Reynolds Oral & Facial Surgery

When should I have my wisdom teeth removed?

The following information is aimed at helping patients distinguish the proper timing for the removal of wisdom teeth. The most common question asked by patients is “When should I have my wisdom teeth removed?”

The timing for removal of wisdom teeth is based on three things, the age of the patient, root formation, and position of the tooth. As far as the age of the patient goes, the younger the better. Younger patients do better for surgical procedures and have lower overall complications. Regarding root formation; the ideal time to remove wisdom teeth is when there is one third root formation. On a panoramic x-ray, the patient’s wisdom teeth would look squarish. It is also a good time to remove wisdom teeth between one third and two-thirds root formation. When there is more than two-thirds root formation we find that there is an increase of risk for removing wisdom teeth, especially nerve injury to the inferior alveolar nerve, and maxillary sinus involvement.

 wisdom tooth with 50% root formation
 wisdom tooth with 2/3 root formation

One of the considerations when looking at the wisdom teeth is whether they will be able to erupt into a more easily removable position. The root formation brings the tooth up to the surface causing the eruption of the tooth. However in cases of wisdom teeth when there is insufficient space, the tooth may not be able to erupt no matter how much root formation we wait for, and that root formation can make them more likely to have a nerve injury or sinus complications.

In certain cases, the patient may have zero root formation but has partially formed crowns. When the wisdom teeth are blocking out second molars they should be removed early. Therefore, if the patient is undergoing an unrelated surgery but will receive IV sedation, it is recommended to remove the partially formed crowns at the same time if they are easily accessible. Often times we have had to do exposure and ligation procedures on a canine of young patients (around 12), who have requested IV sedation, and because of the level of sedation, it was advantageous to remove the wisdom teeth at the same time.

case03

case04

Wisdom teeth have the greatest variability in time of eruption and root formation of any tooth. We have removed wisdom teeth which were considered to be in the ideal root formation category, (from one third to two-thirds root formation), that were in patients as young as eleven years old and have also seen patients that were 25 and who still have had only two-thirds root formation. The most common age for wisdom teeth to be in the 1/3rd to 2/3rds root formation stage is 16 years old.

Our recommendation is to have patients get a panoramic x-ray at the age of 15 years old, and be prepared to have them out around sixteen. This is the most common time for removal of wisdom teeth.


Dr. Reynolds and Dr. Gresehober are Physicians (i.e. have earned an M.D. degree) in addition to being Dentists. The will carefully evaluate your medical history and help decide on the risks and benefits of wisdom tooth removal in light of your particular health scenario. We believe strongly in tailoring your experience to best match your overall health so that you can have the best possible outcome.

WHY REYNOLDS ORAL AND FACIAL SURGERY?

Reynolds Oral and Facial Surgery is one of the best oral and facial surgery teams around. With more than 20 years of experience and extensive training, we know what it takes to make sure your procedure runs smoothly. Dr. Reynolds and Dr. Gresehover have a keen eye for detail and strive to make sure to answer any questions you may have. Our team understands that medical procedures can be very nerve-racking experiences which is why we make sure you are comfortable and have the best experience possible. We also invest heavily in the most advanced surgical technology available ensuring you get the best results possible. 


SCHEDULE YOUR CONSULTATION
970.663.6878

FINANCING AVAILABLE!

 

The Decision Making Process in Third Molar Extractions.: Peter D Waite D.M.D.,M.D.,M.S. , Ralph R Reynolds, D.M.D. M.D.
The Effects of Preoperative Preparative Information on the Clinical Course Following Extractions of Thirds Molars.; Vallerand: JOMS; 1994;52:pp.1165-1170
Patients’ Anxieties with Third Molar Surgery.; Earl, P.; British Journal of Oral and Maxillofacial Surgery; 1994 p293-7
Management of Third Molar Teeth; Hipps, Ben R. ,DDS; OMS Clinics of North Am.5:1 (Feb 93), p.77-85
Principles of Oral and Maxillofacial Surgery, Peterson, Indresano, Marciani, Roser; Lippincott p.104 Table 6-

