July 12, 2016
By AGNES DEZAK, RDH
Almost any hygienist who works with denture patients has stories about treating people who are unhappy and uncomfortable with their dentures or partials. While these devices are an improvement over the total or partial edentulism that patients would face without them, many patients still experience discomfort or self-consciousness, and many are sad that the prosthetics cannot perform like their natural teeth did.
It is not just a few isolated denture patients that feel this discomfort and sadness. Research shows that it is very common for edentulous patients to have negative feelings about their condition. One study of 50 edentulous people found that their responses to tooth loss included “bereavement, lowered self-confidence, altered self-image, dislike of appearance, an inability to discuss this taboo subject, a concern about prosthodontic privacy, behaving in a way that keeps the tooth loss secret, altered behavior in socializing and forming close relationships, premature aging, and lack of preparation.”
This is quite a list of issues, but experienced hygienists likely understand its truth. The researchers conclude, “Tooth loss can be disabling and handicapping.” To offer an additional, perhaps more poignant perspective, another study examined the experiences of getting dentures and losing teeth as compared to other life experiences. Research subjects in this study ranked getting dentures as a more significant life adjustment than retiring from work, getting married, or having a child.
Findings such as these underscore why it’s important for every member of the dental team to provide support and guidance for denture patients, and to help educate them on the options available for improving their comfort and confidence. In some cases, patients may be helped with simple measures such as denture relines. But the dental community also has more powerful options for patients who seek added stability and retention for their dentures.
Options For Dental Implants
Dental implants for denture stabilization have become increasingly popular in recent years. Data shows that placing two implants in the anterior mandible can make a major difference in the quality of life for patients, and can help maintain bone in the jaw that would otherwise resorb following teeth loss. In 2002, McGill University issued a consensus statement on overdentures, which stated in part, “Mandibular two-implant overdentures have been shown to be superior to conventional dentures in randomized and nonrandomized clinical trials that ranged in duration from six months to nine years.”
The only problem is that for many patients, traditional dental implants are not a viable option. This is due to a number of factors. First, patients must have adequate bone levels to anchor the implants. While bone levels are often not a problem for patients who have only recently become edentulous, long-time denture wearers often have ridges that have resorbed too much for implant placement. This resorption can be treated with bone grafting, but this treatment adds a layer of expense and medical complexity.
The expense of traditional implants, whether or not bone grafting is required, is also a major hurdle for many senior-aged patients. Many of these patients are on fixed incomes and have a hard time accommodating an expense that is many thousands of dollars. Finally, the invasiveness and time involved in the placement of traditional implants can dissuade many patients from pursuing this treatment. The placement procedure can be very traumatic for patients and may require significant healing time. Because the procedure is so invasive, people who are not in optimal health may not qualify for it even if they want to proceed with it. The procedure requires coordination from multiple health-care professionals to ensure that new medications are compatible with existing prescriptions, and that patients are healthy enough to undergo surgery.
Therefore, while many in the dental industry acknowledge that implant-retained dentures can serve patients better and alleviate many of the common problems patients have with dentures and partials, the treatment may not always be feasible. The expense and time commitment can be disheartening for patients who want a solution for their ill-fitting dentures.
Attractive Alternatives To Traditional Implants
The good news is that traditional implants are no longer the only option for these patients. Over the past five to 10 years, mini dental implants have emerged as an attractive alternative to traditional implants. These implants range in size from 1.8 mm to approximately 3 mm versus the traditional implant diameter of 3.75 mm. MDI Mini Dental Implants by 3M ESPE represent a good example of a mini implant system. These mini implants (originally known as the IMTEC Sendax MDI System) were the first on the market approved for the long-term use of denture stabilization.
