Charles E. Pechous, III, DDS SC

Can partial dentures fit better?

The short answer to this is yes, but…  The reason I give a qualifier is because it really depends on who made the partial and the dentist who did the work prior to sending it to the lab.  Most dentists can take an impression but the qualifier here is that it needs to be evaluated for the impression it just took of the mouth and teeth that will be wearing the partial denture.

This evaluation is critical to the fit and function of the partial denture.  If it’s wrong then the whole process is wrong and the fit will not be ideal (to say the least).  The whole process of making the partial denture is way too complicated to get into right now.

Suffice it to say, there are about 245 steps to make a partial denture from start to finish.  Most as a patient you will not see done but the dentist is in charge of doing and overseeing all those steps and evaluating those for accuracy.  If your dentist is off at the beginning of the process the magnitude of that error is magnified as you go along.  Hopefully it’s picked up as an error early on and corrected by your dentist. If not this could be why your partial “doesn’t fit”.

The other area of concern would be in the design of the partial denture as it sits on your remaining teeth and your gums.  This design process is the sole responsibility of the dentist.  Your dentist literally writes a legal document (a prescription) to the lab, who is making the partial denture to tell them how to make the partial denture. This communication can be a two-way collaboration but the dentist needs final say on how it’s done.

A prosthodontist is a dental specialist in the restoration and replacement of teeth. We do know the steps to making a partial denture fit your mouth and take into your considerations and concerns on how the partial is to fit and talk to you with knowledge and experience about your partial denture.  There are other options to making a partial denture that cannot be taught in school because they are too advanced for the general dental students.  This is another reason why there are dental specialists!

Every dentist out there carries with them a certain amount of pride and confidence in their ability as a dentist. It is the result of years of schooling and trying to be the best you can be. In the end we have our doctorate in dental surgery (DDS or DMD it’s the same degree). We are doctors of teeth and as a consequence the default “expert” of all things teeth.

Every patient wants to believe that his or her dentist knows all and is able to do everything they need dentally. Can a general dentist do everything that dentistry has to offer? The answer to this in general is on average most dentists are able to provide most things dentistry has to offer to a certain level.

The real question that should be asked is does training/specialization matter for you as the patient.  My answer to this as an educator and practitioner is yes it does. Think about this for a moment. Do you think your general/family dentist can operate at the same level of expertise as a dental specialist? The answer to that is no. You don’t have to believe me just look at the dental specialists out there that you do see. Oral surgeons, orthodontists and pedodontists (children’s dentist) and yes prosthodontists.

Just the existence of specialists should be a clue to their needed existence and use by the general dentists to help their patients. Where would most dentists go if they had their choice? A specialist of course! I know this because I have treated some of these dentists. So, your choice of a dental specialist can be and in general is the best choice for your dental treatment.

The next common question to overcome is that it must cost more to go to a dental specialist. In fact, most specialists are right in line with what general dentists charge for the same procedure. So why would you not go to a specialist? Only you can answer that! If the cost is more for certain procedures its due to the training and expertise. Why suffer with something when a dental specialist could get you through most dental difficulties.

How patients pick their dentist…

It is a question that most patients have to deal with sometime in their life.  It can be a stressful event. How the patient gets to the point where they are walking through the door of the dentist’s office is most likely all about marketing.

I am here to say this is the wrong way to find your dentist. You can believe me now or believe me after some work is done that you are not happy with, or after some teeth have been removed (extracted is the dental term, it just sounds too technically harsh).

A typical patient walks into a dental office after using the internet, finding out if they take the insurance and other people’s recommendations and sets to figuring out if this is the right fit. Here is where another mistake is made, and it’s not your fault.

The typical patient evaluates everything in the office except what goes into their mouth, which is why they are there in the first place! Think about it… you look at the office décor, office staff, the dentist’s appearance and personality, perhaps even the room that you are in and everything else but what you are actually there for!

Here is where it’s not your fault as a patient because you have to trust that the dentist can do what he says he is going to do. That trust is built on all you have seen, read and heard and not on the training, experience and knowledge that the dentist has. All you need to do is look up a prosthodontist!

They are specialists that can restore and replace your teeth and are friendly and nice and the office is all that a dental office should be. In the end you are getting the best that dentistry has to offer for you by the only dental specialist that restores and replaces teeth, a prosthodontist. We do more than just teach dentists how to be dentists, we also treat patients!

The Kenosha News recently did an article on how to pick a dentist and they did the general public a disservice.  The only thing maybe right about it is that you have to be comfortable with your choice and word of mouth is a good start to finding a dentist. That is about all they got right!!! The rest was about as wrong as you could get.

 Most patients are looking for a dentist that has the skills and brains to help you out with your dental problems. Most patients probably assume that is the case with all dentists. So they move on to other criteria like the office and the people working there and probably price/cost is an issue as well.  So lets give you a dental problem like a tooth that needs a crown or a white or silver filling.

 So how do you find a dentist like that? You have two broad choices to choose from. A general dentist or a prosthodontist. How do you know which is better for you?  Since we cannot look at each individual dentist and get a personality or likeability profile which does matter but should not be the sole criteria you use, we have to look at really the most important part, which is training and experience.

 A prosthodontist is a dental specialist in crowns, bridges, partial dentures, complete dentures, dental implants, cosmetic (white fillings, non metal crowns) dentistry.  We are trained in all aspects of restoring teeth and missing teeth. A general dentist goes to school for four years in dental school. A prosthodontist goes to four years of dental school and then three additional years of training and school to become a specialist. There is a difference in education and training.

 Since it can be hard enough to get an appointment let alone interview your dentist prior to going to meet them the training can be your only real divining rod on who to choose. Everyone wants their dentist to be the smartest and most gifted but the reality is most dentists are not by definition at the top of their classes. 90 percent of each class is not in the top 10 percent!

 So lets take the average general dentist and average prosthodontist. Looking at the training and education the average prosthodontist is better trained and better educated than the average general dentist. So in choosing a prosthodontist for your dental work you are getting a better trained and educated dentist than a general dentist! However there is nothing average about what a prosthodontist does for patients.

 So now for that crown or filling you need, I ask you, “Who do you want to do your dental work”?