Contemporary Orthodontics 2nd ed.W.R. Proffit; 1993, Mosby, table 3-2
Rantanen, A. V.; The Age of Eruption of Third Molar Teeth; Acta Odontal Scand 1967; 25(suppl): 48.
Engstrom, C., Engstrom, H., Sagne, S.; Lower Third Molar Development in Relationship to Skeletal Maturity and Chronological Age; Angle Orthod 1983;53(2):97
Richardson, E. R., Malhotra, S. K., Semenya, K., Longitudinal Study of Three Veiws of Mandibular Third Molar Eruption in Males; Am J Orthod; 86(2):119
Management of Impacted Teeth other than Third Molars Zeitler, D. L. ; OMS CLinics of N. Am. 5:1 (Feb 93) p 95
Management of Impacted Teeth, Alling, C. C., Catone, G. A., J Oral Maxillofac Surg; 51(suppl 1):3-6, 93
Contemporary Oral And Maxillofacial Surgery; Peterson, L. J., Ellis, E. III, Hupp, J. R., Tucker, M. R., 2nd Ed.; Mosby
Stone Age Man’s Dentition Begg, P. R., Am J. Orthod 40:289-312, 373-83, 462-65, 517-31,; 1954
Etiology and Indications for the Management of Impacted Teeth; Lytle, J. J., OMS Clinics of N. Am. 5:1(Feb 93),p. 63-75
Varrela, J.: Occurrence of Malocclusion in Attritive Environment: A Study of a Skull Sample From Southwest Finland; Scand J Dent Res 98:242-247, 1990
Odusanya S. A., Abayomi,I. O.,Third Molar Eruption Among Rural Nigerians; Oral Surg Oral Med Oral Pathol 71:151-4, 1991
Oral Pathology: Clinical-Pathologic Correlations; Regezi,J. A., Scuibba, J.; 2nd ed., Saunders, 1993
Contemporary Orthodontics 2nd ed.W.R. Proffit; 1993, Mosby, p 112-6
Contemporary Oral And Maxillofacial Surgery; Peterson, L. J., Ellis, E. III, Hupp, J. R., Tucker, M. R., 2nd Ed.; Mosby
Contemporary Oral And Maxillofacial Surgery; Peterson, L. J., Ellis, E. III, Hupp, J. R., Tucker, M. R., 2nd Ed.; Mosby
Principles of Oral and Maxillofacial Surgery, Peterson, Indresano, Marciani, Roser; Lippincott p.103-4
Contemporary Orthodontics 2nd ed.W.R. Proffit; 1993, Mosby, p. 92
Prognosis of third molar eruption, C. Ganss, W. Hockban, A. M. Kielbassa, H. E. Umstadt, Marburg/Lahn, Germany; Oral Surg, Oral Med, Oral Pathol: 1993;76:688-93
Prognosis of third molar eruption, C. Ganss, W. Hockban, A. M. Kielbassa, H. E. Umstadt, Marburg/Lahn, Germany; Oral Surg, Oral Med, Oral Pathol: 1993;76:688-93
“Incidence of Large Third-Molar-Associated Cystic Lesions Requiring Hospitalization; Berg, T I, Acta Odontal Scand 1996; 54327-31 Oslo ISSN 0001-6357.
Nemcovsky, C. E., Libfeld, H., Zubery, Y., “Effect of of Non-Erupted Third Molars on Distal Roots and Supporting Structures of Approximal Teeth: A Radiographic Survey of 202 Cases;JClinical Perio;1996; 23:810-15
A Long Term, Follow-Up, Radiographic Evaluation of Asymptomatic Impacted Third Molars in Orthodontically Treated Patients; Kahl, B., Gerlach, L., Hilgers, R. D., Int. J Oral Maxillofac Surg 1994; 23:279-85
Oral and Maxillofacial Infections; Topazian and Goldberg, 3rd ed. Saunders1994 p.230-41
Berg, T. I., Incidence of infections Requireing Hospitalization Associated with Partially Erupted Third Molars; Acta Odont Scand. 1996; 54:309-313
Effect of Erupting Third Molars on Dental Caries and Gingival Health in Finnish Students, Venta, I., Meurman, J. H., Murtomaa, H., Turtola, L., Caries Res 1993; 27:438-443.
Effect of removing Third Molars on Plaque and Gingival Indicies: Giglio, J. A., Gunsolley, J. C., Laskin, D. M., Short, K., J Oral Maxillofac Surg; 52:584-87, 1994
Effect of Erupting Third Molars on Dental Caries and Gingival Health in Finnish Students, Venta, I., Meurman, J. H., Murtomaa, H., Turtola, L., Caries Res 1993; 27:438-443.
Are Mandibular Third Molars a Risk For Angle Fractures?, Tevepaugh, D. B., Dodson, T. B. ; J Oral Maxillofac Surg 53:646-49,1995
Principles of Oral and Maxillofacial Surgery, Peterson, Indresano, Marciani, Roser; Lippincottp.106
Oral Pathology: Clinical-Pathologic Correlations; J. Regezi and J. Sciubba; 2nd Ed.1993, W. B. Saunders
Infections in Elderly Patients Associated with Impacted Third Molars:Osaki; OOO 79(2) 137-41, 1995, Feb
Germectomy or Delayed Removal Of Impacted Third Molars: The relationship between age and incidence of complications; Chiapasco, M., Crescentini, M., Romanoni, G.; J oral Maxillofac Surg; 53:418-22, 1995
Clinical Anesthesia, Barash,P.G.; Cullen,B.F.; Stoelting, R. K.; Lippincott,2nd ed,1993 p. 13-15

Why should I have my wisdom teeth removed?

