I dont know whom i am addressing when i am writing –Must consult a Prosthodontist before tooth extraction. In fact it is both for the dentist as well as for the patient.
If a person is getting her all teeth or a few teeth removed from a particular dentist and he is the one who would provide him artificial dentres, it is perfectly fine. There is trust between both of them. However, at times the situation in India is quite peculiar – many patients get their teeth removed from a dentist and then go for artificial dentures to a different dentist. That’ s their sweet will!
However, at times it is difficult for a general dentist to decide whether by removing his all the teeth would he be able to get a good functional set of artificial dentures because the relationship of upper and lower natural teeth is not proper which implies that relationship of upper and lower ridges is also not optimal. After all, the artificial dentures would also be guided by the alveolar ridges -there can’t be much deviation!
I think i am getting hard to understand –this is the topic i used to hate during my school days. So, i am making it simple by taking the example of a 65plus man who met me to know whether he should get his all teeth removed.
First of all, when i saw his mouth i found that a dental quack has done his job on his teeth by making some poor quality artificial teeth which were damaging his oral tissues and often caused bleeding from his mouth. I told him that whatever ‘bad’ dental work he has got done from the quack needs to be undone. After a couple of days he met me –all these pictures have been taken during his second visit when he had got rid of quack’s poor dentures.
You see in this picture that there are quite a few root stumps in his mouth and the quack had made dentures over those stumps. We come across such cases quite frequently. You can see in these photographs that the relationship of his upper and lower teeth is not normal — perhaps you wont understand if i say that the bite is edge to edge which has led to so much abnormal wearing of his lower teeth.
He asked me if i can get all the teeth removed and get an artificial denture made. Looking at his teeth, i told him that he should first consult the dentist from whom he is to get his artificial dentures made. If he is of the opinion that after removal of all his teeth, proper functional artificial denture can be supplied to this man, it is okay, otherwise he should not get all his teeth removed particularly when he is not having complaint except occasional sensitivity. However, all those root stumps should definitely be removed.
Any dentist is qualified to provide artificial dentures and they are doing wonderful job. Prosthodontist — the name i have mentioned above is the specialist who is a dentist but has done 3-years masters in learning the art and craft of mouth rehabilitation by artificial dentures, partial dentures, fixed dentures, artificial crowns etc. In my opinion such cases must seek expert opinion of a prosthodontist before taking a decision about removal of all teeth. This is important.
Imagine a situation — this patient- leave aside the issue how his teeth are presently–gets all his teeth removed with the hope that he would get a nice set of upper and lower artificial teeth only to be told after 2-3 months by another dentist that it may not be possible to do his mouth rehabilitation in a proper way. I hope you understand what i wanted to convey — he says he does not have any big trouble with his teeth but on dentist’s advice he gets all his teeth removed and later on he is unable to use artificial dentures properly. Then God bless the dentist and this person.