Dentures and Partials
Complete dentures are used to replace missing teeth for people with no remaining teeth. Dentures may also be used for people who have lost several teeth. In this case, the appliance is called a partial denture or an overdenture.
Tooth loss may result from periodontal disease, tooth decay, or traumatic injury. It is very important to replace missing teeth. The ill effects of not doing so can be a shift in remaining teeth, an inability to bite and chew properly, as well as a sagging facial appearance, which makes one appear older than they are.
The beauty of dentures today is that they are designed to be comfortable and functional. They are very similar in appearance to natural teeth, and can improve a smile or facial appearance.
During the first dental visit to evaluate the need for dentures, your dentist will examine your gums and supporting bone structure to identify the appropriate treatment plan. In some cases, oral surgery is performed to correct bony ridges that may interfere with the stability of the denture. In other cases, the remaining teeth may need to be extracted before dentures can be placed. Once your dentist has decided that dentures are right for you, an impression of the gums will be made to identify every ridge and crevice to ensure the best denture fit possible. The overall process takes several appointments over one to two months.
In cases where teeth need to be removed, an immediate denture is typically placed to enable proper healing of the extraction sites and serve as an esthetic replacement for natural teeth. The immediate dentures can be easily modified for changing ridge contours during healing until final dentures can be made. In constructing the immediate dentures, dentists will use a shade and mold chart to choose replacement teeth that will most closely match your natural teeth, minimizing any changes in appearance.
Placing the Final Dentures
Complete dentures are made when gums are restored to a healthy condition and sufficient time has passed for healing. Complete dentures replace all teeth in the upper or lower jaws of the mouth. Gums will naturally shrink through the healing process of tooth loss, which normally takes from 6 to 12 months. During this period the immediate dentures may require adjustments to accommodate the changes in the gums and underlying bone structure. This could include soft and hard relining procedures made to the immediate denture.
It is extremely important to practice healthy dental hygiene when wearing dentures. There is an increased risk of developing a more serious medical condition should oral irritation result from improper dental hygiene. These conditions include, but are not limited to, periodontal disease (gum disease), leukoplakia (thickened white, potentially precancerous patches on the mucous membranes, also called smoker’s tongue) and fungal (denture stomatitis) infections.
The gums, tongue and palate should be brushed with a soft bristle brush every evening when the dentures are removed, and each day before you insert the dentures to stimulate the gums and remove plaque accumulation. When removing dentures at night, brush the dentures carefully to remove any loose debris and plaque then soak them in a cleansing solution. Your dentist will be able to recommend one. Some people keep their dentures in an ultrasonic cleaner, but keep in mind that an ultrasonic cleaner doesn’t replace brushing. When cleaning your dentures, place a towel beneath the denture or clean them over a sink filled with water to avoid breakage.
Adapting to Dentures
You should see your dentist 24 hours after delivery of your new dentures. It is not unusual to experience some initial discomfort. Minor adjustments to the denture can increase comfort and eliminate problems before they become more serious. Initially, a new denture may feel unusual in the mouth. The cheeks, lips, and tongue are very sensitive areas that require time to adjust to new dentures. It is not uncommon to bite one’s cheek or tongue while acclimating to new dentures. However, persistent soreness or irritation should be reported to your dentist.
In addition to adjusting to the feel of new dentures, it will also take some practice learning to chew with them. Begin by slowly chewing on very small pieces of soft food, using both sides of the mouth simultaneously. As your comfort and confidence increase you can progress to larger pieces of soft food and then proceed to harder foods.
Speaking may also require practice. It may be difficult to pronounce certain words. Usually, this problem is overcome within two weeks. New denture wearers can adjust more quickly to their new prosthesis by practicing reading aloud.
With a well fitting denture and practice, denture adhesives may not be necessary. Denture wearers should expect the lower denture to fit somewhat loosely. They may need to learn how to use the muscles of the cheeks and tongue to keep the denture in place. Although this might sound bothersome, with practice, it becomes second nature.
Denture Readjustment or Replacement
If your dentures fit poorly, cause persistent mouth irritation, chip, crack, or break, it is important to see your dentist. Although most gum remodeling occurs within the first year, changes in gums and bone continue throughout one’s lifetime. Over time this may result in ill fitting or loose dentures and may compromise facial appearance.
In addition, movement of the dentures on the gums may cause significant irritation. For this reason, it is recommended that complete dentures be remade or at least relined every five to seven years.
Dentures are no longer the only way to restore a mouth that has little or no non-restorable teeth. Strategically placed implants can also used to support permanently cemented bridges eliminating the need for a denture. The cost tends to be greater but the implants and bridges more closely resemble the feel of real teeth although not everyone is a candidate for implants. In addition, implants can be placed to support a complete denture that is very stable and esthetic