"My _____ keeps falling out. Can you help me?"

Fill in the blank in the title with denture, partial, crown, bridge, onlay, filling---basically anything a dentist does or makes for you to replace something you’ve lost.

It is important to remember that these items are custom made to fit and work in your mouth. Even fillings are customized to your tooth and bite during and after placement. If something is repeatedly loosening, breaking, or falling out, there is a reason behind it—and we need to discover that reason to see what we can do to keep it from continuing to happen.

In general, there are two (2) methods to keep items secure;

1. intimate contact between the item and yourself
2. no outside forces that dislodge the item from its place in your mouth

Let’s explore each of these in more detail.

Intimate Contact:

It needs to fit extremely well. For dentures and other removable devices, this relies on the denture base being in close contact with your gums. For items like fillings and crowns, it relies on the material being in close contact with your tooth. For lab made items, the impression and lab manufacturing are the keys to a good custom fit. Think of it like a custom tailored suit. If the measurements are off, your suit won’t fit.

Outside Forces:

Our mouth is subject to many forces from activities like eating, habits (thumb sucking, nail biting, etc.), and grinding/clenching. To keep something in your mouth we need these forces to not be strong enough to dislodge it.

Unfortunately, we don’t just bite straight up and down. There are side to side forces (called lateral excursions) in many of our mouth activities. When we bite into something with our front teeth, the lower jaw gets thrust forward (called protrusive movement). All these movements can cause unusual forces on your dentition and need to be taken into account when we evaluate you.

One example is removable dentures that fit well, but dislodge (or fall down) with chewing. Your dentist needs to find the interference point and adjust it. Another example is habitual behaviors that can place forces on your teeth that they wouldn’t normally have. Destructive habits by the patient can knock out fillings, onlays, inlays, or crowns. The patient needs to control and reign in these destructive habits. This may require additional treatment (either within or outside the dental field) or a different appliance to wear at specific times.

In addition, your mouth can change over time and cause a problem that wasn’t apparent when the item was originally placed. For example, grinding can wear down your teeth and make them shorter. If the shape of your tooth or your ridge (the part left when teeth are removed) is too short or too flat, even normal forces can become excessive forces, and it is hard to get the appliance or item to stay put. You may need a longer tooth (crown lengthening) or a reduction of biting forces or even a new appliance or item in order to get a better match to your current mouth condition.

Getting a problem area fixed may take a lot of trial and error so you, as the patient, must be patient as your dentist works with you to fix it.

Dr. Jennifer Robb is a general dentist serving patients of all ages at her dental office located at 1612 Cooper Foster Park Rd., Lorain, OH 44053. Call 440-960-1940 for more information or check us out at www.drjrobb.com and follow us on Facebook at www.facebook.com/DrJenniferRobb