The placement procedure for mini implants is quite different from that of traditional implants. They can be placed and loaded in a one-day appointment with a general dentist who is certified in the procedure. In a typical denture stabilization procedure, four mini implants are placed in the lower mandible. With the assistance of diagnostic imaging tools, the dentist marks the proper locations for the implants on the patient’s ridge, and then uses a pilot drill to create a small hole in the tissue. The implants are then inserted into the pilot holes and tightened into place with a series of drivers and wrenches. This minimally invasive procedure is a stark contrast to the procedure for traditional implants, which involves cutting a flap in the tissue and requires significant healing time before loading.
Once the implants are placed, the patient’s denture is fitted with metal housings that allow it to snap onto the o-ball shaped heads of the mini implants. In some cases a new denture is fabricated for this procedure, but it is also possible to retrofit the patient’s existing denture if it is in good condition. After the denture is fitted with the housings, the patient is instructed on proper care and sent home. In just one day, it is possible for patients to experience a dramatic change in denture retention.
As might be inferred from this description of the procedure, mini dental implants are quite different from traditional implants, and can help address many of the hurdles that patients face when they consider implant treatment. Because a general dentist places them in a minimally invasive procedure, mini implants are significantly more affordable than standard-diameter implants. As mentioned, in some cases the patient’s existing denture can be used, which adds to the affordability.
While many edentulous patients do not have adequate bone levels for standard implants, the bone requirements for mini implants are significantly lower. Additionally, patients who are turned off by the time required for traditional implants are often very excited to hear that mini implants often can be placed and loaded in just one day.
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The Hygienist’s Role In Implant Treatment
The dentist is typically the member of the practice responsible for sharing treatment plan information with prospective patients, but it is very helpful for hygienists to have an understanding of the placement procedure and the benefits of mini implants so they can share a brief overview with interested patients. Because hygienists often hear complaints from denture patients about discomfort, sore spots, and trouble eating, this can provide a natural opening to discussing implant treatment and directing the patient to ask the dentist more questions. While the dentist will explain the clinical details of the treatment, hygienists in practices that place mini implants should feel comfortable sharing their own perspective about how exciting and life changing the treatment can be.
While hygienists typically are not involved in the placement procedure, they are a very important part of the care team after mini implant placement. Proper care begins with brushing, which can be a challenge for edentulous patients out of the habit of brushing, who were likely not good brushers when they had natural teeth. Proper brushing can also be an issue simply due to someone’s age. For these reasons, use of an electric toothbrush is strongly encouraged. This can be a great help for patients with dexterity issues, and toothbrushes with built-in timers can help ensure that patients achieve an adequate duration of brushing. Patients should be instructed to brush throughout the mouth and pay particular attention to the implants, as plaque can build up on them just as it does on natural teeth, potentially compromising the long-term success of the implants.
Patients should return to the dental office for checkups every six months following implant placement. This helps the dental team ensure that the implants remain stable and that patients care for them properly. Many hygienists have likely faced challenges with motivating denture patients to take good care of their appliances, and this can continue to be an issue for some implant patients. However, many implant patients do regain motivation to take good care of their dental health once they experience the stability and confidence of mini implants. Being able to eat foods such as steak, corn on the cob, and apples gives patients a tangible motivator to maintain their implants.
Another reason that patients must return to the office regularly following implant placement is that the o-rings in the denture require periodic replacement. The o-rings wear out over time, and we recommend changing them once a year, or as needed according to the patient’s comfort level. Patients who experience slight mobility with their dentures often find that changing the o-rings brings them back to a level of stability they prefer.
Improving Quality Of Life
It is very difficult to see patients suffer from discomfort and insecurity caused by loose dentures. Patients not happy with their dentures lose confidence when socializing and eating, and can even have trouble with important rituals such as blowing out birthday candles. Problems like these take a toll on people, more so than they may disclose to their dental teams.
