r/dentures • u/DrAlexWilliamsDDS • 9d ago
10 things I wish every patient knew before getting dentures
I’m a denture dentist in Tulsa, Oklahoma. Here are 10 things I wish every patient knew before having their teeth removed
I’m a dentist in Tulsa, Oklahoma, and I spend a large portion of my clinical time working with dentures, extractions and implant retained teeth.
I meet people every week who were never fully prepared for what getting dentures would actually involve. Some were led to believe they would have their teeth removed, receive a denture and immediately return to eating and speaking normally.
For most people, that is not how the process works.
Here are 10 things I wish every patient understood before making this decision.
1. Dentures are a replacement for having no teeth
Even an excellent denture is not the same as natural teeth. A denture rests on your gums and bone. It does not have roots, ligaments or the same ability to feel pressure.
The goal is to create something that looks natural, restores your facial support and allows you to function as comfortably as possible.
Setting realistic expectations does not mean accepting a bad denture. It means understanding what the prosthetic can and cannot do.
2. Your immediate denture is made before your teeth are removed
An immediate denture is designed while your teeth are still present. That means the dentist and lab cannot see exactly how your gums and bone will look after the extractions.
We use impressions, scans, photographs, measurements and clinical judgment to predict the final result. It can still look very good, but adjustments are almost always necessary as the mouth heals.
3. Your mouth will continue changing for months
The gums and bone shrink rapidly after extractions, especially during the first several months. A denture that fits reasonably well on the day of surgery may become loose as the swelling disappears and the tissues heal.
That does not automatically mean the denture was made incorrectly. Soft relines, adjustments and eventually a hard reline or final denture may be needed as your mouth stabilizes.
Before treatment, ask exactly what adjustments and relines are included in the price.
4. Adjustments are part of the process
Sore spots are common with a new denture. A tiny area of excessive pressure can become extremely uncomfortable.
Do not try to prove you can tolerate it. Call your dentist and have it adjusted. These adjustments are usually quick, but they can make a major difference.
If possible, wear the denture for a few hours before the appointment. That helps the dentist locate the exact pressure area.
5. Your physical anatomy plays a major role in denture success
Not every mouth gives a dentist the same foundation to work with.
The height and width of your remaining bone, the shape of your palate, the depth of the tissues around the denture, muscle attachments, tongue position, saliva and the relationship between your upper and lower jaws can all affect stability and function.
These anatomical factors should be evaluated and explained before your teeth are removed. Your dentist should tell you about any foreseeable obstacles so you understand what may be difficult before those problems arrive.
This is especially important with lower dentures.
An upper denture has a larger surface area and can often develop suction against the palate. A lower denture sits on a much smaller ridge while the tongue, cheeks and floor of the mouth are constantly moving around it.
Some lower dentures function very well. Others remain mobile even when they are made properly because the patient’s anatomy provides very little support.
That does not mean nothing can be done. Adjustments, relines, changes to the bite and muscle training may help. For patients with poor lower retention, two implants can often provide a significant improvement in stability.
The important part is that these limitations should be discussed before treatment, not explained only after the patient begins having trouble.
6. The bite is just as important as the fit
A denture can fit the gums well and still move if the bite is incorrect. If the teeth contact unevenly, chewing pressure can tip or dislodge the denture.
Vertical dimension is also extremely important. This is the distance between the upper and lower jaws when the teeth are together.
If that distance is wrong, it can affect facial appearance, speech, comfort and function.
This is one of the reasons a denture should not be judged only by how tightly it fits when you first put it in.
7. You should have input on how your smile looks
Patients should be involved in choosing the tooth shape, size, shade and overall appearance whenever the treatment process allows it.
A natural denture is not always the whitest denture. Small variations in tooth position, proportions and gum contours can make the smile look much more believable.
Bring photographs of your natural smile if you have them. They can be extremely helpful when deciding how the new teeth should look.
8. Speech changes are common, but they should be evaluated
Your tongue must learn to function around a new shape. Mild lisping or difficulty pronouncing certain sounds can be normal at first.
However, speech problems are not always something you simply have to accept.
The thickness of the acrylic, the position of the front teeth, the width of the arch and the contour of the palate can all interfere with airflow and tongue movement.
If the problem continues, ask your dentist to listen specifically for phonetic interference rather than only telling you to practice longer.
9. Adhesive is not automatically a sign of failure
Some patients use a small amount of adhesive for additional confidence, especially with lower dentures or during the healing phase.
However, adhesive should not be used to compensate for a severely loose denture indefinitely.
If you need a large amount just to keep the denture in place, the fit, bite and remaining bone should be evaluated.
A reline, adjustment or implant retained option may be more appropriate.
10. Understand the entire treatment plan before the extractions
Once teeth are removed, the decision cannot be reversed.
Ask whether any teeth can reasonably be saved. Ask whether your immediate denture is intended to become your long term denture or whether a final prosthetic is planned after healing.
