What Have You Learned at This Blog?
INTERESTING STUFF – 27 February 2016

An Elder Bites the Apple

Applebasket150Yesterday, I bit into an apple and heard that satisfying “crack” that happens as the fruit's skin breaks and a bit juice dribbles down the chin. Now, some of you are undoubtedly thinking that this is nothing to write home (or a blog post) about but you would be wrong, and I suspect many old people agree with me.

For nearly a decade, I wore an old-fashioned, conventional upper denture that, as they all do, covered the entirety of the gum and roof of my mouth. Even though the fit of my denture was extraordinarily good, biting an apple and eating corn on the cob have been nothing but a memory.

Also, for all these years, I felt that I alone supported the Sriracha hot sauce company so that I could taste at least something.

Many people do not know there are taste buds located on our upper palate, fewer than on the tongue for sure, but they are there and they contribute to our ability to taste. With the denture, along with normal decline in taste buds with age, most food has been a weak shadow of its previous self to me. Strong hot sauce gave mild-tasting food some oomph.

There's a boring, old joke among elders: If I'd known I would live this long, I'd have taken better care of my teeth. All too true although god knows I put thousands more dollars in my mouth over the years than the rest of my body required to keep it in working order.

Fifteen months ago, I wound up in a dentist's office with a huge infection in my upper gum. Of course, I couldn't wear my denture during the week it took to heal so I was stuck at home for the duration because nobody – NOBODY gets to see me without it.

Afterward, the denture never fit right again and I needed to use that disgusting “glue” to keep it in place, something I'd never required before. I asked the dentist if there wasn't some other solution for me.

Sure, he said, implants. Except the number I would need for an entire upper gum is so far beyond my means that it might as well be labeled Trumpian. When I explained that, he suggested an “overdenture.”

OverdentureDefinitionImage

In my case, it would involve implants, but only four saving me tens of thousands of dollars. It turned out, however, there was a snag. Because I'm old and have some bone loss, before implants could be made we had to grow me some new bone in my upper gum.

This was an entirely new idea to me and I consider it a miracle. The dentist drilled several holes, inserted powdered human bone from which the DNA has been removed so my body would not reject it and then we let it sit for several months until x-rays showed that it had hardened and grown together with my own bone. Like I said, a miracle.

(There are other kinds of bone grafting that might be used in this procedure depending on individual circumstances.)

More drilling came next to insert the titanium implants. They too sat there for several months until the metal had fused with bone. By this time, a year had passed but like most long-term projects, in my old age I no longer have the impatience that plagued my youth.

Or maybe it was that well-known elder phenomenon of time passing so swiftly now that we hardly notice a year gone by.

Molds were made of my gum with the implants and of the teeth in my old-fashioned denture to create the overdenture. There is a great deal miniature engineering involved, but there is art involved too.

For example, compared to my real teeth, the bite was slightly off kilter in my old denture and the dentist has corrected it now to be reasonably close to what I recall it had been with my original teeth.

Here is a drawing I found online of what an overdenture – my kind, anyway – looks like (this shows six implants; I have four).

Overdenturedrawin250b

The “wire” between the implants, like the implants themselves, is made of nearly indestructible titanium. On the inside of the overdenture, not shown here, are tiny "clips" to match the wires so that the denture snaps into place on the wire and is unsnapped each day for removal to clean it and the wire.

Finally, there are a series of minute adjustments over a few weeks to alleviate any painful areas on the gum and shave any thick spots on the denture. In my case, the cut in the denture above the two front teeth had to be lengthened so it would not rub against the frenulum (also frenum) - that little fold of tissue that connects the gum to the inner lip.

These and some other final fixes will be done in one or two more visits and I will be a much happier woman. Well, I already am if you don't count that I choke whenever I think of the price.

The total came to just over $18,000, about half the average price for a full set of implants although prices vary widely from place to place, dentist to dentist and specific procedures required.