The good news is that hygienists, by virtue of their role as teachers and listeners, have a great opportunity to help educate patients about denture stabilization options. While some patients may have written off the possibility of dental implants due to their cost or other reasons, they may not be aware that mini dental implants give them another option for regaining confidence and function with their dentures. The emotional impact that denture stabilization has for these people makes it very rewarding to work in a practice that places mini implants. RDH
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References
1. Fiske J, Davis DM, Frances C, Gelbier S. The emotional effects of tooth loss in edentulous people. Br Dent J. 1998 Jan 24;184(2):90-93.
Bergendal B. The relative importance of tooth loss and denture wearing in Swedish adults. Community Dent Health. 1989 Jun;6(2):103-111.
ADA Council on Scientific Affairs. Dental endosseous implants: an update. J Am Dent Assoc. 2004 Jan;135(1):92-97.
Christensen GJ. The ‘mini’ implant has arrived. J Am Dent Assoc. 2006 Mar;137(3):387-390.
AGNES DEZAK, RDH, currently provides dental hygiene and periodontal therapy at Concierge Dental Group where they focus on implant dentistry. She is a member of the American Dental Hygienists’ Association, the Dental Hygienists’ Association of the State of New York, the Buffalo Dental Hygienists’ Association, and the International Congress of Oral Implantologists. DeZak is also the owner of Western New York Dental Sharpening, servicing dental offices and clinics throughout Western New York.
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I feel I have the best care possible under Dr. Gorbatov and his team. His work is top quality and because of him I know my teeth and the health...
Alex P. (Fort Lauderdale, FL)
Highly recommend this dental office. Dr. Gorbatov provides high quality, state of the art dental services. He has a very calming demeanor and the entire staff is professional, warm and...
Valerie
The dentist fit me in last minute when my normal dentist was unavailable I tried them on the recommendation of a friend after I broke a veneer and had 3...
Mark Krawiec (Hollywood, FL)
My experience was very smooth. When I called for appt, the next available time was in two days, I didn’t expect it will be that soon.Everybody in the office is...
Daria Tis
Very impressed with Dr. Gorbatov's ethics. He truly cared about my situation, the fact that I was from another city and had limited time off of work to address my...
Tatiana Safonova (Sunny Isles Beach, FL)
Let me start by saying Dr Gorbatov is amazing, a true credit to the art of dentistry. He is a perfectionist and his assistant Lidi is amazing also in her...
Keith Miller
Amazing experience! The office is beautiful, the staff is knowledgeable and super friendly.
Maria Slomka
Thanks to Dr.Gorbatov and his team to save my teeth! They helped me to revise other dentist's mistake.Team very professiinal, attentive to my needs and details of case. Will continue...
Sergii Cherednyk
I've been looking for a good dentist since So. FL lacks them. Not anymore, great professional services, and best of all, you will find a personal touch. You will truly...
ML GG (Hollywood, FL)
Most beautiful veneers ! Dr. Gorbatov is the most talented doctor ever !Air flow cleaning is the best in their clinic ❤️
Julia Zhguleva
One of a kind dentist. Always take the time and explain to you all the choices. He does have a smile for me every time I have to go to...
Liviomail
I have been with the dentist for a few years now and love the care I receive. You are taken care of from the front desk person, through your visit!...
Juan Rodriguez (Greenacres, FL)
The best service and people ever! I love the atmosphere here and the work that was done! Thank you! Highly recommended!!!❤️
Ulka Hovyc
I went to the office to get teeth cleaning! The receptionist was overwhelmed with something, but she was the sweetest. My dental hygienist did great job, made sure I feel...
Elizaveta C. (Miami, FL)
I love this dentist office the service here is very fast and comfortable. The staff is extremely nice and caring. I recommend this dentistry to everyone :)
Анна Anna
Hello, Dr.Gorbatov is truly THE BEST ,so please just forget about all the rest! I truly witnessed MIRACLE IN MAKING!!! My sister now have a MOVIE STAR SMILE! Thank you...
Valnea Del Bianco (Hallandale Beach, FL)
Thank you personally and from the bottom of my heart for the kindness and consideration you showed my mom, Catherine the other day! ?