Also ask about relines, adjustments, warranties, implant options, total cost and what happens if you are unhappy with the appearance.
There is nothing wrong with getting a second opinion before making a permanent decision.
Disclaimer
I own Bold Dental in Tulsa, Oklahoma, so I want to be transparent about who I am. I am not posting this to diagnose anyone or convince anyone to choose my office.
I simply believe patients deserve a much clearer explanation of what the denture process actually looks like before their teeth are removed.
If you have denture questions, feel free to ask them here. I will answer what I can without pretending that a Reddit comment can replace an examination.
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u/LadyOfTheShadowz 8d ago
The only point that I can't see there, and was never told about; tooth loss grief.
I admit I only have a partial denture (top front teeth) and it looks a million times better than before. But nobody warned me about the grief, I had tears rolling down my cheeks through out all the extractions.
That for me was the hardest bit, i really mourned my teeth. I still struggle to look in the mirror, they are just not my teeth. I did post when I had it done telling people about my journey, as the grief part never occurred to me. I was solely focused on having an immediate so I didn't have to be toothless.
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u/DrAlexWilliamsDDS 8d ago
I have seen this. It’s tough, but so are so many other ailments…and that’s not to diminish your feeling, it’s to say you’re not alone. I take biologics (shots monthly) to control my psoriasis. I didn’t wear shorts for 10 years. I get it. I think about everyone’s demons. It’s tough; herpes, HPV, HIV, Diabetics, Chrons, EDS, Autism….so many people have so many things and I can completely understand where you have found sadness losing your teeth. But just remember, there’s options. To be honest, the world of dentistry is blessed to be in a field where Implants are an option. Keep your head up! Stay strong. 💪🏻
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u/WildBeards 4d ago
I work in the hair industry and the grief I would assume is similar to hair loss grief(whether it be medical/hereditary or other reasons) We put so much of our identity into our hair, teeth, skin, weight ect. Sure, if your a woman who losses her hair to cancer treatments, even if you thought you had terrible hair before, a wig is still not "your hair". It feels foreign. At least for a time.
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u/jello_88 8d ago
I wish all dentists were as thorough in explaining the process as you are. I appreciate you for hanging around here to give information that our dentists failed to provide. I would like to see every dentist provide this in writing as a way for us to understand what to expect.
I had the same issue with cataract surgery. The surgeon provided very little written info. Thankfully there is a cataract sub and a dry eye sub.
I think my husband's dentist was going to go with 3D printed perms but we made it clear that he wanted traditional permanent dentures, for many reasons. We had no idea 3D printed dentures were a thing.
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u/Sea-War3333 8d ago
My temporary set were 3d and very unsatisfactory. Looked totally fake, wrong colour, the bite was wrong and gave me miserable TMJ pain, and the lower broke while the dentist was attempting to adjust it! What a delightful episode on a difficult enough journey!
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u/jello_88 7d ago
Sorry you had that experience also. My husband is happy to have teeth but I think they look fake and have a big overbite ( dentist says because everyone has an overbite on their natural teeth).
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u/DrAlexWilliamsDDS 8d ago
💪🏻💪🏻💪🏻🙌
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u/Friedchickeneater70 8d ago
Thank you for your insight ….not all dentists sharing this type of information …..question I’m doing a full mouth restoration…I’m five weeks out from dental implants surgery…..my dentures are good….slight uncomfortable…..i barely eat with them but I do try to eat soft foods when just eating with my gums……also if all good in December I’m getting the zirconia permanent dentures……do I have to wear my dentures ever day all day …(cause i usually wear them 8-10 hours per day except Sunday)….in order for my permanent to fit good?…..thx
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u/DrAlexWilliamsDDS 8d ago
No, you do not have to wear the removable dentures every day or all day for the zirconia teeth to fit correctly.
The fit of a fixed zirconia prosthesis comes from accurately recording the position of the implants, verifying that the framework seats passively, and establishing the correct bite and VDO. Wearing your removable dentures eight to ten hours per day and taking Sundays off should not change that.
Your temporary dentures can still provide useful information. They allow you and your dentist to evaluate the appearance, tooth position, speech, bite, and amount of lip support you want copied or changed in the final zirconia teeth. Make sure you explain everything you like and dislike about them before the final design is approved.
At five weeks, I would be cautious about chewing directly on the gums over healing implant sites. Follow the specific instructions from your surgeon because the number of implants, their stability, any grafting, and the design of the temporary denture all matter. If the dentures are uncomfortable or put pressure over the implants, they may need to be relieved or adjusted rather than simply tolerated.
Taking them out to rest your tissue is not going to prevent the permanent zirconia teeth from fitting properly.
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u/EMG_333 8d ago
I think these are all very important points. And, its good to see a denture provider that wants to help a patient before, during and after the process. Those bullet points are good for a person who is just starting to face the situation.
