smile more!


Robert G. Tupac, DDS, FACP, Inc.,
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309

Restore Your Mouth With Modern Technology

Unsecured dentures are an old-fashioned solution for people who have lost all of their teeth.  Wearing them can be painful, inconvenient and awkward.  They are unable to chew a variety of foods, which eliminates many of the foods previously enjoyed.  They also affect the pronunciation of certain words and sounds, affecting natural speech.  A variety of implant based solutions are available.

• removable implant overdentures that attach to two implants with snaps.  This cost effective option holds the denture in place, makes it easier to chew and doesn't affect the sense of taste.  The teeth can be removed for cleaning and the need for denture adhesives is eliminated.
• removable overdentures on an implant bar provide an even more secure fit, because three or four implants provide stronger support for the removable dentures, which still can be removed for cleaning.
• fixed implant supported bridges are a more durable solution for the replacement of natural teeth because they are screwed onto four or more implants.  This solution stimulates bone maintenance, restores chewing function completely, and maintains taste sensation.

Dental implants stimulate the bone and maintain the shape of your jaws and face, preventing the collapsed, overclosed "denture look".

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

Same Day All-on-4 Full Mouth Implants

Dental Implants

The All-on-4 technique allows four implants to be placed in the upper or lower jaw to anchor a permanent bridge of teeth.  It is especially good for patients who have limited bone and do not wish to have bone grafting performed, because the implants are placed in the front of the mouth where most patients tend to have enough bone remaining.  This technique can be used for denture patients, or for those who have to lose all of their teeth.

The implant placement is designed using a 3D scan of the jaws and computer software that programs the precise surgical position of the implants and the permanent teeth they will support.  Typically, when the bone is sufficient in amount and density, a provisional fixed bridge can be placed the same day as the implants.

Patients Testimonials

Here are some comments from satisfied patients:

• "No matter what I did, I just couldn't stop the bone loss around my teeth.  The same day they were removed, the implants were placed and I had permanent bridges.  They looked great, I could eat with them, and there was minimal discomfort.  After the weekend, I was back in the office." Dr. R.G.
• "I had an upper denture for many years and was losing my lower teeth.  I decided to have the implants and couldn't be happier.  I can eat anything." Sandra O.
• "I just couldn't afford to take care of my teeth when I was a kid.  Now I am working and Dr. Tupac took out my upper teeth and put in the bridge all at once.  I have my mouth back."   Brian T.

We have been providing this treatment for many years, with great success.

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

When Implants Are Not An Option: Partials or Dentures

Replace Missing Teeth

Prior to the availability of dental implants, prosthodontists routinely treated patients with missing teeth (some or all) with removable partials or dentures.  In addition, not all patients are candidates for implants, due to financial, anatomical or medical considerations.

Prosthodontists are specialists in the replacement of missing teeth.  What sets them apart from general dentists is their extensive training in the diagnosis, design and fabrication of these prostheses.  When a patient is missing some teeth, or has some teeth that need to be removed, but doesn't want to lose them all, a removable partial denture can be a predictable functional and esthetic solution.  We have many patients who have had removable partials that last for ten or more years.  This success depends on the proper planning and treatment techniques that are part of the specialty of prosthodontics.


Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

All-on-4 Considerations

Dental Implant

If you are missing all of your teeth in your upper or lower jaw, the All-on-4 technique has been reported in this blog as an extremely successful method for placing dental implants and restoring them with a fixed bridge.  This technique allows the placement of four implants in the upper jaw in such a way as to avoid the maxillary sinus and not require bone grafting, and four in the lower jaw and avoid the mandibular nerve.  The posterior implants on both sides are tilted in such a way that there is excellent bone anchorage and load distribution and allows the final prosthesis to hold as many as 12 teeth with only short cantilevers.

Multiple studies in the literature, substantiate Dr. Tupac's All-on-4 experience with a cumulative implant survival rate of 92.2% to 100%.  Presurgical diagnosis includes a cone-beam computed tomographic scan to assess the bone volume and density.  It also allows development of a surgical guide to allow for optimal implant position.

Who is a candidate for Dental Implant treatment?

Besides not having any teeth in your upper or lower jaw, what makes you a candidate?  You must be generally healthy and have acceptable oral hygiene.  You must have a jawbone that is greater than 5mm  in width and greater than 10mm in vertical height.  The implants, when placed, must have sufficient stability for immediate function, as determined by the torque measures during placement.

From a facial standpoint, an evaluation of your smile line determines the visibility of the transition from the bridge to your tissues, which must be not visible.  Your lip contour reveals the possible need for a flange for support.  The height of the lower third of your face must allow for the dimensions of the prosthesis.  Inside your mouth, the character of the gum tissues is evaluated.  The height of your bite and jaw relationships need to have room for teeth and esthetic tooth display.

If you want to be examined for this successful procedure that allows you to walk in with a denture and walk out with an implant supported bridge in the same day, give us a call.

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

What To Eat With Dentures?

Since gums were never intended to withstand the same chewing forces that natural teeth can, it may be necessary for people who wear dentures to modify food choices and preparation techniques in order to maintain a healthy diet.

Studies have shown that tooth loss can be associated with a poor-quality diet, and changes in chewing ability can alter nutritional intake.

