Dentures

Full or partial tooth loss, if left untreated, doesn’t just affect a person’s self-image — it can also increase the risk of developing nutritional problems and other systemic health disorders. Fortunately, there’s a reliable and time-tested method for treating this condition: dentures.

A denture is a removable replacement for missing teeth and adjacent tissues. They are made of acrylic resin, sometimes in combination with various metals.

Types of Dentures

There are several varieties of dentures available to address specific issues, from partial dentures to implant-supported overdentures. The best option for you will depend on your individual situation.

  • Complete dentures.Complete dentures are made when all of your natural teeth are missing. You can have a complete denture on your upper or lower jaw or both. These dentures can be fabricated to conform to your mouth with near-perfect accuracy.

  • Immediate dentures.These are usually a temporary means of helping you transition to successful denture wearing. Because of the muscular readjustment required, as well as the natural shrinkage of gums, the dentures which are placed immediately after tooth extraction won’t fit as well as permanent dentures made when the healing is complete. They do, however, provide you with new teeth right away, and give you time to adjust.

  • Overdenture.An overdenture is a removable denture that fits over a small number of remaining natural teeth or implants. The natural teeth must be prepared to provide stability and support for the denture.

  • Implant-supported overdentures. To increase the stability of a lower or upper denture, it’s possible for it to be securely anchored using two or more dental implants. The upper jaw requires more implants (generally three or more) than the lower jaw due to a lesser bone density. Many people find this option offers a great balance of comfort, functionality, and value.

  • Transitional partial dentures.These relatively inexpensive removable plastic dentures serve as a temporary tooth replacement and space maintainer as you wait for your mouth to heal from tooth extraction, for example. Once the healing process is complete, dental implants can be placed.

  • Removable partial dentures (RPDs).Removable partial dentures usually consist of replacement teeth attached to pink or gum-colored plastic bases, which are connected by a well-constructed metal framework (usually made of cast Vitallium). Removable partial dentures attach to your natural teeth with metal clasps or devices called precision attachments. Precision attachments are generally more esthetic than metal clasps and are nearly invisible. Crowns on your natural teeth may improve the fit of a removable partial denture and they are usually required with attachments. Partials with precision attachments generally cost more than those with metal clasps.Partial dentures are often a solution when several teeth are missing, and serve a much lighter and less obtrusive solution than dentures made of plastic. They are typically more expensive than plastic dentures, but they fit much better and remain less expensive than implants or fixed bridgework.

Complete vs. Partial Dentures

Complete dentures replace all the teeth, while a partial denture fills in the spaces created by missing teeth and prevents other teeth from changing position.Candidates for complete dentures have lost most or all of their teeth. A partial denture is suitable for those who have some natural teeth remaining. A denture improves chewing ability and speech and provides support for facial muscles. It will greatly enhance the facial appearance and smile.

Conventional vs. Immediate Dentures

Complete dentures are called “conventional” or “immediate” according to when they are made and when they are inserted into the mouth. Immediate dentures are inserted immediately after the removal of the remaining teeth. To make this possible, the dentist takes measurements and makes the models of the patient`s jaws during a preliminary visit.

An advantage of immediate dentures is that the wearer does not have to be without teeth during the healing period. However, bones and gums can shrink over time, especially during the period of healing in the first six months after the removal of teeth. When gums shrink, immediate dentures may require rebasing or relining to fit properly. A conventional denture can then be made once the tissues have healed. Healing may take at least 6-8 weeks.

How are dentures made?

Making quality dentures is a blend of science and art.The denture process takes about one month and five appointments: the initial diagnosis is made; an impression and a wax bite are made to determine vertical dimensions and proper jaw position; a “try-in” is placed to assure proper color, shape, and fit; and the patient`s final denture is placed, following any minor adjustments.