Patrizia Rondelli (Hollywood, FL)
I have been having a lot of issues with my teeth for quiet some time, including broken molars and bad procedures at other dental facilities. I came to Dr. Gorbatov...
Felix Spengler (Miami, FL)
I was very pleased with the service, the staff was awesome, especially Lidi the assistant that was very professional and made me feel comfortable during my appointment. I will definitely...
Roman Sidler
I had a procedure done by Dr. Gorbatov, it was amazing, I didn't feel anything, he has very gentle hands and techniques and I didn't even feel the shot! I...
Jessica Y Montero (West Palm Beach, FL)
Dr. Gorbatov and staff are WONDERFUL! Highly skilled, innovative, up to date with the most updated technology. The entire staff is warm, friendly, kind, and extremely helpful. I came across...
Dr. Dee
Thank you Dr. Gorbatov for the great experience, your gentle touch and quality work you have done on my teeth. I have been very pleased with your professional, yet personable...
Irina D. (Port Orange, FL)
First time here the staff and Dr were so informative and professional thank you for making my experience run so smooth ?
Evelyn Garcia (Greenacres, FL)
My experience here was absolutely great!. From Anna who I first spoke to about an appointment to Lida and Patricia who made me feel relaxed and comfortable during my procedure....
sean scott
I had an amazing experience with Dr Gorbatov and his excellent staff. I went to him for a second opinion and he told me I did not need any work...
James Borelli
I absolutely loved my experience with Dr G and his amazing staff 🌸 so very welcoming and thorough 🌸🌸🌸
Kelly Spillman
I finally found a great dentist who does its all, root canals, caps, and implants. I needed major work on my mouth all at once, although it was expensive because...
Diane O’Brocki (Loxahatchee, FL)
I came to Dr. Gorbatov as a referral and everyone has been so friendly, kind, helpful and understanding about my nervousness. I greatly appreciate everyone’s kindness during both of my...
Rachel Fludd
I've been going here for a few years now. I'm a periomaintenance case, so I'm in four times a year. The hygienists do a great job, provide me with excellent...
Devin Scheller
Dr. GORBATOV is the most charismatic, cheerful Dentist with tremendous energy. Today I can confirm that he is the best dentist in Florida. He had been looking for a good...
Myriam Harter
I want to say that this office and the staff are by far the best professionals in dentistry in Hollywood!! they become family!! I want to thank you all for...
norma masoud
I want to say that I never write reviews. However I have to say that this dentist center is amazing! From the moment you enter you feel like family. Everyone...
Lisa Jerkins (Wellington, FL)
Great service Knowledgeable doctor Friendly staff 5+ stars!! Someone hacked into my account and gave false review. Not me!!! Outstanding service @ Dr Gorbatov Dentistry!!!!
Ellen Zlobinskiy (Hallandale Beach, FL)
Fantastico me atendieron como en ninguna parte. Excelent Servicio . Atentencion y profesionales' los recomiendo ampliamente. Dr. Gorbatov es un Sol . Su asistente un Amor, y todo su equipo....
Mery Sanchez
Very happy with quick service, suggestions & prices. Will be a repeat customer
Jaclyn Franceschini (Fort Lauderdale, FL)
If you're looking for an Exceptional dentist then you should visit Dr. Gorbatov Dentistry. I've only been going to this dentist office a little over two months to obtain a...
S Jackson
Entire office & staff is very accommodating and attentive to all your needs. The dentist was very nice and professional and really took the time to explain to me everything...
Tiffany D. (Hollywood, FL)
The best dentist hands done. Great attitude of all here. Doctor Gorbatov uses the latest and most biocompatible materials. I would not trust my teeth to anyone else.
Damaris Nightingale
This is the best dentist in the world who really cares about each and every patient and makes your smile look perfect! After visiting the new office you will be...
Kseniia Dursinova (Sunny Isles, FL)
This is the best dental office!!!. Everyone is very nice and professional. Dr Gorbatov and the Hygienist Lilia have golden hands. No discomfort at all. I Highly recommend Dr Gorbatov...