Here are some strategies for maintaining nutritional intake with dentures: 

• choose diets that are adequate in vitamins,  minerals and fiber from fresh (cut) fruits and cooked (softer) vegetables

• decrease consumption of foods rich with simple sugars

• eating moist foods or sipping liquids to facilitate chewing is helpful

• balancing your bite by eating smaller amounts on both sides of the mouth at the same time makes things more manageable

By identifying foods that you may be avoiding, you may find new ways to modify how to eat things to include other foods to ensure a healthy diet.

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

Failure of Small Diameter (Mini) Implants

Small diameter implants were first developed by NobelBiocare as smooth surfaced implants for use as temporary implants that could be implemented as part of a treatment plan as intermediate support for a temporary prosthesis while the permanent implants achieved osseointegration.  While conventional diameter (3mm or more) implants were cleared for use by the FDA in 1976, more recently, small diameter (1.8 to 2.9mm) implants have been developed with the same surface characteristics as conventional diameter implants, and were cleared for use by the FDA in 1997.  The reasons for use of SDIs are inadequate bone quantity without grafting and a minimally invasive placement procedure.  Because grafting is not an alternative often chosen by patients, mini implants offer a successful alternative.  They can be highly successful if used to support a lower overdenture.

Prevent Implants Failure

Mini implants are subject to failure, however.  Therefore, there are some requirements to prevent failure: enough bone (4mm in width and 13mm in length), 30Ncm of resistance during placement to indicate sufficient bone quality, the largest SDI possible in available bone--preferably  not 1.8mm diameter and length at least 13mm, parallel placement (divergence less than 15 degrees), implants spread out to allow for size of attachment apparatus, no excess tissue thickness at the crest of the bone, and not used in patients who clench or grind.  These clinical requirements have been developed by Dr. Gordon Christensen.


Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

How To Care For Dentures

Careful daily removal of the bacterial and fungal biofilm present in the mouth and on complete dentures is important to minimize denture inflammation (stomatitis) and to help contribute to good oral and general health.  The latest evidence in the literature recommends that patients who wear dentures should do the following:

1. daily cleansing by soaking is superior to denture creams and pastes and less abrasive
2. denture cleansers should only be used outside the mouth
3. dentures should be thoroughly rinsed after cleaning before reinsertion into the mouth
4. dentures should never be placed in boiling water, because they will warp
5. dentures can be soaked in diluted bleach solutions but only for 10 minutes or less

Your local Board Certified Prosthodontist (denture specialist) can help you with your dentures.

Source:  evidence-based guidelines from the AmericanCollege of Prosthodontists as commissioned by the American Dental Association

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

Dental Implants vs. Dentures

Living with Dentures

Dentures are not a substitute for natural teeth; they are better than not having any teeth at all.  Dentures rest on gum tissues that were never intended to withstand chewing forces.  After teeth are removed, the jawbone undergoes a continuous process of atrophy, which presents itself as shrinkage of the gums.  As the bone recedes, the area available to support and retain a denture becomes more compromised.  These continuous changes require that the dentures be refitted or remade at regular intervals.  As the bone shrinks, support for facial musculature deteriorates, musculature weakens and tissue tone flattens.  Dentures can only be cleaned outside of the mouth.  A trained eye can spot a denture from across a room.

The Benefit of  Dental Implants

Dental implants can be used to replace a single missing tooth, or an entire arch of teeth.  Because they are anchored in the jawbone, their main benefit is that they preserve the bone.  They create a foundation for the stability and permanence of teeth.  Because of their permanence, they maintain facial and muscle structure.  They are cleaned in your mouth, just like natural teeth.  An entire arch of twelve teeth can be replaced with as few as four (All-on-4) implants.  Sometimes, they implants and prosthesis can be placed at the time of tooth extraction.  To see if you are a candidate, give us a call.


Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

Get The Teeth You Deserve

Do you deserve a Dr. Tupac set of dentures?  Of, course, you do!  If it is time for your first set, or a replacement set, the office of Board Certified Prosthodontist Dr. Robert Tupac provides the most careful, accurate, well fitting and beautiful dentures you can have!  As a specialist, we make impressions of your mouth in a custom fashion, use the most esthetic teeth and make sure they are in the most attractive position for your smile and the support of your lips and cheeks, and make sure your bite is comfortable and you can eat properly.  You get to participate in the process, and the teeth are not finished until you approve of them.  We provide any necessary adjustments at no further charge, and are always available to you.


Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

What To Eat With Dentures?

How to enjoy food with your dentures!

Since gums were never intended to withstand the same chewing forces that natural teeth can, it may be necessary for people who wear dentures to modify food choices and preparation techniques in order to maintain a healthy diet.

Studies have shown that tooth loss can be associated with a poor-quality diet, and changes in chewing ability can alter nutritional intake.

Here are some strategies for maintaining nutritional intake with dentures:  

• choose diets that are adequate in vitamins,  minerals and fiber from fresh (cut) fruits and cooked (softer) vegetables
• decrease consumption of foods rich with simple sugars
• eating moist foods or sipping liquids to facilitate chewing is helpful
• balancing your bite by eating smaller amounts on both sides of the mouth at the same time makes things more manageable

By identifying foods that you may be avoiding, you may find new ways to modify how to eat things to include other foods to ensure a healthy diet.

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

When A Partial Is The Right Thing To Do

Removable partial dentures replace missing teeth for millions of Americans.  They are long-lasting, hygienic appliances that are indicated in many prosthodontic situations.  If you look closely at this lady's teeth, you can see that her front four teeth are on her partial, but when she smiles and speaks, you can't even tell!

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309