I am deeply aware of how lucky I am, that many people cannot afford this. One of the great failings of Medicare is that except in very few, very specific (read: hardly any) circumstances, it does not cover routine dental work and certainly not implants or dentures.

The money for my overdenture and the work involved came out of my end-of-life fund intended to pay for my care for a couple of years if I become completely disabled.

It took a long while to decide to go forward but in the end it came down to the fact that sometimes you just need to close your eyes, take a leap and hope for the best.

It's not rational but I'm hoping to live long enough before I need the end-of-life fund for it to be replenished from some careful, safe investments. It's worth the gamble to me to once again fully enjoy one of life's greatest pleasures - food in all its glory of amazing tastes.

Now there will be a lot more apples eaten as they should be (crunch), much tastier food in general and come summer, I'm looking forward to my first corn on the cob in a long time - no hot sauce needed.

Corn-on-the-cob2

Comments

Thanks, Ronni, for the description of overdentures and the process you went through. Very interesting and informative for those of us who may need dentures in the future. And I'm so glad you can once again experience that crunch of one of life's pure pleasures!

Really interesting subject, Ronni that I can relate to having had a similar experience to the tune of $6,000 for 2 implants. It is so amazing what medicine/dentistry is doing today for all, not just elders. We live in a wonderful time......for some things at least. :) Dee

I gulped when I read how much you had to pay for your "overdenture", although it sounds like a wonderful idea. Implants, like you say, are horrendously expensive, but once you recover from the pain and the expense, they are a life-long solution. I have only one implant, blended in with my other teeth, which I have filled, re-filled and supported in various ways to make them last. But still, biting into that apple or corn cob is worth it!

I'm reading "Being Mortal" for my book club and just finished a section where he talks about elders losing their teeth. Your crisp apple crunch made me very happy.

How timely can info get? On Tuesday, my dentist will be installing a full upper plate. We considered the implant-overdenture strategy, but costs and my age tilted the decision toward the plate. Will just have to say bye-bye to crunchy apples and corn, but I've resigned myself to living with it.

Glad you were able to go the other way, Ronni.

Congratulations, Ronni for 'biting the bullet' and getting the titanium teeth.
You have given an excellent description of the procedure and one that perhaps will help others to take this step. I wish you many more bites of apple and plenty of corn on the cob.

I had an earlier version of this done in the mid-90s when I was around 60 and have never looked back. Yes, it was crazy-expensive, but the two dentists who performed the miracle were generous in helping this former secretary afford the painful,but oh so effective, procedure.

Wonderful information outside the cost, Ronni. Exciting to read about the method to build up bone that was not available when I had implants to replace a bridge 15 plus years ago. Because of the damage to the anchor teeth and bone loss by having had the bridge for so many decades, I had to have a bone graft from my chin to the lower jaw. That procedure which preceded the implant process was much worse than the actual implants. I suspect that could have been avoided with the growth of new bone from bone powder!

One of the saddest issues with my parents dentures because they had needed them in their early adult lives was the deterioration of the bone and gum tissue needed to properly fit their dentures. Relining's were no longer successful. They became major sources of frustration and discomfort for them. I applaud your tough decision. We never know from one day to the next what we will be facing, but you chose to make the days you have the best you can in a very elemental way. Sad it is not more affordable for everyone.

For some unknown reason*, I still have most of my original teeth. Eating foods like apples, corn on the cob and raw veggies has not been a problem. However, last week I developed some tenderness in my gum which negated my chomping down on all but soft foods. What a bummer. I'd forgotten how important food is to one's quality of life (As well as to one's general health). It's a shame that Medicare does not recognize this as being as important as proving one with a prosthetic limb or pacemaker.

*I never really took any great care of my teeth except for regular brushing and staying away from sugary drinks etc. I can count on one hand the number of times I visited a dentist.

This is fascinating. I still have all my teeth, but I hope to live a long time, so who knows. Thank you for sharing, even though it cost a year's college tuition for just 4 teeth!