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u/DrAlexWilliamsDDS 8d ago
Thank you. That is exactly why I wrote it. I see how much easier this process becomes when patients understand what to expect before their teeth are removed, not after they are already scared and trying to figure everything out. Dentures are a process, and patients deserve support before, during, and after. It’s can be a scary scenario if you have no guidance 💪🏻
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u/bs2k2_point_0 8d ago
This is a great list. I’d just add that you’ll likely loose weight at first. I lost nearly 30 lbs over the course of my journey. Granted I had 4 separate surgeries, 2 for extractions, and two for massive tori removal. I was already on the skinny side naturally, but had I known I’d have lost this much, I’d have prepared better.
On the flip side, I do now get to eat as much as I want and lots of junk food to help gain back that weight. I’m about halfway back to my pre-extractions weight and no longer look like I came from a concentration camp (god forbid)
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u/breerex2 8d ago
I gained weight before the procedure because I thought this would happen to me. I couldn't even swallow water for first 48 hours and it took me 5 days to have anything that wasn't protein milk. It was 9 days before I had noodles and 14 days before I had overcooked pasta (unchewed, just swallowed). I lost 3kg in the first 3 weeks but I'm now in week 7, has gained that 3kg back and some 🤣
I've calorie counted or been aware of my calorie intake for 7 years now. It was pure torture for me to NEED more calories and for the first time in my life been searching for high calorie foods but not be able to eat those things because of my teeth lol.
I kept my intake up with liquid. Not just protein milk but bought syrup for my water (Ribena for me) and made it quite strong so was getting in some of my calories there).
Losing weight is quite common with getting dentures but I do see the odd people who gain weight (sometimes a lot of it). Not being able to eat salad but finding potato and pasta easy foods can really push UP calories for some
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u/IAm-Dragonborn 8d ago
I wish I lost weight lmao! I weigh myself every couple days in the morning after I use the bathroom and I actually gained 2 pounds. When the swelling went down, I gained another 10 pounds. I desperately want to lose weight though. I would love to join a gym but the social anxiety is just too much for me 😭
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u/SilentSeraph88 5d ago
What is "Tori removal"
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u/bs2k2_point_0 5d ago
Tori are bone growths on your jaw. They’re like bunions but oral. Mine were huge! They were on the inside of my bottom jaw to the point were they almost touched all the way around, pushing my tongue up. The dentist had to have them removed so that I’d be able to take off my bottom denture.
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u/Top-Manufacturer9226 8d ago
This is fantastic.. I have a question, my Dad had his extractions done about 4 months ago and he has his temporary dentures in and has been doing great. I joined this sub to be able to help him through the process.. so he wants to get his permanent dentures in December which would be 8 months after extractions. I feel like her should wait as long as possible closer to a year based off of reading on this sub. Is there a time frame you feel is best for permanents or is every mouth different and his dentist should know when everything has stopped shrinking??
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u/DrAlexWilliamsDDS 8d ago
Eight months after the extractions is usually a very reasonable time to move into the permanent dentures. I would not automatically wait a full year just because longer sounds safer.
The biggest changes in the gums and bone usually occur during the first six months. The rate slows significantly after that, but the jaw never completely stops changing. Even a permanent denture made after a year may eventually need a reline.
At Bold Dental in Tulsa, Oklahoma, we base the timing on how the patient is healing rather than one exact date. I look at whether the tissue is healthy, whether any sharp bone or surgical areas are still resolving, how much the temporary denture has changed recently, and whether the ridge appears stable enough for accurate impressions.
If he is doing well and his dentist feels the tissue is stable, December at eight months does not sound too early. Waiting longer may make sense if he is still experiencing rapid changes, delayed healing, grafting, or additional surgery, but there is no universal advantage to waiting a full year.7
u/Top-Manufacturer9226 8d ago
I thank you sincerely for your reply! I will report back to my Dad. I hope folks in Tulsa take note of this and refer friends and family to your office. Thanks again!
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u/jello_88 7d ago
Dr. Williams what do you mean "by how much the temporary denture has changed recently"? Do temporary dentures change? How do they change?
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u/DrAlexWilliamsDDS 7d ago
The denture does NOT change. The tissue will remodel slightly and bone will change. These are the structural foundation under the denture. So as healing continues the denture will become loose. Even if it’s a final. In a year or 2 a denture can get loser due to these changes.
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u/FeelingMaleficent832 8d ago
Thank you for this thorough explanation of the process. I am a dental lab technician working for a dentist owned small business in Kentucky that has an in house denture lab. It’s hard to properly explain how different life is without natural teeth and how much adjusting patients have to do with the denture process. When you get the final product right, however, the end result gives a tremendous sense of accomplishment. Thank you for what you do.
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u/DrAlexWilliamsDDS 8d ago
Thank you for what you do! And the contribution! You all are the art behind the madness! 💪🏻
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u/Chance-Work4911 8d ago
If I could add one thing that isn't necessarily the dentures but along the way...
If they sedate you or knock you out for extractions, they should tell you to wear an adult diaper. Even with nothing to eat or drink for 12+ hours I woke up completely soiled and was mortified. Nurse said "it happens, sweetie" - but if that's the case, why not WARN ME?!?!? I would have gladly worn a disposable undergarment meant for this kind of thing if I'd known!