Al Chaviano
High-level professionals. Thank you, Dr. Gorbatov. I'm going to recommend your clinic to my friends. With best regards!
Vlad Shishko (Sunny Isles, FL)
I recommend this place to anyone that needs any type of dental work done , I always feel welcome from the moment i sign in untill my visit is over...
Lyn F (Wellington, FL)
A Center for Dental Excellence is fantastic. They’re understanding and extremely competent. Not only is the dental care itself excellent, but their quality of caring about their patients is unparalleled....
Haylee J (Aberdeen, FL)
I highly recommend Dr.Gorbatov dentistry . I tried so many doctors and finally I found people who knows what they do, I can trust my and my family to them....
Nuriya Deberdeeva
I am extremely happy I found Dr.Gorbatov! He saved my vacation and helped me in emergency mode(I broke my front tooth) I am changing my dentist to Dr.Gorbatov, convenience, no...
Tatiana Vaccaro
This is the Best Dental Office I ever was. Great personality, gentle touch and perfectionism in all aspects of cosmetic dentistry. Thank you Dr. Gorbatov for creating Smile I always...
Yuriy Gorobets (Hallandale Beach, FL)
I’m very grateful for the work that Dr. Gorbatov did! Very professional and knowledgeable.Highly recommended!☺️
V P
Dr. Gorbatov is the best dentist in Florida. He is my dentist many years. He is very professional and honest. The best doctor in Florida. Great professional and very honest.
Polina Padva
Dr. Gorbatov is a highly qualified, very skilled dentist. I came to Dr. Gorbatov to remove amalgam fillings and replace crowns.All the personnel that work in the office are very...
Irene Mandel
I absolutely LOVE the attentive and friendly customer service and quality of work they provide here at Dr.Gorbatov’s office!! I would highly recommend them to anyone looking for a touch...
Serena Morrisey
Had an amazing experience. Staff was very caring and nice. They are very honest
Billie Selinsky (Wellington, FL)
This was my first experience and it was amazing! I haven’t been in a dentist chair in 6 years but I felt very comfortable getting my xrays there! Staff is...
Gloomii
Wonderful service! I recently had a dental cleaning for the first time at Dr. Gorvatov Dentistry. The whole process was smooth and relaxed. Their office environment is pleasant and the...
Karol Rodriguez
First visit with the Dentist recommended by a friend. Dentist was helpful and staff was friendly. Clean office . Doctor is gentle and knowledgeable.
Fetta Republic
Thank You so much for great service, I’m very satisfied with the level of service I received can definitely recommend
Janina Grabska
Great staff I was nervous but they made me feel at ease. I am confident that they will give me the smile that I airways wanted. The receptionist personality is...
Uuggh uggh (West Palm Beach, FL)
First time ever giving a dentist visit 5 stars. The staff was very kind and attentive. Albina was very professional and I would recommend her to anyone who visits! Definitely...
Alejandro Figueredo
Great Dentist and Team. Fantastic experience and service. My husband had a dental emergency while on vacation and Anna got us in immediately. Dr. Gorbatov is very attentative and caring...
Giannotti Jessi
This dentist and his staff went way above and beyond to not only remedy my issue with my teeth but made me feel extremely comfortable as well as giving me...
George Cavros
The best doctor and very kind team❤️The best New Special Cleaning with Air - Flow! Amazing👌🏻😀
Victoria Volkova
Amazing doctor and very friendly and professional stuff! Definitely the best doctor in Miami!
Lily AA
I know Dr. Gorbatov and use his service already for 15 years since we moved to Florida. He is an amazing doctor capable to do all types of dental and...
Eugenia Aulov-Volchek (Sunny Isles Beach, FL)
I've been looking for a good dentist since So. FL lacks them. Not anymore, great professional services, and best of all, you will find a personal touch. You will truly...