WHY DO WISDOM TEETH NEED TO COME OUT?

For oral surgeons, the most common procedure is removing impacted wisdom teeth. This is a common problem affecting 75% of the population. But there are many misconceptions in the population concerning wisdom teeth. Many people believe that all wisdom teeth must come out and then again there are those people who aren’t aware of the dangers of wisdom teeth at all.

INFECTION:

The most frequent clinical problem we see is pericoronitis, (a localized gum infection). Without enough room for a total eruption, the gum tissue around the wisdom tooth can become irritated and infected, resulting in recurrent pain, swelling, and problems with chewing and/or swallowing.

CYST FORMATION:

Non-infectious diseases may also arise in association with an impacted wisdom tooth. Cysts are fluid-filled “balloons” inside the jaw bone that develop as a result of impacted teeth and slowly expand destroying adjacent jaw bone and occasionally teeth. They can be very difficult to treat if your wisdom teeth are not removed in your teenage years. Although rare, tumors can be associated with the delayed removal of wisdom teeth.

DAMAGE TO ADJACENT TEETH:

If there is inadequate room to clean around the wisdom tooth, the tooth directly in front, the second molar, can be adversely affected resulting in gum disease, bone loss around the tooth, and/or decay.

Wisdom teeth are the last molar teeth to come in. One in each quadrant of your mouth, lower right, upper right, lower left, upper left. Technically they are third molars. The first molars arrive in your mouth around age 6 being nicknamed the 6-year molars. The second molars come in around 12 years old and carry a nickname similarly. Third molars or wisdom teeth have a variable arrival time in the mouth anywhere between the age of 13 and 27. Most are to come in around age 18. Thusly they were named wisdom teeth because it was at that age when young men and women were assumed to arrive at a new level of wisdom.

The purpose of wisdom teeth, just like any other molars, are to chew the food we eat. The wisdom teeth, it seems, were actually intended to fit into the mouth as we lost other teeth or as the other teeth wore down. But most people don’t lose other teeth and because our diets are refined we don’t wear down our teeth as much as our ancestors did (see “Why Do We Have Wisdom Teeth?”).

The common issue with wisdom teeth is they do not fit in the mouth in a healthy way and are unable to attain a healthy position in the mouth the way teeth normally do–with the gums around the neck of the tooth. In other words, the crown would be in the mouth, the neck of the tooth would have gums around it and the root would be into the jaw bone. When the teeth are in this healthy position, the bacteria that populate our mouths are kept from getting down into the deeper spaces of our body because the gums create a seal around the neck of the tooth. If the gums were too high on the crown of the tooth they would not be able to make that seal because the crown is covered with enamel–the pearly white stuff you see when you smile. The enamel is hard and slippery like glass and prevents the gums from sticking to it and also prevents them from creating a seal when they are up around the crown of the tooth. All this information is important if you understand that many times wisdom teeth can’t attain that healthy position. They may develop slightly but cannot get the gums around the neck of the tooth. Or they come in sideways and break the seal between the gums and the tooth in front of them. In either one of these cases, the bacteria is able to get down into the tissue and create an infection, which is the number one reason for removing wisdom teeth. A different type of infection is a cavity. A cavity in the wisdom tooth or in the adjacent tooth caused by the malposition (or poor position) of the wisdom tooth is another common problem with wisdom teeth.

The number one reason for removing wisdom teeth is infection.

Another issue commonly associated with wisdom teeth is cyst formation. If the crown of the wisdom tooth is never able to come into the mouth, then that crown deep in the jaw bone can have a cyst created around it. That’s because all teeth start deep in the jaw bone and they have a follicle around them when they are formed. This little follicle is a tiny sac that helps them erupt into the mouth–when they break through the gums and come in. If the tooth never breaks through the gums to come in, then that follicle can enlarge and create a cyst. The cyst is very slow-growing and cannot be felt but can be very destructive if left untreated. As it grows, it replaces your jaw bone with a fluid-filled sac. If it gets big enough it can weaken your jaw bone, move other teeth and even break through the gums itself and get infected.

There are many more reasons to get wisdom teeth out, but the bottom line is that wisdom teeth often don’t fit in the mouth in a healthy way and should come out. The way to judge this is to get an x-ray of the teeth and the jaw and have your dentist evaluate them. It may not sound like a very important procedure but taking care of impacted wisdom teeth can prevent problems associated with your gums, teeth, jawbones and overall health in the future.