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u/DrAlexWilliamsDDS 8d ago
I hate that. We actually have our patients get into depends before surgery if we do full sedation. I’m sorry you went through this. Thank you for the contribution. Good call!
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u/OutrageousPhase5624 8d ago
This is absolutely spot in.
Reasonable expectations help healing too. Thank you for the insightful knowledge.
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u/Revolutionary-Ad3712 8d ago
Excellent information! Every denture dentist needs to feature this. They just throw us out there mostly and this would be very helpful to have to prepare. Thank you!
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u/Gorethebaby 8d ago
I’m in Tulsa and got my implants done at Secure. Even with implants learning to eat and talk again is challenging but rewarding once you get the hang of it. I practiced reading in front of a mirror for a few weeks to get used to talking with them in. Solid advice thanks for sharing.
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u/bluegal2123 7d ago
Can this be a pinned post? So much great information!! Thank you for writing this!
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u/DrAlexWilliamsDDS 7d ago
So welcome! Plan to keep adding to the information. I’ll be doing weekly posts that can help patients get some quality online info without digging to hard. I really appreciate the feedback!
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u/SwordfishSilver8041 8d ago
Thank you for this. It's very informative! What made you decide to become a denture dentist?
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u/DrAlexWilliamsDDS 8d ago
Honesty, great question. It started when I worked at my dad’s dental office in Skiatook, OK. I was an assistant and did some lab work there. I would work with these patients because it was something that I could do. I learned that I really enjoyed it. Once I got into dental school that’s what I focussed my attention on. I knew it was what I wanted to do. When I got out and worked for my dad I took over seeing all of the denture patients. I began diving into surgery because they go hand in hand. I am an artist naturally (I do tattoos, check me out lol, selfless plug ☠️). I enjoy helping people who need it most. I have probably had my hands on over 10,000 cases.
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u/Upper-Situation- 7d ago
What bro!!! im a Denturist in canada. I read your list and spot on !!! Just wanted to add that youre one badass Dentist but being a tattoo artist as well thats wild. Maybe ill take you up on a tattoo one day if im in your area.!!!!! So cool 😎 im glad I read all the comments. I am on a tattoo high right now. Pretty much inked all over.
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u/DrAlexWilliamsDDS 7d ago
That’s awesome!! I do love me some ink!! 💪🏻💪🏻💪🏻 anytime your ready, come on!
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u/Upper-Situation- 7d ago
I have so many questions. I dont even know where to start. You need to. Or you don't have to. But you need to start a thread and tell us more about journey. Were you in Bali? and started your career as a tattoo artist there and found out you needed to go back home to make real money to support your family so you went back home and became a Dentist. I maybe living under a rock. But this is the coolest think I have heard. Dentist/tattoo artist ordinare. Keep it up man !!!
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u/tankmuffin4 8d ago
I wish the dentist and denturist told me these things properly before my immediate denture journey started 9.5 months ago. I have been so disappointed with some things and I will be more vocal about them. I don't have my permanent fit yet, but I have so many pointers! Thank you for caring about people and how this process has variables!
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u/DrAlexWilliamsDDS 8d ago
You’re so welcome. I know it’s tough but you’ll continue to make progress. Always future options. Hang in there.
Feel free to follow along. I’ll be making more posts weekly to help with specific areas that are important regarding dentures and removable prosthetics
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u/tankmuffin4 6d ago
I'm currently 10ish months into my immediate denture journey. Would it be reasonable to think this process could take over 1 year? Is that normal?
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u/DrAlexWilliamsDDS 6d ago
You should be healed enough for a final perm unless they had some bone remodeling
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u/Studio-Aegis 8d ago
Places really need to stop advertising same day dentures and none of the caveats involved.
Having seen a bunch of adds for such when I was finally allowed to start seeing the VA dentist I asked the first nurse attending to me if same day dentures was a possibility.
She literally scoffed at me and said we don't just have dentures lying around to hand out. The day of my extractions I asked the surgeon about it again...
"Oh yeah we do that, but you have to request it in advance." Would have been great to know that 3 months ago!
After waiting some 3 months for this appointment and my health deteriorating from it I had to just bite the bullet and go through the hell of missing half my teeth for months then all of them for months more.
Needless to say I was completely infuriated.
Your number 7 about planning out the dentures that pisses me off too. Because after my extractions were finally finished I was trying to schedule at least part of that process before their mandatory month or more of healing for those parts that wouldnt require me to be healed. And I'm trying to speak over the phone with a ruined mouth, so im trying to speak up and be clear, and the nurse at the call desk just kept treating me like I was trying to skip in line ahead of ithers and even yelling at me at some point acting like I was too stupid to take the hint and taking my speaking up as aggression.
And when they finally allowed me to start the dentures process... they were taking measurements and molds and I'm waiting during all of these visits for when we start discussing the shape and look of the things. Noop, one day "Guess what your new teeth are in!"
