Dual-Use Dental Implants

Secured foundations stabilize lower and upper dentures.

Hailing from a little town outside Niagara Falls, New York, Gerald Conahan first became a snowbird in 1998 when he bought a condo in Venice. Shortly thereafter, Gerald’s annual, two-month stay in Florida turned into a nine-month stay, and now he’s officially a resident of the Sunshine State.

Photo by Jordan Pysz.

Gerald Conahan

In Florida, Gerald found more than warm weather and a great place to spend most of the months of his retirement years. He also discovered the answer to a longtime problem he had with his teeth.
“When I was very young, I had soft teeth,” Gerald shares. “Even though I went to the dentist regularly, I couldn’t keep my teeth from decaying. When I was in my twenties, one tooth got so bad that my dentist said he couldn’t save it. One thing led to another, and eventually, all my teeth had to be removed. I’ve been wearing upper and lower dentures ever since, for at least thirty, maybe forty years.”
In most cases, upper dentures fit securely because the palate enables the creation of enough suction to hold the appliance in place. This was true in Gerald’s case. The story is often different with lower dentures, however.
Lower dentures can be more difficult to keep stable. This is because there is no palate in the bottom jaw, due to the location of the tongue, and less suction is produced. As a result, lower dentures tend to slip and slide.
Like many people with lower dentures, Gerald had difficulties keeping his lower denture secure.
“After a while, my lower denture would become loose and get very sloppy,” Gerald describes. “It wasn’t comfortable, and I had trouble chewing. I really had to watch what I ate.
“I couldn’t eat anything that took a lot of heavy chewing, especially steak, unless it was a filet mignon, and even that had to be very, very tender. I couldn’t eat any other cut of steak or anything else that was tough to chew.”
Not long ago, Gerald learned how some dentists use dental implants to secure dentures and keep them from moving. He inquired about them at one dental practice but was told he was not a candidate because he lacked sufficient bone in his jaw to bond with the implants.
Gerald was not deterred. He mentioned his interest in dental implants to another dentist, who referred him to Alexander Gaukhman, DMD, of Siesta Dental.
Dr. Gaukhman is an experienced, skillful dentist who offers exceptional general, cosmetic and restorative dentistry at his offices in Sarasota, Venice and Osprey.
“I had already been to one dentist and had new dentures made,” relates Gerald. “Still, I had it in the back of my mind to look into the implants. When Dr. Gaukhman looked me over, he said, Yes. He could put the implants in with the bone I had left in my lower jaw.”

Atypical Scenario

“Gerald was referred to my practice by another dentist specifically because he could not keep his lower denture stable,” reports Dr. Gaukhman. “He could not eat because the denture would slide right out.
“The denture he had was made properly, but Gerald didn’t have enough bone in his lower jaw to support it, which is very common. However, he did have just enough bone to place dental implants. Securing a lower denture with dental implants is the most effective way to stabilize it. I recommended two implants to secure Gerald’s lower denture.”
Dental implants are screw-like metal posts that are surgically placed into the jawbone and serve as the foundation for replacement teeth. The replacements may be crowns in the case of single teeth, or bridges or dentures for multiple teeth. Implants are made of a titanium alloy that fuses with the patient’s bone to become a solid unit.

Photo by Jordan Pysz.

Gerald spreads his smile all around town now.

When dentures are secured by implants, they don’t rock or move; they stay in place when wearers speak and eat. Secured dentures also provided added strength for biting and chewing. At Siesta Dental, implants are often placed on the day of tooth extraction. In most cases, temporary dentures are also created at that time.
“Typically, once the patient’s problem is diagnosed and the treatment is determined, I take impressions of the teeth,” expounds Dr. Gaukhman. “When the dentures are ready, which is usually the same day or the next day, I extract the teeth and put the dentures in right away. The dentures act like a bandage. They stop bleeding and limit swelling.
“For the next three to six months, the patient wears temporary dentures until the implants fuse and the gums heal. Then the temporary dentures are replaced with the permanent appliances.”
Gerald’s situation was a little different. He had recently gotten new dentures and didn’t need another lower denture made for him, temporary or permanent. That was no problem for Dr. Gaukhman. He was able to adjust Gerald’s existing denture to fit with the implants.
“In Gerald’s case, I placed the two implants, and after they healed, I was able to retrofit his existing denture,” confirms Dr. Gaukhman. “We do not have to start from scratch for people who have relatively new, two- to three-year-old appliances. Retrofitting a denture essentially involves making two holes in the denture to accept the implant attachments.
“Since we have our own dental lab on site at Siesta Dental, it is especially easy for us to do this work. It takes just a couple of hours and can be done in one visit.”
“Dr. Gaukhman put in the implants for me, and that went very well,” says Gerald. “He gave me some type of Novocain®, and the procedure wasn’t too bad. I went back to the office regularly so he could check the implants and make sure everything was okay.
“Several months went by while we waited for the implants to fuse with the bone in my jaw. Just a couple of weeks ago, he prepared my lower denture with the clips that snap onto those implants, and everything went fine with that as well.”