  1. First, an accurate impression (mold) of your jaw—as well as the alveolar ridges on the top and bottom of your mouth—is made using special materials. In addition, measurements are made to show how your jaws relate to one another and how much space is between them (bite relationship). The color or shade of your natural teeth will also be determined. The impression, bite, and shade is given to the dental laboratory so a denture can be custom-made for your mouth.

  2. The dental laboratory makes a mold or model of your jaw, places the teeth in a wax base, and carves the wax to the exact form wanted in the finished denture. Working together, the dentist and lab technician choose from among many different sizes and shapes of prosthetic teeth to re-create a natural-looking smile. Usually, a “wax try-in” of the denture will be done at the dentist`s office so any adjustments can be done before the denture is completed.When everyone is satisfied with the result, the temporary dentures are made in permanent form.

  3. The denture is completed at the dental laboratory using the “lost wax” technique. A mold of the wax-up denture is made, the wax is removed and the remaining space is filled with pink plastic in dough form. The mold is then heated to harden the plastic. The denture is then polished and ready for wear.

Getting Used to Your Denture

At first, wearing dentures may require some getting used to in terms of talking and eating, as the dentures become “balanced” in the space formerly occupied by the teeth. But over time, the muscles, nerves, and ligaments of the mouth learn to work in new ways, which allows these functions to occur normally. Dentures also help support the facial skeleton and the soft tissues of the lips and cheeks, which can help create a more youthful appearance.

For the first few weeks, a new denture may feel awkward or bulky. However, your mouth will eventually become accustomed to wearing it. Inserting and removing the denture will require some practice. Your denture should easily fit into place. Never force the partial denture into position by biting down. This could bend or break the clasps.

At first, you may be asked to wear your denture all the time. Although this may be temporarily uncomfortable, it is the quickest way to identify those denture parts that may need adjustment. If the denture puts too much pressure on a particular area, that spot will become sore. Your denture can be adjusted to fit more comfortably. After making adjustments, you may need to take the denture out of your mouth before going to bed and replace it in the morning.

Start out by eating soft foods that are cut into small pieces. Chew on both sides of the mouth to keep even pressure on the denture. Avoid sticky or hard foods, including gum.

Common Concerns with Dentures

  • Eating will take a little practice. Start with soft foods cut into small pieces. Chew slowly using both sides of your mouth at the same time to prevent the dentures from tipping. As you become accustomed to chewing, add other foods until you return to your normal diet.

  • Continue to chew food using both sides of the mouth at the same time. Be cautious with hot or hard foods and sharp-edged bones or shells.

  • Some people worry about how dentures will affect their speech. Consider how your speech is affected when you have a number of your natural teeth missing.

  • Pronouncing certain words may require practice. Reading out loud and repeating troublesome words will help. If your dentures “click” while you`re talking, speak more slowly. You may find that your dentures occasionally slip when you laugh, cough or smile. Reposition the dentures by gently biting down and swallowing. If a speaking problem persists, consult your dentist.

Taking Care of Your Denture

It’s best to stand over a folded towel or a sink of water when handling your denture, just in case you accidentally drop it. Brush the denture (preferably with a denture brush) daily to remove food deposits and plaque, and keep it from becoming permanently stained. Avoid using a brush with hard bristles, which can damage the denture. Look for denture cleansers with the American Dental Association (ADA) Seal of Acceptance. Pay special attention to cleaning teeth that fit under the denture`s metal clasps. Plaque that becomes trapped under the clasps will increase the risk of tooth decay.

Hand soap or mild dishwashing liquid to clean dentures is also acceptable. Other types of household cleaners and many kinds of toothpaste are too abrasive and should not be used for cleaning dentures. A denture could lose its proper shape if it is not kept moist. At night, the denture should be placed in soaking solution or water. However, if the appliance has metal attachments, they could be tarnished if placed in soaking solution.

Even with full dentures, you still need to take good care of your mouth. Every morning, brush your gums, tongue, and palate with a soft-bristled brush before you put in your dentures. This removes plaque and stimulates circulation in the mouth. Selecting a balanced diet for proper nutrition is also important for maintaining a healthy mouth.

