Expert: Zev Kaufman, D.D.S. - 10/2/2008

Question
QUESTION: My dentist has informed me that due to advanced periodontal disease I need to seriously consider dentures.  I have had two major jaw surgeries in the past and as such my dentist did not feel comfortable doing the work.  I saw a prosthodontist who agreed that I need dentures but said a regular dentist should be able to handle the job.  Do I shop til I find a regular dentist who's comfortable with my past medical history? I am missing about a third of my natural teeth already and the lower front are very loose.  Given that and advanced periodontal disease how long can I/ should I put off getting dentures?  I know without seeing my specific case you can't give an exact time... but in general?

ANSWER: Dear Janice:
The general rule is to remove natural teeth as soon as their presence is compromising and causing more bone loss.  The remaining alveolar bone is crucial for well fitting dentures as well as further restoration with implants.  Why is the Prosthodontist not making you the dentures??? It is part of the Prosthodontist's training.  My advise to you is to proceed with dentures as soon as possible.  This way your tooth loss is controlled and you preserve as much bone as possible.  In addition...I would definitely go to a Prosthodonist to get the work done.  It is always better to be treated by the most qualified individual (as long as you can afford it).  If your Prosthodontist is not interested, goto www.prosthodontics.org and look up another Prosthodontist.  You may call me in the office (info at www.drzevkaufman.com) and I'll gladly recommend a colleague.  I will be at my office on Monday 10/6/08 (We are on vacation this week).
I wish you luck
Dr. Zev Kaufman

---------- FOLLOW-UP ----------

QUESTION: Hi again and thanks for the prompt reply! In answer to your question... the prosthodontist is quite happy to do the work and I would actually prefer him to do it but the problem is I live in Northern Michigan and he is a three hour drive away.  I didn't realize until consulting with him that the process of dentures would require so many visits following the extraction of my remaining teeth and placement of immediate dentures... there is just no way I can get the time off work to make what could be several visits a week.  Unfortunately he is the closest prosthodontist (he's in Grand Rapids) My other problem and the reason I asked how long I can wait is that cost is an issue, I have no dental insurance and this is going to cost a lot.  The prosthodontic school at the University of Michigan no longer has payment plans so that is not an option and they weren't going to be much cheaper than the doctor I saw.   I really don't want to go back to the local dentist but what other option do I have?

Answer
Dear Janice:
Common problem...The best person to ask about timing would be the Prosthodontist that you saw, since he had a chance to clinically examine you.  I cannot do that, and thus cannot give you a proper estimate.
As to the cost... Many dentists offer financing through two companies that I am familiar with...
Capital One, and Care Credit.  I offer care credit through my office and it works very well for my patients. Info at www.carecredit.com
If your dentist offers this financing, you can pay monthly payments and finance your work.
You might shop around for a local dentist and ask to be honest with you and tell you if he/she feels comfortable doing the work.  Ask to see pictures of pervious work and possibly patient recommendations.
Aside of that, I cannot think of anything else.
Best of luck,
Dr. Zev Kaufman