TAKING ACTION: ELECTIVE REMOVAL:

You may be saying to yourself, “All of this sounds bad, but I’m not having any problems from my wisdom teeth right now. Why should I get them out?” If you are young and healthy, and lucky enough not to be experiencing any of these problems, we may recommend that you have your wisdom teeth removed prophylactically. In other words, you may elect (like so many others) to have your wisdom teeth removed intentionally before any of these problems can develop to prevent future issues before they can occur. Although we cannot say with certainty that you may experience one or more of the above issues, in most cases it is reasonable to recommend elective wisdom tooth removal while you are young and healthy instead of 20-30 years in the future when the risk of complications increases substantially.

In some instances, infections caused by wisdom teeth can be life-threatening. In the early days of medical knowledge, there was a disease known as Ludwig’s Angina. This is a life-threatening swelling of the neck, tongue, and throat. At the time, they did not know what it was caused by. Now we know that it is typically caused by uncontrolled bacterial infections from the lower molar teeth, including wisdom teeth. Yes, wisdom teeth can cause life-threatening infections, even today with modern-day antibiotics. In the past several years we have rarely seen this case, but each one of them was extremely serious and their prognosis was guarded. Although these cases are extremely rare, the consequences of malpositioned impacted wisdom teeth are serious and the wisest thing to do would be to get them checked out by a professional.

Please do not eat or drink anything prior to your surgery. Having anything in your stomach can increase the risk for serious anesthetic complications.

WHY REYNOLDS ORAL AND FACIAL SURGERY?

Reynolds Oral and Facial Surgery is one of the best oral and facial surgery teams around. With more than 20 years of experience and extensive training, we know what it takes to make sure your procedure runs smoothly. Dr. Reynolds and Dr. Gresehover have a keen eye for detail and strive to make sure to answer any questions you may have. Our team understands that medical procedures can be very nerve-racking experiences which is why we make sure you are comfortable and have the best experience possible. We also invest heavily in the most advanced surgical technology available ensuring you get the best results possible. 


SCHEDULE YOUR CONSULTATION
970.663.6878

FINANCING AVAILABLE!

Why do we have wisdom teeth?

Countless patients explain that wisdom teeth don’t seem like a very ‘wise’ idea. Why do we have wisdom teeth if we just have to remove them?

So why do we have wisdom teeth anyway?

One of the early theories is that through evolution, our jaws have changed in size and now we can no longer fit the same number of teeth we originally had, or rather our ancestors had, in our jaws. However, studies were done by Dr. P.R. Begg in 1954–supported by work done by Varela in 1990 and Odusanya & Abayomi in 1991– support the opposite theory. Contrary to the evolutionary theory, scientists explain that the evolution of the jaw would take much longer and when comparing the relative jaw sizes of our ancestors, there is no significant difference.

Evolutionary changes have not kept pace with dietary changes in humans over the last 500 years and that has lead to an increase in impaction rates. These scientists studied skulls from people 500 years ago and counted the percentage of impactions they had.

(An impaction is when the crown of the tooth is covered by some other tissue.)

The crown of the tooth should be all the way in the mouth, with the roots down through the gums and into the bone–this is the normal healthy state for a tooth. By studying these skulls, they were able to come up with a percentage for impactions and only 500 years ago they found there was a low impaction rate which is much different from the 75% impaction rate that we have now.

So what happened in that 500 years? 

When studying the individual teeth, it’s found that people from 500 years ago had much more attrition. Attrition is where the teeth wear down from grinding hard. This attrition can grind down on the top, between the teeth, and on the sides because the individual teeth move slightly in their sockets. Because the diet 500 years ago was a much coarser, attritive diet, there was more abrasion to the teeth and the interproximal wear (between teeth) decreased the overall length and width of the teeth when they lied side by side, thus making it possible for wisdom teeth to fit in the dental arch in a proper way. In fact, recent studies of modern Aborigines, who even in today’s modern world have a very coarse, attritive diet, have shown a very low impaction rate. Their diet consists of food that is not well cleaned and may have grit, sand, or other abrasive debris still in them. Other foods in their diet are tough, fibrous, and require more chewing, unlike today’s refined diet which doesn’t wear the teeth down. Another study that reconfirmed these findings was by Odusanya & Abayomi. They studied African boys who were brought up in rural areas versus those brought up in urban areas and found there was an increased incidence of impactions in the urban population.

Although many people have the misfortune of having wisdom teeth, many people are born with fewer than the normal four wisdom teeth or may not have any wisdom teeth at all. A visit to our office or your dentists’ office will determine the position of your wisdom teeth (if you have them at all) and if you need to have them removed.

WHY REYNOLDS ORAL AND FACIAL SURGERY?

Reynolds Oral and Facial Surgery is one of the best oral and facial surgery teams around. With more than 20 years of experience and extensive training, we know what it takes to make sure your procedure runs smoothly. Dr. Reynolds and Dr. Gresehover have a keen eye for detail and strive to make sure to answer any questions you may have. Our team understands that medical procedures can be very nerve-racking experiences which is why we make sure you are comfortable and have the best experience possible. We also invest heavily in the most advanced surgical technology available ensuring you get the best results possible. 