Adjustments

Over time, adjusting the denture may be necessary. As you age, your mouth naturally changes, which can affect the fit of the denture. Your bone and gum ridges can recede or shrink, resulting in a loose-fitting denture. Loose dentures can cause various problems, including sores or infections. Dentures that do not fit properly can be adjusted. Avoid using a do-it-yourself kit to adjust your dentures, as this can damage the appliance beyond repair. Glues sold over the counter often contain harmful chemicals and should not be used on a denture.

If your denture no longer fits properly, if it breaks, cracks or chips, or if one of the teeth becomes loose, see your dentist immediately. In many cases, dentists can make necessary adjustments or repairs, often on the same day. Complicated repairs may require that the denture be sent to a special dental laboratory.

Over time, dentures will need to be relined, rebased, or remade due to normal wear. To reline or rebase a denture, the dentist uses the existing denture teeth and refits the denture base or makes a new denture base. Dentures may need to be replaced if they become loose and the teeth show signs of significant wear.

Denture Adhesives

Denture adhesives can provide additional retention for well-fitting dentures. Denture adhesives are not the solution for old, ill-fitting dentures. A poorly fitting denture, which causes constant irritation over a long period, may contribute to the development of sores. These dentures may need a reline or need to be replaced. If your dentures begin to feel loose, or cause pronounced discomfort, consult with your dentist immediately.

Fixed Dentures

If you have lost an entire arch of teeth (top and/or bottom), or are soon to have your remaining teeth removed because they are too unhealthy to save, you may be able to replace them with fixed dentures supported by dental implants. Doctors and patients alike prefer fixed over removable dentures because they:

  • Look, feel and function just like natural teeth

  • Don’t slip when you eat or talk

  • Prevent bone loss in the jaw

  • Last a lifetime

How It Works

Dental implants serve the same purpose as the roots of natural teeth: anchoring the replacement teeth to your jawbone. Just like natural tooth roots, they lie under the gum line and therefore are not visible in the mouth. Only the lifelike prosthetic teeth attached to them (the fixed denture) can be seen by you or anyone else. Because dental implants are made of titanium, a metal that has the unique ability to fuse to living bone, they are extremely stable and reliable. How many implants are needed? The number varies because each individual has unique conditions: Depending on the volume and density of the bone in your jaw, you will need as few as four implants or as many as six for your new teeth to function as well as a set of healthy, natural teeth.

What to Expect

The surgery to place dental implants that support a fixed denture is a simple, routine procedure carried out in an office setting, under local anesthesia in most cases. (If you need to have failing teeth removed, that will be done first, often the same day your implants are placed). After numbing the area, the appropriate number of implants will be placed in your jaw at precisely planned angles and positions to maximize support and avoid anatomical structures such as nerves and sinuses. Depending on how many implants are needed, the surgery can take anywhere from one to three hours. Most people who have dental implants placed find that any post-operative discomfort can be managed with over-the-counter anti-inflammatory medication such as ibuprofen or acetaminophen. Some don’t even need to take that.

What happens immediately after surgery will depend on what’s best to promote healing in your individual situation. Sometimes a set of temporary teeth can be attached immediately so that you can leave the office with new teeth. A few months later, your permanent replacement teeth with be installed. In other cases, the implants will be left to heal for several months before any teeth are attached. Sometimes that is the best way to ensure that the implants remain undisturbed as they go through the process of fusing to your jawbone, which is known as osseointegration.

In either case, you will need to go easy on your newly placed implants during the crucial healing phase following surgery. You will be advised to eat a softer diet and avoid hard, chewy foods until the process of osseointegration is complete — about three months. While this may seem like a long time, keep in mind that people who wear removable dentures often avoid these foods permanently. The good news is that once your implants have fused to your jawbone and your new permanent teeth are attached, you will be able to eat anything you want. In fact, you are likely to forget you even have dental implants!