Sat - By Appointment
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.
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
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.
Share With Your Friends:
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)
Thank you doctor for my beautiful smile!
V V (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)
Excellent Service! Friendly, Clean and Prompt!
Deidre Reid-Thomas (West Palm Beach, FL)
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 have been going to this office now for the past 3 years. From Jessica working the front, to having my teeth cleaned, and both Drs. working on my teeth,...
Joanne Purdy (Wellington, FL)
What a great experience at the dentist!! I wish I had found these guys years ago, maybe I wouldn't be so afraid of the dentist. Thought I needed a root...
Craig Balsam (Wellington, FL)
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)
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)
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)
My experience was great.Doctor is very professional.I really recommend.The best place to go for your dental.
Olga Meverden (Sunny Isles Beach, FL)
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)
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)
Very professional office. Good dentist.Clean dental office
Anna K. (Hollywood, FL)
I have been Dr. Gorbatov's patient for over 8 years and have always received excellent service. The facility and staff are wonderful. I would highly recommend A Center for Dental...
Teresita Camacho (Lake Worth, FL)
From the minute I walked in the dr Gorbatov office till the and of my treatment I was pleasantly surprised with professionalism and care of Dr and his staff. I...
Anna (Hollywood, FL)
Very happy with quick service, suggestions & prices. Will be a repeat customer
Jaclyn Franceschini (Fort Lauderdale, FL)
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 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)
The dentist is very friendly and gentle during procedures.
Sofie M (Sunny Isles Beach, FL)
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)
I always have a great experience when I come here, the staff is wonderful and I would not change my dental office for anything in the world.. Jessica is amazing...
Shiloh Robinson (Wellington, FL)
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)
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)
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)
Benjamin R. (West Pam Beach, FL)
S u p e r b ...Immaculate dentistry! I was impressed with a GREAT attention to details! His work is truly an ART and priceless! Everyone in the office is...
Gordana Skracic (Aventura, FL)
Very high professionalism, excellent atmosphere and responsiveness of employees have made this business one of the best. A well-functioning team led by one of the best professionals of the US...
Lili Ivanova (Sunny Isles Beach, FL)
For me, dental work always came with the presumption of pain and discomfort. That's why it was always very difficult to get any recommended work done, because all I'd have...
Iry T. (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'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)
I was very fortunate to find Dr. Gorbatov right when I had a major issue with an old crown that fell off and led to a major infection just a...
Octavian Miron (Aventura, FL)
Excellent service , friendly & professional !!!
Mauricio Bonifacio (Sunny Isles, FL)
Awesome service. Highly recommended
Iliana Gonzalez (Royal Palm Beach, FL)
The atmosphere in this office is beyond believe, I instantly felt comfortable with Dr Dimitiri and his assistant Yuri. They work great together. I had 6 veneers put in and...
Ruslan Gahramanov (Sunny Isles Beach, FL)
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)
Love Dr. Gorbatov! He is skilled, professional, thorough, nice, and always keeps me comfortable. The assistants and office staff are great too. I highly recommend Dr. Gorbatov!
fannabl (Hallandale Beach, FL)
Well I’ve been going to Dr. Gorbatov since 1996.... Yes ! I’m a loyal. With all the dental issues I’ve had, he’s been able to resolve them and been keeping...
Burke Crump (Wellington, FL)
No teeth fell out mid cleaning. 10/10
Erik Purdy (West Palm Beach, FL)
Very helpful and amazing response time! Found them on Instagram and I'm happy I did!
Cece Esk (Hollywood, FL)
Loved coming here, very nice Doctor and wonderful experience with a great cleaning. Receptionist is awesome too.
Lina Lobo (Greenacres, 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)
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)
Jessica at the front has helped me tremendously and the Dr has made the large amount of work that I have had done painless
Celeste Clossin (Wellington, FL)
Fast service and the best staff! I highly recommend this Dentist. I've been going to this Dentist for 2 years and I travel far now just to come here. They...
Christine (Orlando, FL)
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)
You are the best guys! You definitely make me smile more :) Thank you sooooo much! Olga Aksenova ❤️
Olga Axenova (Hallandale Beach, FL)
Dr. Gorbatov is an outstanding dental surgeon and professional in every sense of the word. He and his entire staff are wonderful--- by far the most knowledgeable and compassionate of...
Salt&Light (West Palm Beach, FL)
I’ve been coming here for almost 10 years now and can surely say that the customer service provided is one of the best in town. Make sure to be nice...
