Dentures that Do Not Wobble

By Jack Krayenhoff

Sorry I did not come up with a more dignified title for this interview, but it makes the point of it so accurately. I just couldn't resist.

It is all about dentures, particularly about the new technique of anchoring them on tooth implants, and about the obvious man to ask about this is James Bay Denturist Chris Nordell. His office is in the hidden part of James Bay Mall - you have to sort of dive into it from the parking lot.

To begin with, what exactly does a denturist do?

"The official definition", says Nordell, "is somebody who is capable of fitting and fabricating any movable denture device. That means I am the one between the dentist and the laboratory."

He goes on to explain that Canada has led the development of his occupation, and that only recently other countries have begun to follow. Traditionally the dentist did not only the extractions but also the impressions, the recording of the bite position and so on, and would send those to the technician to fabricate the dentures. All this is now done by the denturist, who will also see the patient before the extractions and prepare a denture that will be ready at the dentist's office to be worn right away.

The denturist is also needed after the extraction, to help the patient get used to the denture. Some realignment is usually necessary when the tissues have fully healed but also later throughout the years, because a jaw bone without teeth-especially the lower jaw- will over the years shrink, sometimes so much that a completely new denture becomes necessary. And this is one point where tooth implants are important.

The idea of tooth implants, Nordell explains, was first conceived by a Swedish dentist. He knew from orthopaedic surgeons that when a Titanium rod with tiny holes in the surface was inserted into bone, new bone cells would grow into those openings, so that the rod would become immovably connected with the bone. This dentist then developed little Titanium posts that were inserted in the jawbone. After a few months they, too, had become part of the jaw so to speak, and could be used to support an artificial tooth so solidly that it could take the considerable stress of biting. And it also served to keep the jaw bone from shrinking. The jaw bone needs the stress of biting to keep its shape, but the pressure of a denture does not provide that stress, it appears.

The success of tooth implants led to their use in anchoring dentures. Clipping a denture to two or more implants, fitted with abutments, will keep it from wobbling and make it very stable. Stable enough to bite into an apple? "Yes", replies Nordell, "but for that you might be better off with four implants rather than two".

And that raises the question of the cost of implants, which is substantial. The implants themselves cost around $2,000 a piece. Then there is the cost of the abutments, and the work of the dentist. Upper and lower dentures together run upward from $3,500; for a single arch 60% of that. "Still", says Nordell "economical solutions are usually possible."

He says that all sorts of variations of the traditional implants have been tried that may be less expensive, but he designates dentists who use them as mavericks. "Their results have not been confirmed in the literature. There is a lot of confusion and misunderstanding in the field of implants. I make sure I spend plenty of time to answer my patients' questions", he concludes