Upper Denture Downside

Rita* is a retired administrative assistant and a Staten Island native who relocated to Florida four years ago to flee the cold and snow of New York. But she couldn’t flee from a deteriorating dental issue that had been dogging her for years.Stock photo from istockphoto.com.
“I knew for a while I had a problem with my upper gums, but I kept putting off doing anything about it,” recalls Rita. “Every time I went to the dentist, I’d hear the same thing about how my gums were receding.
“I had pain occasionally, and there was sensitivity because as my gums receded, more nerve was exposed. I was told to expect that.”
Dentists typically monitor progression of recession by measuring the gum pockets. These are the spaces between the edge of the gums and the teeth. The deeper these pockets become, the more likely it is that a tooth will loosen and the higher the risk of losing the tooth.
“I wanted to do something about my gums before my teeth fell out,” recounts Rita. “When I first moved to Florida, I lived in Bradenton, and I went to a dentist there. He wanted to fit me for a denture, but I wasn’t sure about that then.
“When I decided it was the right time to get the work done, I started looking around for a dentist. I wanted dental implants, and since I was told I probably needed a denture, I went online and did research.”
Rita wanted a dentist with expertise in dentures and implants to do the job, and her search led her to Dr. Gaukhman at Siesta Dental. She saw that Dr. Gaukhman scored rave reviews online. The dentist was also close to her new home in Venice, which was a bonus.
Rita’s mind was made up to visit Dr. Gaukhman when she read about his process for restoring smiles with implant-retained dentures in Florida Health Care News. She read that he makes the molds, extracts the teeth and creates a temporary denture in his in-office lab in one day.

“I’m very happy with the entire experience and my decision to go to Siesta Dental,
and I’m ecstatic about my results.”-Rita

“I wanted dental implants, and I saw that Dr. Gaukhman did implant surgery at Siesta Dental, so I went there,” offers Rita. “I had all my top teeth removed and got a temporary denture the same day. I expected that, but I didn’t expect the denture to look so nice or the process to cause so little pain.”
“When Rita first arrived, she had badly receding gums,” verifies Dr. Gaukhman. “When the gums recede due to periodontal disease, patients like Rita lose bone due to bacteria. The only treatment is to remove the teeth because those bacteria cannot be killed with just antibiotics.
“Rita had tried antibiotics and deep cleanings to treat her condition, but those attempts were unsuccessful. Her condition got worse until her upper teeth were no longer salvageable, so I extracted them and created a denture for her.”
While Rita was pleased with the appearance of her temporary denture, she was less than thrilled with the way it felt.
“It covered the roof of my mouth, and that was annoying, as well as a little uncomfortable,” she explains. “It didn’t hurt; it’s just that I couldn’t eat the way I wanted to because I couldn’t really bite into certain foods, like steak. I didn’t eat steak for six months.”

Secure Solution

Upper dentures generally fit securely because there’s enough suction from the palate to hold them in place. However, traditional upper dentures have some drawbacks that can be corrected by securing them with dental implants.
“The tongue is mainly responsible for discerning taste, but the palate, or roof of the mouth, plays a role as well,” informs the dentist. “When a denture is made for the upper jaw, it covers the palate, which can deprive patients of sensing the full range of tastes.
“In addition, some patients have a gag reflex due to the denture being placed over the palate. With an implant-retained upper denture, the shape of the denture is more like a horseshoe instead of a full, palate-covering appliance. It frees up the taste buds and eliminates the gag reflex. Implant-retained upper dentures are simply more comfortable.”
When Dr. Gaukhman creates implant-retained lower dentures, he generally secures them with two implants, as he did for Gerald. For upper dentures, however, he typically uses four implants.
“I use four implants on the top due to gravity,” he discloses. “Dentures work with or against gravity. Lower dentures move down with gravity, so two implants are sufficient. Implant-retained upper dentures have to work against gravity without the help of suction from the palate, so four implants keep them more securely in place.”

