Prosthetic Dentistry of Tumwater

Having denture problems?

I have seen many people suffer with slipping, poorly fitting, unattractive dentures or simply dentures that are just too old.
The first question for someone with denture problems is, “How old are your dentures?” The second question is, “Who made them.”
If your dentures are over five to eight years old, you need a new set. Dentures are made of PMMA, a type of acrylic polymer. PMMA is great if cared for properly but the expected lifetime of PMMA is only eight to ten years. After ten years, the PMMA becomes more porous and can hold on to some nasty bacteria and even fungus. Yes, fungus. It also becomes more brittle and can break easily.
Yes, I have heard of many people who wear dentures much longer than that. This is really risky and may lead to excessive bone loss, overgrowth of gum tissue, infections and even worse problems. One recent research article in a very trusted journal even suggested that sleeping with old dentures in your mouth can make you twice as likely to get pneumonia. They called dentures sponges for bacteria.
Now, we come to the second question, “Who made your dentures.”
Is there a difference? Yes.
In Washington State, we have three different types of denture providers. General dentists have been making complete dentures since dentures became popular in the eighteenth century. Nowadays, many general dentists just prefer to not make complete dentures. It is time consuming and the follow up problems can really stress some people.
The second provider group are denturists. Denturists are not dentists. They are technicians who have one to two years of training in a technical program. It became legal for denturists to make dentures in Washington State around the year 2000. The legislature decided that they would allow denturists to practice in order to provide less expensive denture service for our poorer citizens.
The third provider group are prosthodontists. This is me. A prosthodontist is a dentist who went back to school full-time in a university or hospital based residency program for an extra two or three years to study dentures, implants, crowns and bridges. A prosthodontist is the only type of dentist in the United States who can legally say that he or she is a specialist in dentures.
There was a time when complete dentures were the only way to replace missing teeth. For people who are comfortable with complete dentures I say, “good for you.” There are many thousands of others who don’t do so well with dentures, especially those replacing lower teeth. Thankfully, we
Talk soon,

Rick Jude, DMD

A few thoughts on dental insurance…

We often hear our patients voice frustration over their “lousy” dental insurance plan and the very limited benefits that they pay out. And understandably so. When dental insurance, as we know it, was first designed in the 1960’s, the maximum benefit the insurance company would pay was $1000.00 per person, per year. Fast forward fifty years…and guess what? They’re still paying about $1000.00 per person, per year! Needless to say, dental insurance has not kept up with inflation. And when you combine this low maximum payout with all of the limitations and exclusions that most dental plans have….well, you get the picture.

We like to help our patients see their dental insurance in a different light. We prefer to use the term “dental benefits”, explaining that it’s really more of a coupon-like discount that can be applied to some treatments rather than insurance “coverage”. It’s there to provide a little help.

It’s important to know that Dr. Jude will never make a treatment recommendation based upon the limitations of your insurance plan, but that he will always make treatment recommendations based upon a thorough examination of your mouth and his years of experience and expertise. He can often provide various treatment options for you that will best work within your budget. And you can rest assured that the administrative team, Jessica and Allison, will help you to maximize the use of your insurance benefits whenever possible!

Give us a call if you have any questions about your dental benefits. We’re here to help!

– Allison W.

Your part of the equation: What you need to do to keep your teeth

Floss the ones you want to keep!

Mom was right…


1.  Floss properly at least once a day


Notice that I list flossing first. That’s because fluoride cannot penetrate plaque. (Plaque is the sticky white substance that builds up on your teeth.  It is made of food debris, bacteria and dead skin cells)  So, brushing with a great fluoride toothpaste or rinsing with a fluoride containing rinse simply doesn’t work until you have removed the plaque from in between your teeth.

2.  WaterPik (unless your dentist says otherwise)

No, I do not own stock in WaterPik. These machines are simply that good.  My advice is to stick with WaterPik brand and to use it at least once per day to flush toxins from around the periodontal pocket and in between the teeth.   Yes, this is what your parents or grandparents were told to use in the seventies.  Then, for some reason, they fell out of favor.  Well, they’re back and patients who use them have the nicest looking gums I have ever seen!

These days, we’re all about getting rid of inflammation. In the mouth, Waterpik use really reduces inflammation around the gums.

Just remember three things.  First, please read the directions.  Second, start on a low setting and stay below 80 percent for a year or so.  Third, use lukewarm water.  Not hot, not cold – but lukewarm.

3.  Brush Properly, 2 – 3 times a day

By properly, I mean slowly and gently, but thoroughly. Start with your upper teeth and brush cheek side of each tooth.  Then brush the palate side of each tooth and finally, the biting surface of the back teeth.  After that, you are ready to do the same on the lower arch.

For most people, an electric toothbrush (Sonicare or Oral B) can do a better job than an old-fashioned toothbrush.

4.  Watch your sugar intake

Sugar is sneaky. It’s in everything! Or so it seems….

Every time you consume sugar, so do the bacteria in your mouth. The bacteria convert it to acid and this acid eats holes in your teeth. That simple! That is how you get cavities.  Also, be careful of highly acidic drinks such as colas or other sodas.

Unexpected sources of sugar include but are not limited to:

  • Coffee – specialty coffees often contain syrups… syrup means sugar
  • Sports drinks – yep, often a source of sugar
  • Breath mints

5.  Consider fluoride

Yeah, yeah… I know that many people think that fluoride is from the devil. However, just like so many other things in life, I believe it is about the amount you use.  Too much fluoride is a very bad thing.  So, keep fluoride-containing products away from young kids.

If you are past 18 or 19 years of age, you no longer need to swallow fluoride supplements. But, you do need to use topical fluoride on your teeth.

6Of course, see your dentist and hygienist regularly

Do all of the above and your future dental problems should decrease greatly. Just remember that while prevention plays a very important part here, you do still need to see us.  Most people need to see their dentist and hygienist twice a year.  Some people can cut back to once a year but some people need to be seen three or four times per year.

It is your responsibility to remove plaque and left over food from your teeth several times a day. That is the reason for the toothbrush, floss and WaterPik.  Plaque is soft and easily removed.

Tartar or dental calculus is hard and not so easily removed. That is your hygienist’s job.

If tartar is not removed regularly, it can greatly increase the occurrence of gum disease (periodontal disease) and/or dental decay (cavities).


I sincerely hope this helps,


Rick Jude

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