SCHEDULE YOUR CONSULTATION
970.663.6878

FINANCING AVAILABLE!

What is teeth-in-an-hour?

TEETH-IN-AN-HOUR™ is a revolutionary concept providing patients with fully functioning teeth on dental implants in a single procedure that takes about an hour. This technology was developed by Nobel Biocare and utilizes collaboration between both the restorative doctor and the oral surgeon. This merging of knowledge and experience achieves not only increased safety but also a more precise implant placement. In addition, the fabrication of a final prosthesis is completed prior to the surgery. The computer-guided implant surgery is done in an arthroscopic fashion without requiring any flap reflection. This benefits the patient in that there is less postoperative discomfort, less swelling, and less bruising. Patients can often resume their normal activities the next day.

The process begins when a CAT scan is taken of the patient’s jaw bone. This CAT scan allows for the generation of a three-dimensional model of the jaw bone that can then be used with virtual reality software to plan the implant placement without the presence of the patient. The results are a more accurate implant placement and less chair time for the patient.

WHY REYNOLDS ORAL AND FACIAL SURGERY?

Reynolds Oral and Facial Surgery is one of the best oral and facial surgery teams around. With more than 20 years of experience and extensive training, we know what it takes to make sure your procedure runs smoothly. Dr. Reynolds and Dr. Gresehover have a keen eye for detail and strive to make sure to answer any questions you may have. Our team understands that medical procedures can be very nerve-racking experiences which is why we make sure you are comfortable and have the best experience possible. We also invest heavily in the most advanced surgical technology available ensuring you get the best results possible. 


SCHEDULE YOUR CONSULTATION
970.663.6878

FINANCING AVAILABLE!

What is an implant-supported overdenture?

An Implant Supported Overdenture is a contemporary restoration that has revolutionized the way surgeons and dentists think of replacing a full set of teeth. Standard dentures are unsecured prostheses with inherent limitations. Most often, dentures are painful, inconvenient and unstable. Such dentures can make chewing foods difficult, limiting the foods that you once enjoyed. Modern dentistry can help with implant-supported dentures. The Implant Supported Overdenture treatment concept replaces your missing teeth with a full dental bridge supported by dental implants. Fewer implants are needed and overall treatment time and cost is reduced. An Implant Supported Overdenture solution also ensures greater stability in the bone, reducing the need for bone graft surgery to increase bone volume. Implant-supported overdentures stay connected with bar and clip attachment methods or use a variety of abutment-based attachments (ball, magnets, and resilient stud attachments such as Locators). The most appropriate attachment system for your individual needs relates to a variety of factors that are determined early in the treatment. Typically, a temporary set of teeth can be placed on the same day of surgery. The temporary teeth allow you to lead a normal life immediately after surgery. After a short healing period, your dentist will place the final bridge. Your quality of life is improved, and you can start enjoying your favorite foods again with renewed confidence.

IMPLANT SUPPORTED OVERDENTURES OFFER YOU MANY ADVANTAGES:

  • A cost-effective solution. When compared to some other implant-supported restoration methods, your new replacement teeth require fewer implants for each jaw. With fewer implants required, the cost is lowered.
  • Reduced need for bone grafting. The special angled placement of two of the implants ensures a secure and stable anchorage for the replaced arch, often making bone grafting unnecessary.
  • Faster treatment and healing time. Your replacement arch can be attached to your implants immediately after insertion.

Scientifically proven and documented. Implant-Supported Overdentures have had good clinical outcomes from decade long studies with favorable results.

WHY REYNOLDS ORAL AND FACIAL SURGERY?

Reynolds Oral and Facial Surgery is one of the best oral and facial surgery teams around. With more than 20 years of experience and extensive training, we know what it takes to make sure your procedure runs smoothly. Dr. Reynolds and Dr. Gresehover have a keen eye for detail and strive to make sure to answer any questions you may have. Our team understands that medical procedures can be very nerve-racking experiences which is why we make sure you are comfortable and have the best experience possible. We also invest heavily in the most advanced surgical technology available ensuring you get the best results possible. 


SCHEDULE YOUR CONSULTATION
970.663.6878

FINANCING AVAILABLE!

What is bone grafting for implants?

DO I HAVE ENOUGH BONE?

After tooth extraction, if the walls of the socket are very thick, they will usually fill naturally with bone in two to three months. However, when the walls of your socket are very thin (such as in your upper and lower front teeth), this type of healing will not be as predictable. In these situations, a bone graft is often placed at the time of tooth extraction to help your body fill in the empty socket with bone. This step will maintain the width and volume of bone you will need for implant placement several months later.