Lasting Impressions

After being told he was not a candidate for dental implants, Gerald didn’t give up. His persistence paid off when he found Dr. Gaukhman and Siesta Dental. Gerald is pleased with the dentist’s process, but his journey is not over yet. The clips currently on Gerald’s lower denture that attach it to the implants are temporary.
“I have to wait about six weeks until these clips loosen, and then Dr. Gaukhman will put in the permanent clips,” he states. “I also had to go back to the office early on to have the denture filed down a little because it bothered my gums, but they said that was normal. The dental technician fixed them, and now they’re perfect.”
From the beginning, Rita wanted implants for her upper denture to ensure its stability. Keeping the appliance off her palate and more comfortable became another important consideration after wearing the temporary. With her permanent upper denture secured by implants, Rita has that comfort and stability, as well as strength for biting and chewing.
“I love my permanent denture,” she enthuses. “It’s much more comfortable because I don’t have a plate covering the roof of my mouth. And it’s so much easier to eat; I can eat anything I want now. I’ve already eaten steak, hamburgers, all sorts of things.
“Steak was one of the first things I ate after I got my denture. Just to be able to bite into a hamburger now is great.”
Gerald finds it easier to eat as well. While he’s eating a lot more foods than he did before the implants, he isn’t rushing into all of his favorite hard-to-chew foods just yet.
“I’m eating and chewing a lot better, but I haven’t taken on steak yet,” he muses. “I’m going to wait until I get the permanent clips, then I’ll definitely be at one of those steak places trying out my denture. I’m looking forward to it.”
Comfort isn’t the only benefit of Rita’s new denture. She also likes its appearance and the ease of its wear and care.

“I would absolutely recommend the implant process and Siesta Dental. Everybody there is very professional, and they’re very patient oriented”-Gerald

“The new denture is wonderful,” she marvels. “Everybody tells me it looks absolutely natural. I really like that it doesn’t slip and slide all around. It snaps in and out. I take my denture out at night to clean it, snap it back in my mouth in the morning and I’m good to go.”
For Gerald, the most amazing thing is the permanence of his lower denture. Unlike before, the implant-retained denture doesn’t become loose and move around when he speaks and eats.
“Sometimes before, when I bit on something on one side of my mouth, the denture would lift up on the other side, so I had to chew on both sides of my mouth at the same time,” he observes. “Now, I don’t have to worry about that. I’m thrilled with the results.”
Rita and Gerald say their overall experiences at Siesta Dental were very positive. Rita gives Dr. Gaukhman and his staff credit for making her visits to the practice as easy and pain free as possible.
“When I walk into the office, everybody is so nice, and they take good care of me,” she comments. “Personally, I’m one of those people who hate dentists, but I can’t hate these people. Dr. Gaukhman is great. He made me feel very comfortable about getting this work done.
“I only have good things to say about Dr. Gaukhman and his staff because they’re just excellent. They’re so friendly and caring. I’m very happy with the entire experience and my decision to go to Siesta Dental, and I’m ecstatic about my results. I recommend Dr. Gaukhman to anyone.”
Gerald agrees.
“I would absolutely recommend the implant process and Siesta Dental. Everybody there is very professional, and they’re very patient oriented and concerned. After I had my implants put in, they called me to make sure I was healing properly, in addition to the regular appointments I had with them.
“I give Dr. Gaukhman and Siesta Dental a double A-plus rating!”

*Patient name witheld at their request.
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      Venetian Dental is devoted to restoring and enhancing the natural beauty of your smile. Their state-of-the art dental offices offer the latest in dental technology and patient amenities. They provide comprehensive treatment planning, and use r... Read More

    • Alexander Gaukhman, DMD

      Alexander Gaukhman, DMD, earned his dental degree at Nova Southeastern University College of Dentistry, Ft. Lauderdale. He completed his undergraduate studies at Florida Atlantic University, Boca Raton. Dr. Gaukhman is a diplomate of the Inter... Read More