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Young Patient Redefines the Face of Dentures by Allison DiMatteo, BA, MPS and Rebecca Nobach, BS

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Kristi's story
Throughout her childhood, Kristi always had really sensitive teeth. Hot and cold food and drinks bothered her teeth, and brushing them was always painful. Her gums frequently bled, often leading to more apprehension and fear about brushing. During her teenage years, cavities developed and fillings were placed, but she frequently had abscesses that were only treated when she was in pain. At 15, she had two molars extracted because other types of treatment were not financially feasible.

The tooth decay continued into adulthood and seemed to worsen through her pregnancies. During her third pregnancy, when she was 26, her front tooth chipped off. At about three months postpartum she was trying to get back into shape, changing her hair and refreshing her overall appearance, but she couldn't look at herself in the mirror because of her teeth.

"I was always self-conscious about my teeth, and never smiled," Kristi said. "I wanted to enhance my appearance and improve my health, and that's what motivated me to make a change and start looking online for economical denture options."

While viewing denture-specific websites, Kristi found that she wasn't the only young adult needing dentures. She was also surprised by the smile transformations that other patients were experiencing with dentures, which gave her the hope and encouragement to continue pursuing denture rehabilitation. Her next step was explaining her situation to her family, especially her husband.

"At first he was confused and surprised, because he didn't know how I'd been feeling about my smile [and] my teeth, [or] my pain and embarrassment," Kristi said. "I worked up the courage to show him the extent of the damage, and after receiving his support, that's when I decided to make an appointment."

She began looking for a provider of economical dentures because she knew cost would be one of her biggest challenges. Before the appointment, she was incredibly anxious because she would have to expose what she saw as her biggest flaw, one that she had hidden for as long as she could remember: her teeth. During the appointment, however, the dentist was very sympathetic, recognizing that extractions and dentures are a monumental physical and mental ordeal.

"I was very emotional and couldn't process all of what the dentist was saying during the appointment," she said. "But I did understand that I needed to have all of my teeth extracted in order to improve my health and have a more esthetic smile. My dentist told me that if I didn't have them extracted, my mouth would never be healthy."

With the news from her dentist, Kristi started posting on denture forums to learn more about the actual extraction procedure. Reading about what others had gone through was more valuable to her than any information her dentist had shared with her about what to expect. When she started planning, Kristi knew she would be receiving the lowest-quality dentures available. The option she could afford was transitional dentures—at a cost of $400 per arch—that would need to be replaced after one year.

"These were flat dentures with very little character," Kristi described. "I knew the other options available were higher quality, but I didn't completely understand the differences and why the higher-quality—and more expensive—materials made for better-looking and better-functioning dentures."

All of Kristi's teeth were extracted, and she received an immediate temporary denture. "The transitional denture was only supposed to last a year, but it wasn't until a year and a half later that I could afford the final set," Kristi said. Around the time she received her "final" set of dentures, she learned about the benefits of implant-supported dentures, and realized that her journey with dentures was just beginning. Although she was glad to have her final dentures and felt more comfortable smiling, mobility issues resulted in a constant sensation of something foreign in her mouth.







A patient's education
While those who have experienced tooth loss and extractions have restorative and esthetic options available, emotional and physical issues can still plague patients, leading to guilt, shame, confusion and insecurity.

These emotions stem from a variety of factors, including fear, miscommunication with the dentist, a lack of understanding of the denture or restorative process, and unacknowledged expectations.

For young adults seeking dentures, this process can also be isolating, as the social implications of having dentures can proliferate their insecurities. Many young denture patients are not aware that other young adults have also lost their teeth and need dentures.

Fortunately, there is hope. Through forums, websites and blogs devoted to dentures (e.g., Morethanadenture.com, Denturesanewsmile.ning.com, etc.), patients have access to first-person, real-life stories from others who have faced similar apprehensions and had similar questions about tooth loss, extractions, and dentures. These resources offer patients who are anxious, unsure, and confused about their options, the support and understandable information they need. Independent of their dentist, patients find that this online networking represents an avenue to share their experiences and emotions throughout their dental treatments.

Kristi knows firsthand how valuable these resources can be. At the age of 26, after enduring a lifetime of dental complications, Kristi wanted a healthy and beautiful smile. Although anxious and uncertain, she started what would become a five-year journey to a complete full-mouth smile makeover. She used the websites and forums to gain knowledge, understanding, and support throughout the denture process, as well as sharing her own experiences to help others cope.

Her contributions began after she received her first set of temporary dentures, when she documented her experience by recording video blogs (vlogs) and posting them on YouTube. As her following grew, she continued creating videos and writing on her blog, sharing her experience and answering questions from others.

"Through my own experience and relationships with other denture wearers, I've found that many patients experience a disconnect with their dentist during denture planning and treatment," she said. "By sharing my story with patients and now also dentists, I hope that dental professionals will better understand and address the concerns, questions and anxieties that patients experience during the denture process."