Hype Kay (Royal Palm Beach, FL)
Absolutely amazing. Jess and Jessica at the front made me feel so comfortable and helped me conquer my fear of the dentist. The office is clean and welcoming I completely...
Hayley Kaplan (Wellington, FL)
Dr. Gorbatov is an excellent dentist. I went to several other dentist and they all wanted to do a root canal, but Dr. Gorbatov was able to save my tooth....
Arthur Rubinovich (Sunny Isles, 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)
When I first found this office I was terrified of the dentist and I had constant anxiety when seeing dentists. Now I look forward to cleanings and my anxiety is...
Hayley Kaplan (Wellington, FL)
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 would like say that this office is at the TOP of my list. The staff is awesome, it is very clean and you made at home as soon as...
Jazlyne Jimenez (Lake Worth, FL)
Had a great experience with Dr.Gorbatov, he is really professional and doing great his job always with a smile)) Definitely recommending him
Tanya Kusiumova (Sunny Isles Beach, FL)
Dr. Gorbatov placed an implant for me, I am extremely happy with the result, I had absolutely no pain during the procedure after few month doctor put a crown, looks...
Sergey Kasatkin (Sunny Isles Beach, FL)
Dr. Gorbatov is an excellent dentist whose main priority is making sure his patients are comfortable and get the best dentistry he can offer. He provides an attentive service, and...
Natallia Harbacheuskaya (Hollywood, FL)
Everyone in the office is super amazingly fantastic! They're informative and understanding. Dr. Gorbatov has done great work on my teeth! The dental hygienist has been a charm, makes every...
John Kern (Hollywood, FL)
This is IT!!!! As good as it gets!!! If you want a celebrity smile call his number.
Jacob F. (Miami)
Very good cleaning
Riley Purdy (West Palm Beach, FL)
Very professional nice staff great service.
I switched my dentist because i was dissatisfied with their service and decided to go to Dr.Gorbotov's office for my wisdom tooth extraction. I never thought I would see the...
Oleg Solovey (Sunny Isles, FL)
Had an amazing experience. Staff was very caring and nice. They are very honest
Billie Selinsky (Wellington, FL)
I are retired dentist and visit dr Gorbatov,s office like a patien for dental works. We graduate the same school New York university and l can tell you the dr...
Shmuil Aronovich (Hallandale 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...
ML GG (Aventura, FL)
Since me and my wife moved to Florida from Nj several years ago, we were looking for good dentist, the one we can trust. We tried a few but were...
Tatiana Lapushchik (Hollywood, FL)
Wonderful facility and staff, very professional.
(Sunny Isles, FL)
I take my 90yr great grandmother to this office and they are so kind and she feels so loved here. Every visit she receives excellent service and quality work. Thank...
Farron Ann (Wellington, FL)
Incredible how I was just taking my mother to her dentist appointment to me ending up becoming a patient, Jessica greeted me with such warmth and compassion and immediately noticed...
Aracelis Figueroa (Wellington, FL)
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)
I have been going to Dr Gorbatov at A Center For Dental Excellence for many years now and their use of "Excellence" isn't just a marketing ploy and they definitely...
Lawrence F. (Lake Worth, FL)
I had a great experience with Dr. Dmitry Gorbatov. He was able to save my tooth from getting a root canal. All the staff was really nice, and attentive. I...
Arthur R. (North Miami Beach, FL)
Painless, professional and efficient. Dr Gorbatov is great!
Suzanne Wilt (West Palm Beach, FL)
I had been looking for a dentist for a few months and I was referred to Dr. Gorbatov and I can certainly see why. I've always been a little skeptical...
Jazlyne Jimenez (Hallandale Beach, FL)
Been going here forever and they do an excellent job with all your dental needs and even with cosmetic dentistry as well!
Lauren Harris (Lake Worth, FL)
Good quality office, and dental work.
Igor Gonchar (Hallandale Beach, FL)
Dr. Gorbatov was very thorough and went over all concerns I had (I'm not really a fan of the dentist). He is definitely the nicest Dentist I have ever been...
Sofia Rodriguez (Hallandale Beach, FL)
I have lived and worked all over North America. One of the greatest challenges of relocating is finding the best dental practice. "Center For Dental Excellence" was recommended to me...
Gregory Sutton (Wellington, FL)
Love the staff and great service!!
Rebeca Saravia (Dania Beach, FL)
The receptionist goes above and be on for the customers. Excellent service the doctor treats you with all his attention feels like I’m right at home and explain everything detailed....
Sophie Garcia (Royal Palm Beach, FL)