Inadequate Bone for dental implant
1. Inadequate Bone
Bone Graft Material Placed
2. Graft Material Placed
After Dental Implants Placed
3. Implants Placed

There may be inadequate bone for implant placement if your tooth was removed many years ago and your bony ridge is extremely thin. In this case, a bone graft can be placed next to the thin bone and allowed to heal for up to six months. After the graft has fused to your pre-existing bone, the ridge will be re-entered and the implant placed. Bone grafting is usually a relatively comfortable office procedure. Many different bone-grafting materials are available, including your own bone.

Inadequate Bone for dental implant
1. Inadequate Bone
Bone Graft Material and Dental Implant Placed
2. Graft Material and Implant Placed

You may also need bone grafting if the sinus cavities in your upper jaw are very large, or very low, and extend into the tooth-bearing areas. This often occurs when teeth in the back of a person’s upper jaw have been removed many years before, and the amount of bone available for implant placement is limited. A “sinus grafting procedure” is then required. Most often, it is performed in the office with local anesthesia and perhaps sedation. During this procedure, the membrane that lines the sinus will be located and elevated. Bone will then be added to restore the bone height and ensure that dental implants of an adequate length can be placed. This procedure often can be performed at the time of implant placement.

WHY REYNOLDS ORAL AND FACIAL SURGERY?

Reynolds Oral and Facial Surgery is one of the best oral and facial surgery teams around. With more than 20 years of experience and extensive training, we know what it takes to make sure your procedure runs smoothly. Dr. Reynolds and Dr. Gresehover have a keen eye for detail and strive to make sure to answer any questions you may have. Our team understands that medical procedures can be very nerve-racking experiences which is why we make sure you are comfortable and have the best experience possible. We also invest heavily in the most advanced surgical technology available ensuring you get the best results possible. 


SCHEDULE YOUR CONSULTATION
970.663.6878

FINANCING AVAILABLE!

What alternatives are there for a lower denture?

Although many patients have no problem wearing an upper denture, some people find it difficult to wear and eat with lower dentures. Several implant-supported replacement options are available if you are missing all of your lower teeth.

BALL ATTACHMENT DENTURE

One option is to have two implants placed in your lower jaw and a denture made that snaps onto these implants. This option allows your lower denture to be more stable while chewing than without implants. However, there will still be movement of your lower denture, and sore spots will occur if any food particles, especially seeds, are caught under it. As with all removable replacement teeth, you still will need periodic appointments for denture adjustment.

Before Ball Attachment Denture
1. Before
After Dental Implants Placed
2. Implants Placed
Denture Attached
3. Denture Attached

BAR ATTACHMENT DENTURE

Another option involves placing four to six implants, depending on your jaw size or shape, into your lower jaw. After healing is complete, the implants are connected with a custom-made support bar. Your denture will be made with special internal retention clips that attach onto the support bar, enabling the denture to snap firmly into place. This is called an “overdenture.” The advantage of this option is that it is much more stable than the first option and allows very little denture movement. Your denture is still removable for easy cleaning and maintenance.

Before Bar Attachment Denture
1. Before
After Dental Implants Placed
2. Implants Placed
Denture Attached
3. Denture Attached

SCREW-RETAINED DENTURE

A third option involves placing five or more implants in your jaw and attaching a permanent denture. Your denture is held in place by screws or clasps that secure it to the support posts or bar. It doesn’t touch the gum tissue, which allows you to clean under the denture without removing it. This denture will replace all your missing lower teeth and will not be removed except at maintenance visits. Although cleaning under your denture without removing it is more time consuming and requires more dexterity, many patients who want a permanent denture prefer this option.

Before Screw Retained Denture
1. Before
After Dental Implants Placed
2. Implants Placed
Denture Attached
3. Denture Attached

INDIVIDUAL IMPLANTS

The final option is to have all your teeth individually replaced so that they will appear to be growing out of your gum tissue and will most closely resemble the appearance of your natural teeth. This option usually requires eight or more implants. Separate abutments or support posts for each one of these implants will be made and crowns for each missing tooth will be placed. The teeth are often joined together for sinus grafting to replace bone height strength and support. Overall, this is the most costly option, because it requires the most implants and individual replacement tooth fabrication. Your replacement options may also be limited by the current size and shape of your jawbone.

Before Individual Implants
1. Before
After Dental Implants Placed
2. Implants Placed
Healing completed after after dental implant
3. Healing Completed

WHAT IF I’M MISSING ALL OF MY UPPER TEETH?

A similar range of treatment options is also available for your upper jaw. However, because the bone is not as hard as that in the lower jaw, people often need more implants to support their new replacement teeth. Depending upon the number of implants to be placed, it may be possible to eliminate the need for covering the roof of your mouth with a complete denture. This option allows you to fully taste your food and gives you a better sense of its temperature. Your denture will feel more natural. You will still have a removable denture, which makes cleaning the support bar and denture much easier.