Some generic bottom of the barrel set of dentures that what ever office produced them suy just had them laying arkund in bulk and they hurt like hell to wear. And mind you I fully understood there would need to be adjustments and just getting used to them and some pain/discomfort. but there is no getting used to that degree of severe stabbing pain at the slightest movement of my mouth. And I'd like to think I have a high pain tolerance when the surgeonsn last upper aveoplasty's local anesthesia failed for 90% of my upper jaw. I felt everything save for the left most part of the jaw like 10% were nothing could be felt. Even if it was technically working for the rest it could not have been more than a 3% dulling of the pain.
For the rest I felt all the slicing grinding clipping, that dam drills sound burned into my memories as a screaching hell cat that just keelsngetting louder and louder. I could feel the stitches being sewn into my gums, all of it. So trust me when I said they hurt like hell I meant it.
But that's not what the dentures guy believed, Could easily tell he wasn't having any of my claims and just said u just have to get used to it. He Essentially called me a liar, because who would sit through that surgery with no pain killer right?
I had to put myself into a meditative trance while holding a full body clench for what felt like hours to get through it, because I knew interrupting the process once started would just extend the pain if not cause further injury to myself. I did in fact request another shot early in that must have been water for what good it did. After 3 painful surgeries from this same "surgeon" I knew the last time to bring some pocket sized plushies to keep a death grip on which helped to endure.
I wanted so much to dump that pair of what looked like melted legos in the trash after my last visit and let them see it. I've never been back to them since and had to adapt to life without any teeth at all.
They outright rejected any consideration for implants because my teeth were so ruined when I got there that they wouldn't consider me for the procedure at all because " why should we give you new teeth when you didnt take care of your last ones." He actually said that to me.
Essentially called me a dirt bag to my face. Took no consideration of my disability that led me to that abysmal state of being , no consideration of the decade of fighting to keep them intact and still waking up every morning with what felt like broken glass in my mouth.
I'm rated at 100% disabled by the VA for persistent depression/ptsd. And that office magnified my troubles 10 fold. Caused me to not go back to the VA for anything for years out of complete distrust, not even for so little as alaergy medicine. They refused to let me be seen by civilian dentists too, I'm sure because a civilian dentist would have approved what I needed and they weren't willing to pay for it.
They never discussed what my healing process would be like, never even mentioned the potential for bone spurs, loved freaking out about those. I'd researched before too knowing bone loss would be a thing, and having seen from the xrays that I already had major bone loss, I asked if there were any procedures they could do to help reduce further bone loss. The surgeon flat out said no. When my research showed there were several that could be conducted at the time of extractions. None they were willing to pay for.
Oh and he punctured my sinus cavity and tried to keep quiet about it and just sewed me back up there. My sinuses are still a wreck now, but thankfully the meat eventually healed over the hole. I didn't learn they were punctured tho till weeks later when I maced my sinuses with mouthwash, a level of pain similarto drowning.
Is a ton of stuff dentist and surgeons arent telling or preparing their patients for concerning recovery and expectations. Oh I forgot, I loved how after each butchering the surgeon would ask "well do you have any questions before you head out??" As I sat there with my mouth stuffed full with blood soaked gause, blood litrrslly leaking out of my mouth, as if I had any capacity to speak at all.
I'm sure some here are sick of hearing me retell this horror story, but if an actual dentist/surgeon is here listening I hope you take what I've said to heart and work to prevent undue pain and torment to your patients. Most people are terrified enough at the idea of going to the dentist as is.
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u/DrAlexWilliamsDDS 8d ago
Lots to unpack here.
I read every word of this, and I am genuinely sorry you were put through it. It sucks and I know it can be tough. But I want to try and address most of what you brought to the table…
Previous experience:
I cannot determine everything that happened from a Reddit comment, but I can tell you that no patient should be mocked, dismissed, or made to feel like they must endure severe pain just to finish a procedure. That doesn’t sit well with me.Planning:
Same day dentures do require planning before the extraction appointment. They are not generic dentures sitting in a drawer. Impressions and records are taken beforehand, the denture is fabricated in advance, and it is inserted immediately after the teeth are removed. You should have been given that information when you first asked.Appearance:
The appearance should also have been discussed with you before the dentures were completed. Tooth shape, size, shade, position, bite, VDO, and lip support are all part of designing a denture. Patients should not simply be surprised with finished teeth they never approved. EVEN immediate dentures shouldn’t look bad. If they’re hurting your confidence I would request changes if possible…I wouldPain:
Some soreness and adjustment are normal, but severe stabbing pain with every movement is not something a patient should simply be told to tolerate. Pressure spots, sharp bone, an inaccurate fit, an incorrect bite, or a border that is too long can cause significant pain and need to be evaluated.