Her evolving journey
After receiving her "final" set of dentures, Kristi heard about a contest for All-on-4 implant-supported dentures. While she loved the improved esthetics of her dentures, she missed having the bite force that—she had read—implants would provide. She submitted a video for the contest and asked subscribers from her YouTube channel to vote for her. She won the contest and received the All-on-4 makeover in Las Vegas. Four maxillary and four mandibular implants were placed, along with a new denture/bridge hybrid with a titanium framework.

"The implants and hybrid dentures gave me the sensation of having teeth, and there were no mobility issues," Kristi said with satisfaction. "With this new treatment, only the dentist could remove them. Throughout the process, I learned a great deal about material selection and what makes dentures look more natural, so I continued blogging about what I'd been learning and experiencing."

She also discovered the pros and cons of different types of implant-supported dentures, including possible complications related to tissue maintenance. Her evolving needs led her to the University of Florida's Center for Implant Dentistry, to consult with Dr. Will Martin for evaluation of her current hybrid denture and the tissue complications she'd been experiencing.

"What I observed when examining Kristi was that while the positioning of the implants and size of the denture teeth were quite acceptable, there were other material options that could create an even more natural and lifelike appearance," Martin said. "Also, once the hybrids were removed, I could see the tissue irritation that resulted from an inability to properly clean."

Kristi and Dr. Martin started the process of remaking her hybrid, which began with periodontal surgery to establish healthy gingiva. This involved maxillary and mandibular gum grafts, each of which required eight to 10 weeks of healing. Once the tissues were under control, a wax try-in was created, after which new titanium frameworks were made. Ivoclar Vivadent denture materials were selected to provide Kristi with exceptional and natural-looking esthetics, as well as the durability required to withstand mastication.

"The new titanium bridge hybrids provided Kristi with the ultimate support and function," Martin said. "The advanced materials used for creating her new hybrid dentures interact with light in a way that mimics natural teeth and ideal gum pigmentation."





A step into advocacy
Ever since receiving her first transitional dentures, Kristi believes her life has changed for the better. "I'm more confident than ever, and proud of my attractive smile," she said. Although she now has her final implant-supported hybrid denture/bridge, she plans to continue with her online community, which includes more than 10,000 subscribers of her YouTube channel, and her website (Iweardentures.com), with more than 400,000 page views. Through her online presence, she encourages fellow denture wearers to ask questions, share their stories, and learn as much as they can about the options that are available.

"Patients think about the emotional aspects of extractions and wearing dentures, and they also consider the financial investment and the best way for them to approach treatment," Kristi said. "It's hard sometimes to understand that dentists not only have to make a living from these procedures, but that they also focus on the best clinical and technical components of treatment, which can leave patients feeling overwhelmed and confused."

Kristi acknowledged that during denture treatment consultations and appointments, a communication barrier frequently develops between dentists and patients. By sharing her story with her followers and dentists alike, she hopes to bridge the gap between patient and dentist.

In fact, during her five years as a denture wearer, she has established herself as an ambassador to dentists and denture manufacturers — while still advocating for patients — to promote understanding and an exchange of information about extraction, implants, and dentures.

"Unlike … dental professionals, people online have nothing to gain from sharing their honest opinions and experiences," Kristi said. "This authenticity encourages trust and support, which is crucial when [you are] faced with losing your teeth and getting dentures."

What's more, facing tooth extractions, tooth loss and dentures is a very emotional and overwhelming experience, especially for young adults.

"Patients don't always know what questions to ask or what is normal," Kristi said. "When I started on this journey, I had no idea about the components of a material that make dentures look natural, or how the quality of the materials and how they're made affect denture esthetics, cost, and comfort."

That's why she believes that a dentist can be a valuable and supportive resource for patients. By educating patients about details such as different types of materials, what they may experience when undergoing different procedures, and differences among various dentures, the knowledgeable dentist can help patients to better prepare themselves for what's ahead.

Conclusion
As an advocate for denture patients everywhere, Kristi emphasized the need for dentists to establish trust and empathy through an information-sharing approach that patients can process and understand. These conversations are most successful when the emotional, financial, and possible procedural experiences involved in denture treatment are fully addressed.

"Although financial constraints may be a crucial factor in a patient's denture selection, it shouldn't limit his or her knowledge and understanding of everything that's available and possible to restore a smile," Kristi said.

She strongly encourages patients to access trustworthy sites (e.g., Morethanadenture.com) and forums for denture patients, where they can share in and learn from personal success stories, have frequently-asked questions answered, and learn more about denture procedures and materials.



Allison DiMatteo is the founder and owner of Crème della Crème Copywriting & Communication, a professional writing and design company that has served dentistry for more than 15 years.


Rebecca Nobach has been a writer and content strategist for Crème della Crème for more than three years.


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