LIMA — Joel Vega has crafted a few 20-year-old smiles for 80-year-old faces, but it’s not something he usually recommends; a good pair of dentures shouldn’t look fake.
“They’re usually widows looking for new candidates,” Vega said. “People like fake.”
In his subterranean laboratory underneath Whole Health Dentistry, Vega makes teeth — milling new sets for those dealing with tooth loss and/or gum disease — as one of Lima's denture makers. But like many in health care, Vega’s industry is changing, and dentures as a medical device are starting to phase out as both technology and standards shift.
The need for teeth
According to the American College of Prosthodontists, roughly one out of every 10 people in the United States does not have any teeth, a condition known medically as edentulism. Primarily concentrated in low income and geriatric populations, edentulism is especially noticeable among seniors, with about half of all seniors opting for dentures as they get older.
Overall, the ACP estimates the total number of people dealing with toothlessness to increase. Locally, dentists have seen decreases in the number of patients looking for dentures, thanks, in part, to decades of improvements in dental care.
For Van Wert dentist Dr. Kevin Laing, fewer dentures is a great sign.
As Laing explained, dentures are the result of one of two things — either advanced gum disease that affects the ability of a jawbone to hold teeth tightly, or a scenario where someone lets their teeth decay to a point where they can’t be fixed easily. The more common of the two is periodontosis, or advanced gum disease, which comprises 70% of cases.
Since both conditions tend to affect more senior patients. it could be expected that dentists — especially those in a region where the average age is ticking up — are seeing more needs for dentures, but Laing said that hasn’t been the case.
In fact, it’s the opposite. People are taking better care of their teeth and keeping the originals far longer than in the past, Laing said. The introduction of fluoride into the drinking water that first began in the middle of the 20th century in the United States has also certainly helped. By consistently coating teeth in the chemical when drinking from the tap, it’s done a lot of the work in improving the country’s dental health.
“Fluoride has had a tremendous impact,” Laing said. “And people are more aware. They don’t let gum disease get as bad as they used to.”
Spotting a fake pair
While the future looks good, the prevalence of the medical device among today’s seniors can still be seen.
Vega usually doesn’t have much trouble pointing those wearing dentures out. As anyone involved in a trade often will, Vega admires other people’s handiwork. He’s seen a few pair that are even evident to an untrained eye.
As Dr. Michael Campbell, dentist with Lima Dental Associates, pointed out, a noticeable pair of dentures usually results from good intentions. Campbell said he’s had patients come in with celebrity magazines in hand, pointing out smiles the same way some will point out haircuts. The No. 1 celebrity request is the “Tom Cruise,” but others popular styles include the “Brad Pitt,” “Sofia Vergara” and “Barack Obama.”
But pairing a face with a set of teeth requires some finesse. Laing said the industry usually has certain kinds of teeth paired with certain face shapes — such as “square” teeth for square jaws, or the rounder “ovoid” teeth that pair better with feminine faces. Some dentists also send pictures of people who need dentures to denture makers like Vega, who pick out and set the teeth accordingly.
Individuals also have the option of picking out tooth color. At first, the industry offered 10 natural shades to choose from, but that’s changed as people looked for whiter. Now, there’s three “plus white” options that practically glow in the dark.
“I had this gal come in, and she wanted toilet-bowl-white teeth,” Laing said. “She was almost 80 years old. If she smiled in the dark, you can see them across the room. “
Campbell encourages his patients to aim for a more realistic set of teeth. Instead of bringing in a picture of a celebrity, Campbell asks patients to bring in past pictures of themselves, or to have a close family member come in to consult.
Instead of aiming for a big white smile, the idea is to ensure a person’s looks, which can change in the denture process, is restored to where it was with their natural teeth. The extra trusted eye in the room can also help curb a too-white smile.
Besides, getting a “Tom Cruise” smile isn’t exactly the pinnacle of dental care. His midline is off center, Campbell said, which lines up one of his front teeth to sit in the middle of his smile.
Change in the process
The need for full-set dentures may be slackening, but new technologies are moving forward — expanding the type of dental prosthesis and pushing the rate at which their made.
A recent addition in Vega’s lab is a three-dimension printer and scanning setup, which he can use to create digital models and recreate them out of plastic. The machine itself works by flashing a light that hardens a type of liquid. When done layer by layer, the final product can be pulled straight out of the machine.
Aaron Blevins, who runs the machine in Vega’s lab, said the new digital process cuts the time to deliver a new set of dentures in half.
“Twenty years ago when I started, we talked about digital ‘one day,’” Vega said. “People said you would never be able to make denture digitally. I made one just last week.”
He hopes to get his hands on a zirconia 3-D printer next, which can print the material constituting fake teeth. Such new technologies can be pricey, but Vega has a connection as a sponsor with a Spanish-language prosthodontist company out of California, which gave him his current 3-D printer. Vega, who is originally from Puerto Rico, speaks Spanish as his first language.
“I don’t wait until someone tells me it’s good or not. I figure it out,” Vega said. “I hope when they have a 3-D printer in zirconia, I hope they send me one.”
Prosthesis and denture options are also changing. Vega’s lab does more than just dentures, with some custom prosthesis stepping in to offer partial replacements.
Implants have also become more common. While dentures are by and large the cheaper option, more people are going with the more invasive but more stable implant surgery.
As Laing described the procedure, doctors insert screws down into a jaw bone to connect a set of teeth. It sounds simple enough, but the operation can get complicated quickly, as doctors must heavily prep the jaw bone for the addition and ensure the body doesn’t reject the new hardware while avoiding any nerve damage.
Lima Dental Associates also offers a a more stable denture that uses small connections screwed into the jawbone as anchoring points for the medical device, Campbell said.
Technology in health care
Disrupting technologies and changing landscapes in the health care field are not new, but as digital technologies evolve and their potentialities are further explored, such changes are coming faster.
“The world is advancing so rapidly now,” Lima Memorial Health System Chief Operating Officer Bob Armstrong said. “There’s a lot of disruptors. Not only in healthcare, but other in other industries as well.”
For example, the health care industry is currently dealing with the changes provided by teleconferencing, which can help connect local patients to sub-specialist doctors that can provide more in-depth consultations. Armstrong also named genetic testing and increased competition by major tech companies, such as Google and Amazon, as some of the industry’s next big changes.
And while health care providers work to ensure adoption newest technologies of proceeds smoothly and in line with business needs, Armstrong said patients too need to understand their options.
“As technologies evolve, it really does change the landscape for the patients. And one of the biggest challengers and an end user, really overwhelming, educating consumers will be a huge challenge going forward,” Armstrong said.
Reach Josh Ellerbrock at 567-242-0398.