Implant Retained Upper Denture

IMPLANT RETAINED UPPER DENTURE

Depending upon the number of implants to be placed, it may be possible to eliminate the need for covering the roof of your mouth with a complete denture. This option allows you to fully taste your food and gives you a better sense of its temperature. Your denture will feel more natural. You will still have a removable denture, which makes cleaning the support bar and denture much easier.

Individual Upper Dental Implants

INDIVIDUAL UPPER IMPLANTS

If you want a restoration that is similar to your natural teeth and therefore not removable, you probably will need eight to ten individual implants placed. This is followed after healing by the placement of the abutments and new replacement crowns.

Allon4NOBEL

ALL-ON-4®

The All-on-4® treatment concept replaces your missing teeth with a full dental bridge supported by only four dental implants. With fewer implants needed, the overall treatment time is reduced. The unique All-on-4® solution also ensures greater stability in the bone, reducing the need for bone graft surgery to increase bone volume.

(Image Courtesy of Nobel Biocare)

mdi_mandible_2.tif

MINI IMPLANTS FOR DENTURE RETENTION – (BY 3M)

Small one-piece implants, called Mini Dental Implants, can be placed in the lower or upper jaw for denture retention. These implants are only 1.8mm wide and can be placed in atrophic jaws (where there has been bone-loss) when other implants cannot without bone grafting or manipulation. They are less expensive than the wide implants and can be placed in one visit.

(Image Courtesy of 3M)

WHY REYNOLDS ORAL AND FACIAL SURGERY?

Reynolds Oral and Facial Surgery is one of the best oral and facial surgery teams around. With more than 20 years of experience and extensive training, we know what it takes to make sure your procedure runs smoothly. Dr. Reynolds and Dr. Gresehover have a keen eye for detail and strive to make sure to answer any questions you may have. Our team understands that medical procedures can be very nerve-racking experiences which is why we make sure you are comfortable and have the best experience possible. We also invest heavily in the most advanced surgical technology available ensuring you get the best results possible. 


SCHEDULE YOUR CONSULTATION
970.663.6878

FINANCING AVAILABLE!

What are the options for replacing missing teeth?

REPLACING MISSING TEETH

Your teeth affect your whole body. When they’re healthy, you’re healthier too. A missing tooth can affect your bite, speech and eating choices. As you rely more on your remaining teeth, you increase the chance they will wear out prematurely, or be damaged or lost. You may also experience headaches and/or jaw pain.

Who would want their appearance and health to deteriorate? That’s the natural consequence of missing teeth – the jaw literally melts away. Generally, people will lose 25% of their supporting jawbone structure within the first year after tooth loss. Dental implants are more easily placed when teeth are first extracted because bone replacement becomes more complex as time passes. The great news? Implants act just like your natural teeth. They safeguard and preserve your bone structure, oral health, and appearance. Your dentist and the implant surgeon will provide you with options so that you can make the most informed decision concerning tooth replacement.

TOOTH REPLACEMENT OPTIONS

You can select from a number of different options to replace your missing teeth – from temporary to long-lasting solutions. However, smoking, diseases such as diabetes, and radiation therapy to the area, can affect your options. So the question is, what are the options for replacing missing teeth, and which option is best for you? Every person is different, and every situation is different which is why it is important to come in for a consultation. However, the following are a few potential options for replacing missing teeth.

Fixed Bridge, dental bridge

FIXED BRIDGE

A fixed bridge is a connected set of replacement teeth. For support, it is cemented into position on top of the teeth adjacent to the empty space. The protective outer layer of these teeth is usually removed or ground down prior to attaching the bridge.

Flipper, removable plastic retainer

FLIPPER

A fragile, temporary and inexpensive solution is a removable plastic tooth with a plastic retainer, often called a “flipper”.

Metal Partial, removable partial denture

METAL PARTIAL

A less fragile option is a removable partial denture cast in metal and plastic. It is held in place by wire clips. A removable partial denture can be removed and reinserted when required by the patient.

Denture

DENTURE

The most common solution for people missing all teeth in one or both jaws, are complete dentures. Some people adapt well to dentures. Others find them uncomfortable, even intolerable, because of differences in jaw size and shape.

Dental Implants

DENTAL IMPLANTS

Dental implants are the most comfortable and permanent solution. They form a strong foundation for teeth and keep the jaw healthy and strong. Implants support individual replacement teeth or secure specialized dentures in place. Unlike bridges, no healthy teeth are damaged. Unlike most bridges, implants can last a lifetime. Implant-supported replacement teeth can be attractive, stable, and comfortable for almost any patient.

WHY SELECT DENTAL IMPLANTS OVER MORE TRADITIONAL TYPES OF RESTORATIONS?