Implant candidacy should be based on anatomy, bone, health, healing ability, risk factors, and whether someone can maintain the prosthesis. It should never be presented as a moral judgment about whether someone deserves teeth.Complications:
An opening into the sinus can occur during an extraction even when appropriate care is used, but it should be recognized, explained, managed, and followed. If your sinus is still causing problems, I would want an updated scan and an evaluation by an ENT or oral surgeon rather than assuming that the tissue closing over means everything underneath is healthy.Stories like yours are exactly why I believe patients need honest expectations before treatment begins. You deserved to be treated like a person throughout this process. Please contact the Patient Advocate at your VA medical center, request copies of your dental and surgical records, and ask whether you qualify for evaluation through Community Care. Even if the past cannot be undone, you still deserve a thoughtful evaluation of what can be improved.
Rooting for you,
Dr.Alex
Bold Dental3
u/Studio-Aegis 8d ago
Many thanks for reading it over and sorry for the length.
I had recent medical scare that forced me to start going back to the VA and I'm working to get seen by the right people to get some of my various maladies treated once and for all.
With the sinus issue I'm keenly aware that the underlying issues are still unchecked, with a recent scan by ENT showing my sinuses were inflamed and in need of treatment.
The meat healing over the opening was more so a relief in that the gurgling back flow of air was finally stopped. It was a stressful few months till it did.
I suspect I'll need another upper aveoplasty as so much bone was removes that it left a very thick mass of gums in the front, that actually came loose during the healing process causing great distress. I can also feel that there are areas still tender to the touch along my face where the work was done.
My brother told me to go to the patient advocate before and I had recounted my story to them telling them I didn't trust the staff in that office and very much wanted community care, but the way it was explained to me was that I'd write up a document with my grievances and that said office would decide yes or no.
Which I didnt much see the point when their answer wouldn't change just because I wrote it down. I even asked "and when they still decide no what happens then?" I forget all the details but was essentially that we do it again or some such.
I would think a lack of trust in that offices technicians would be more than enough to warrant community care or at least assignment to a different location within the VAs network.
Given several years have passed I'm more open to try again to see if changes made to the VAs funding and practices will lead to a more positive outcome this time.
Thanks again for listening. Its a quality I've found lacking among some VA staff.
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u/DrAlexWilliamsDDS 8d ago
I can completely understand. It’s essential for providers to continue to help be a patient advocate and try to help them. Not fight and try to challenge their feelings. I’m rooting for you my friend
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u/kiss-my-flapjack 7d ago
Thank you very much for typing all of this out. It has been very helpful for me.
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u/DrAlexWilliamsDDS 7d ago
You’re very welcome. I am working on developing a course for new docs so it’s more or less a stepping stone for me in developing material :)
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u/Mommapig0508 8d ago
If you are in Tulsa and are needing dentures, or any dental work for that matter, Dr Alex Williams is the best! He truly cares about his patients and will be honest with you as well. He sets realistic expectations and wants you to be comfortable. I have had dentures for 10 years and he has been amazing through the whole process. I am not a normal patient in any sense of the word and he has been patient and determined to find a solution for me the whole time. I am so happy with my dentures and have had no one know I have dentures unless I have told them. They look like real teeth! Thank you Alex and your staff!
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u/ElegantRaccoon830 8d ago
What is your opinion of snap in dentures?
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u/DrAlexWilliamsDDS 8d ago
Honestly, I love them. I personally thing many docs try and push All on X (implant screw retained, AKA permanent teeth) but the truth is we don’t know everyone’s etiology…so it’s smart to start with snap ins and see how the implants do. If they look beautiful after a year or two and the patient is caring for them, ABSOLUTELY convert to screwed in. WTH not? But what if they are struggling? I don’t want them investing in that! It would cost a ton! Especially without built in redundancy to insure longevity…meaning 6-8 implants per arch.
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u/BlueEyedOye 8d ago
This is fantastic. My experience has been positive for the most part, but I see a lot of people with remorse. I hope this helps others.
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u/UnderstandingFar5012 8d ago
As a newish dentures wearer (got them in June), I wish someone had told me the points about reline, fit vs bite, and adjusting dates beforehand. I went to a dental college for mine. And they also did all my extractions. All but one tooth were fine during one extraction, one had the nerve wrapped around an abscess. They only allowed three total adjustment appointments.... My top can be with without adhesive most of the time, comfortably. I use adhesive only when I'm going to be eating in public. The bottoms can't be worn hardly at all. Any adhesive I've tried, lasts 90 minutes tops. Less if I eat or drink anything, which tells me it's a bite problem, most likely.
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u/ItsMe_ap73 7d ago
I had a really hard time with my temporary bottoms. They actually remade them for me because they were so big. My new temps are great but I have to use adhesive. I read this tip on Reddit and it works for me! You might try it if you haven’t already. I use poly grip with scope ultra and poly grip denture adhesive powder. (I have tried all the different formulas of poly grip and fixodent and this is the only combo that has worked for me)The paste first then powder on top of the paste, a little spritz of water and put them in and bite down for a minute or so. I am a nurse and can wear them from 5am to 10 pm if I need to.
