Expert: Steven C. Scherr, D.D.S. - 3/16/2004

Question
I'm a 55 year old woman who has been wearing a full upper denture and lower bridge for many years.

Recently I went to a dentist for new dentures.

The uppers feel fine although when I smile no upper teeth at all show in the front. All you see are bottom teeth. Don't know if this is normal.

However, the bottom is a big problem that was very costly to me and upsetting when I saw the teeth in wax this week for the first time.

The dentist made a device where the four front bottom teeth clip onto two of my real teeth.
A bridge was placed over that for the back teeth.

The 4 bottom teeth looked really tiny and pink.
When I close my mouth they also were aligned to one side rather than the four teeth being centered under the uppers. I think they even looked smaller since the tooth next to the four teeth was very large and round. (Think this is the crown because before I had 2 dracula type natural teeth sticking up from bottom.)

The two "bridges" were loose.

The dentist asked the dental technician what she thought which scared me.

They decided to try to get darker colored front teeth and hope that the "pink" behind them didn't show through. Told me that nothing could be done to make the four front teeth look more centered.

I am terrified to go back next week to see the new bridges since I really don't think the dentist nor tech nor myself will be pleased with the "experiments" they seem to be trying.

I know dentists/doctors don't like to go up against each other, but I would appreciate any suggestions that you could make so I could bring them up myself to my dentist next week in case these 2 bridges still do not look/feel good.

Thank you very, very much.
Barbara  

Answer
Barbara,

Your concerns are legitimate and warrant exploration.  Each person is an individual.  What works for one person may be totally wrong for another.  Since I haven't had the pleasure of meeting you, I have no way of knowing what is and isn't possible for you.

Since you have been wearing a complete upper denture (I presume comfortably) for years, it seems reasonable that the amount of teeth that show could be no less than you are accustomed to.

It isn't clear to me what kind of device was made for the lower front teeth.  If this is a non-removable bridge (essentially multiple crowns attached together), then this seems like a reasonable approach.  If the appearance of the teeth is not to your satisfaction (size, shape, arrangement, or color), this is the time to be honest with your dentist about how you feel.  Each person is unique.  I guess in a way that makes each person a kind of experiment.  Some of the most respected dental masters ask a trusted technician to help overcome challenging situations.  Would you really rather have a dentist with too much pride to seek assistance from a dental craftsman?

Your dentist and technician are there to help you achieve the look desired to the degree it is possible.  You are a key part of the team.  If your dentist doesn't know exactly what you want, how can it ever be accomplished?  It may be necessary to bend somewhat if there are physical limitations.

The wax try-in is for the purpose of checking the look and fit directly in the mouth.  It just isn't possible to assess some things any other way.  The purpose of the wax is to permit changes to be made.  The denture should not be completed until you are satisfied with the appearance created.

Barbara, if after working with your dentist, you are unable to find common ground, it is best not to have the work inserted.  You can always seek a second opinion.

I wish you well.

Steve