There are several reasons: A dental bridge can sacrifice the structure of surrounding good teeth to bridge the space of the missing tooth/teeth. In addition, removing a denture or a “partial” at night may be inconvenient, not to mention dentures that slip can be uncomfortable and rather embarrassing.

WHY REYNOLDS ORAL AND FACIAL SURGERY?

Reynolds Oral and Facial Surgery is one of the best oral and facial surgery teams around. With more than 20 years of experience and extensive training, we know what it takes to make sure your procedure runs smoothly. Dr. Reynolds and Dr. Gresehover have a keen eye for detail and strive to make sure to answer any questions you may have. Our team understands that medical procedures can be very nerve-racking experiences which is why we make sure you are comfortable and have the best experience possible. We also invest heavily in the most advanced surgical technology available ensuring you get the best results possible. 


SCHEDULE YOUR CONSULTATION
970.663.6878

FINANCING AVAILABLE!

What is the implant process?

THE SURGICAL PROCEDURE

The procedure to place an implant takes 30 to 60 minutes for one implant and only 2 to 3 hours for multiple implants. The number of appointments and time required varies from patient to patient. The surgeon will bring great precision and attention to the details of your case.

Prior to surgery, you may receive antibiotics and for greater comfort, intravenous sedation or nitrous oxide (laughing gas). These options are discussed with you at your consultation appointment. A local anesthetic will be administered to numb the area where the implant will be placed.

When you are comfortable, the surgeon makes a small incision in the gum tissue to reveal the bone, creates space using special instruments, and gently inserts the titanium implant. The top of this implant is often visible through the gum. Sometimes it is better in the early stages of healing to have the implant covered by the gum tissue.

Normal Mouth
1. Normal
After Tooth Loss
2. Tooth Loss
Healed Bone, after bone grafting
3. Healed Bone
Dental Implant Placed
4. Implant Placed
Healing after dental implant placement
5. Healing
Dental Implant Restored
6. Implant Restored

THE HEALING PHASE

Now the healing begins. The length of time varies from person to person, depending upon the quality and quantity of bone. In some cases, implants may be restored immediately after they are placed. The surgeon will advise you on follow-up care and timing. After the initial phase of healing, the surgeon places an abutment (support post) or a healing cap onto the implant during a brief follow-up visit. This allows gum tissue to mature and provides access to the implant.

Occasionally, impressions are made at the time the implant is placed. This enables the crown to be ready when the implants have healed. How long your mouth needs to heal is determined by a variety of factors. Follow-up care (one to four appointments) is usually needed to ensure that your mouth is healing well and to determine when you are ready for the restorative phase of your treatment.

It may be beneficial to perform a soft tissue graft to obtain stronger, more easily cleaned and natural appearing gum tissue in the area around the implant. This process involves moving a small amount of gum tissue from one part of your mouth to the area around the implant. Most often, it is a brief and relatively comfortable procedure.

Whether it’s one tooth or all of your teeth that are being replaced, your dentist will complete the restoration by fitting the replacement tooth (crown) to the dental implant.

DENTAL IMPLANTS PRESENTATION

To provide you with a better understanding of dental implants, we have provided the following multimedia presentation. Many common questions pertaining to dental implants are discussed.

Dental Implants Presentation

WHEN ARE DENTAL IMPLANTS PLACED?

Implants are often placed several months after extraction. At times, an implant may be placed immediately after extraction of a tooth. This may involve a little more risk, but it simplifies the process—you won’t have to wait for another appointment to place the implant. When infection or other problems with the bone are present, immediate implant placement is not the best treatment.

If your tooth has been missing for some time, the adjacent support bone is likely to grow thinner and shrink. This occurs because the root of the natural tooth has to be present to stimulate the bone. As much as one-third of your jaw’s thickness can be lost in the year following tooth extraction. If you are missing enough bone, you may benefit from having additional bone grafted into the area. This ensures the implant will be adequately supported when it is placed in the jaw.

HOW MANY IMPLANTS DO I NEED?

Most frequently, one implant per missing tooth is placed. Because many of the larger teeth in the back of your jaws have two or three roots, the most common approach is to replace missing back teeth with larger implants.

WHY REYNOLDS ORAL AND FACIAL SURGERY?

Reynolds Oral and Facial Surgery is one of the best oral and facial surgery teams around. With more than 20 years of experience and extensive training, we know what it takes to make sure your procedure runs smoothly. Dr. Reynolds and Dr. Gresehover have a keen eye for detail and strive to make sure to answer any questions you may have. Our team understands that medical procedures can be very nerve-racking experiences which is why we make sure you are comfortable and have the best experience possible. We also invest heavily in the most advanced surgical technology available ensuring you get the best results possible. 


SCHEDULE YOUR CONSULTATION
970.663.6878

FINANCING AVAILABLE!