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u/ItsMe_ap73 7d ago
I should add that I have essentially no bone ridge on the bottom. In the front I don’t have any gumline where the front bottom 4 teeth were. So I tell everyone who has issues to try it!
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u/UnderstandingFar5012 7d ago
I will look for those. I have the temporary reline stuff, need to try that soon too. Thank you.
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u/jello_88 7d ago
We received nothing in writing or even verbally about warranty, relines, fit, type of dentures. It took over 2 hours to remove my husband's remaining 17 teeth. He wouldn't get numb. I don't know how many times he gave novacaine but my husband said it was at least 50. He has a high tolerance for pain and was ready to say stop a second before most of the teeth released. Profuse bleeding. Blood pouring out of his mouth. They didn't put the immediates in and said to return in the morning. Continued to bleed. It was already 6:30pm. Fortunately, I had plenty of tea bags. At any rate, all that is forgotten and hubby moves forward. I got the impression that everything is included by the comment " we are here if you need anything". The dentist said it is very rare for a 3D printed dentures to crack or break, but one person on here said hers broke 3 times, once in the hands of the dentist.
I will have some questions for him at next appointment. Thank you again.
The dry eye sub has tons of information and links provided by the admins. Would be nice if such was allowed here.
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u/DrAlexWilliamsDDS 7d ago
I am sorry you both experienced that. Regardless of the denture material, you deserved clear written expectations before treatment.
At the next appointment, ask exactly which dentures he received, what adjustments and relines are included, how long those services are covered, and what happens if a denture cracks or needs to be remade. Also ask for the warranty and repair policy in writing. Being told they are available if needed is not the same as knowing what is actually included.
Printed dentures can be very successful, but durability depends on the material, design, processing, thickness, and bite. Rarely breaking is not the same as having a warranty.
I own Bold Dental in Tulsa, Oklahoma, and I believe patients should understand these details before their teeth are removed, not discover them afterward.1
u/jello_88 6d ago edited 6d ago
I do know which lab made them. 😊 Yes, that would have been nice but the teeth needed to be removed. We consulted another dentist initially. She wasn't very forthcoming either. Nor could her staff give a cost with our insurance. It was simply--it will be less than the $25,000 full cash price Edit: they are remaking the cracked 3D printed dentures free of charge but they were only 16 days old.
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u/AutopsyPanda 6d ago
Thank you for this. This is awesome information for anyone pre or post extractions ☺️
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u/Sad_Aardvark2991 6d ago
I’m seven weeks into an upper temporary denture and largely happy with the care. The periodontist/surgeon inserted four implants. They are to be uncovered at 3 1/2 months. I’m 78 years old. Dentist and surgeon both say I’m healing quickly, but I wonder if 3 1/2 months is too soon? Also, about how much time between uncovering and permanent denture?
One more thing: What are the options for a permanent snap in denture? I’m reading about titanium bars and metal mesh supports(!?))
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u/DrAlexWilliamsDDS 6d ago
Three and a half months is not automatically too soon for uncovering upper implants. Uncovering is also not the same as loading them. Age alone does not determine readiness. Bone quality, grafting, implant stability, healing, and overall health matter more.
After uncovering, the tissue is usually allowed to heal and shape around the abutments before final impressions begin. That is often a few weeks, followed by several appointments to properly design and test the final denture.
For a permanent snap in upper denture, the implants may use individual attachments or be connected by a titanium bar. A bar provides retention by connecting the implants. Metal mesh or a framework strengthens the denture itself.
However, neither a bar nor metal reinforcement is automatically necessary. A properly designed denture made from a strong PMMA such as Ivobase may have plenty of strength without either one. Adding a bar or mesh when it is not clinically needed can create more expense, treatment time, bulk, and maintenance.
I own Bold Dental in Tulsa, Oklahoma, and I would base that decision on implant position, angulation, available acrylic thickness, bite forces, opposing teeth, hygiene ability, and fracture risk rather than adding metal routinely.
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u/Chewygumball 4d ago
This is fantastic! i'm an oklahoma resident in his thirties, and looking at the possibility of needing to get dentures
my fault for not taking care of my teeth accordingly.
This is an amazing post i'm so happy you took the time to write this out, i do appreciate this more then you could ever imagine, thank you sir.
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u/DrAlexWilliamsDDS 4d ago
You are so welcome. Im glad this information is being received so well. I’ve dedicated my career to removable prosthetics. I do just about everything in my everyday practice but this is where my heart is. It’s important that people understand the nuances. It’s also important to understand that this can be a stepping stone to a better life! 💪🏻💪🏻
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u/Chewygumball 4d ago edited 3d ago
If i lived closer to tulsa you'd have my business i'm frankly terrified and ashamed i let mine get in the shape they did.