Well, actually, Tabor, the price was for an entire set of upper teeth held in place with four implants.

Whoopee for your overdenture, Ronni! (first I've ever heard of them!) I have one implant, and am considering a second. I had all my teeth crowned (THAT cost a fortune) years ago when I was told my teeth had "an unusual wearing pattern," i.e., they were apparently just sort of disintegrating. It's fabulous to learn from you today about the terrific new advances that continue to be made in dentistry! Mazeltov! Keep eating those apples!

Ronni: You are indeed a Hardbitten Blogger. As a side issue, is there any chance that powdered bone-grafting could be used for the 'enhancement' of old men? Hah! Dental work chews up an unreasonable portion of our income. Along with your various (and welcomed) protestations against the excesses of both governmental and private entities, could you agitate for inclusion of dental work within Medicare coverage? Dentists will raise holy heck, but so did the physicians, and they're still treatings us/we seniors.

"...sometimes you just need to close your eyes, take a leap and hope for the best." -

I loved that part of your story!!!

Dentures don't always mean you can't have corn on the cob or apples. I can eat both regularly, as do others I know who have dentures.

That said, I'll definitely conceded that the extracting/fitting/refitting/adjustment/reline/repair cycle of dentures is no barrel of laughs, to put it mildly. Who *wouldn't* tell their teenage self to skip soda and be sure to brush and floss twice a day? And watch out for sweets. And no smoking!

Seems easy to say now, alas, and we can't even be sure this routine would have helped, but it would have been worth trying.

Best of luck with that overdenture, Ronni. I think you made a great decision to raid the long-term care fund to pay for the work. Think of it this way--the entire cost of your dental work could be absorbed into the corporate maw of some possibly very unpleasant nursing home in a matter of months.

Yet with your new teeth, you could enjoy food for years. Please keep us posted on how it goes!

Excellent post Ronni and congrats on your new mouth. Both the technique and the cost are amazing but I'd think well worth it. How wonderful it will be to better enjoy what you eat not to mention the possible health benefits.

You're very brave -- but we already knew that! Much braver than I am. Plus I don't have the money... I've lost all but one of my back teeth and have taught myself to chew using the front teeth. So this confirmed carnivore is becoming more of an omnivore.

I'd never heard of overdentures, but they certainly sound like a huge improvement over the old kind. I've been very fortunate so far in keeping all my own teeth (despite a pathological fear of dentists). I just lucked out and got good genes, my mom would have said. Thank goodness those genes included good teeth.

So nice to have good news about a senior's health! Thanks for explaining all about your overdentures. I don't have that much saved any more, and have found that my teeth require more than I do have, since all the enamel has now worn away. I'll just take care of each one when it decays. I've finally found a dentist who works hard for the health of my teeth even if he can't save them all.

I've never heard of over dentures before. (Add this to the loooong list of things I've learned at this blog!) It is wonderful that it is working so well for you.

Great blog post-and, as usual, very informative.

Several comments have been made about the cost of implants. I discovered a wonderful dentist in Costa Rica many years ago. Since I first went to him to replace a lost filling about 18 years ago, when I was there on vacation, I have returned any time I needed major dental work.

Why would I travel down to Costa Rica? Because the cost for excellent dental work is about one-third the cost here. And I get a vacation along with the dental work!

I wrote an article about "Medical Tourism" years ago and, if I can find it, I'll submit it to Ronni for consideration.

Hugs..Elle, your neighbor in Beaverton

I've been lucky so far in that, despite being a bona fide dental phobic who avoided dentists like the plague for far too many years, I still have most of my own teeth. It's got to be due to good genes because it certainly wasn't good care. It's a good thing because I don't think I could deal with the extensive procedures you had--or the COST!--without being rendered totally unconscious! Still, it's excellent information to have just in case.

I'm so glad it's working out for you.

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