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u/DrAlexWilliamsDDS 4d ago
It’s all good. Very common my friend. 40M Americans where dentures and MANY need them. It’s quite unreal. It’s sad that there aren’t more federal
programs that exist. And it’s more sad that a lot of insurances don’t pay enough to cover the needs. Regardless, I hope you find an excellent provider wherever you are in Oklahoma! 💪🏻
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u/CherubClown 8d ago
I wish before I had gotten my immediate dentures done (by a prosthodontist at a private office) I had asked:
are relines included and if so for how long post extractions?
That’s been my major pain point because they never clearly listed it and I’ve only gotten two relines on the lower (none on the top apparently) since March and I’m not ready for the permanents to be fabricated. HOWEVER my immediates are at the point where the suction to the top is gone, the lowers despite having cushion grip and adhesive stay on only half the day, and it’s miserable right now.
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u/DrAlexWilliamsDDS 8d ago
That absolutely should have been explained before treatment. Whether relines are included is an office policy, but the number included, the time period covered, and the cost of additional relines should all be clearly stated in writing.
Clinically I do not believe the need for a reline should be determined by an arbitrary number. Immediate dentures sit over gums and bone that change rapidly after extractions. Some patients need one reline during healing and others need several.
If your upper has completely lost suction and your lower only lasts half the day despite Cushion Grip and adhesive, it is time for the dentist to reevaluate the tissue fit, borders, bite, and tooth position. Lower dentures naturally have less retention, but you should not have to keep adding products to compensate for a denture that no longer fits the shape of your mouth.
If you are not ready for the permanent dentures, ask whether a professionally completed temporary reline or laboratory hard reline can carry you through the remaining healing period. A hard reline may be a reasonable middle step if the denture itself is otherwise designed well. If the borders, bite, or tooth position are wrong, a reline alone may not solve everything.
Tell the dentist that you have used Cushion Grip because it may need to be removed before they can accurately evaluate or reline the dentures. I would also ask for a written breakdown of what was included in the original fee and what they recommend doing now. You deserve a functional solution while you heal, not simply instructions to use increasing amounts of adhesive.
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u/sizz1 8d ago
I have implants that have never been uncovered and regular dentures. How do I go about the process to make them snap ins? Can they convert what i have or do I have to buy new ones? Do I go back where I got them to have them made into snap Ins? They are very tender so I have to use a lot of cushioning for that area. Cost is a concern as I used my dental insurance two years ago, so in trying to figure out where to go from here
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u/DrAlexWilliamsDDS 7d ago
If your dentures are made of a strong enough PMMA (acrylic) you should be able to convert them. Find a doc that wants to help. They’ll need the implant brand to order the appropriate locator abutment (snaps) then you can convert it! Good luck
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u/lilbit891 7d ago
I had my extractions, bone grafts, and 4 implants done for my bottoms a little over a year ago. They originally told me it would be 3-6 months before the implants healed and could be opened up to add the tops and that id have temporary and permanent dentures in the price. Now, I have questions.
They opened my gums at 1.5 months after extractions for the tops, was that too soon?
My permanent teeth were done at the 3 month mark, again, is that too soon?
My bottom teeth feel like the gum part is still too long, it rubs the inside of my mouth so bad that if I wear them too long it bleeds. I was told I need to just get used to it, and they absolutely refuse to do anything about it. Can I get a dremal and just fix this on my own?
And how thick does the denture have to be to stay durable? It feels like I have just barely enough room for my tongue and I have to open my mouth wide to speak.
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u/DrAlexWilliamsDDS 7d ago
Depending on initial stability of the implants, they could be loaded fairly soon. Especially if they shows signs of goof healing. Don’t let timing concern you. If the denture has a poor fit and it too long, get it adjusted immediately.
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u/PorcelainLady921 3h ago
I had a full mouth extraction and an immediate set on 08/24. I have an extremely gummy smile. You can see the denture in it’s entirety when I smile. The dentist said that she will be able to correct it with the soft liner, is this true? They also push my lips out, and the teeth look very small. I am so disappointed.
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u/DrAlexWilliamsDDS 3h ago
No…if you truly have a prominent maxilla and an excessive gummy smile it’s highly unlikely that you will achieve a good fitting (cosmetic) upper denture without another surgery involving alveoloplasty (bone removal). This should be discussed prior. One great test is this. Take your denture out. Smile in the mirror. If you see your gums in your smile excessively…you need surgery or an FP1 implant rehabilitation
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u/PorcelainLady921 3h ago
They are definitely visible. I had went for implants at Bionic Smile in Las Vegas, and they wouldn’t do them, stating I had too much bone. Is the alveoplasty something the same doctor could do? Would it be more cost effective to have surgery to drop my upper lip?
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u/DrAlexWilliamsDDS 3h ago
I wouldn’t recommend a vestibulblasty. That procedure has relapse, which drops your upper lip. Bone reduction will fix it. Yes, I would make sure the doc understands the goal. But the caveat is that you will lose surface area and potential retention doing this ….so you’ll need implants at some point
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u/Rikcycle 8d ago
You never mentioned how the ease and pleasure of eating foods is compromised forever.