Dentures are removable appliances that replace missing teeth. Complete dentures replace all of the teeth and partial dentures replace some of the teeth in the upper or lower jaw. Dentures help support the muscles of the face and lips for a better appearance, as well as improve chewing function. However, you can never achieve the biting forces of natural teeth, fixed bridges, or implant-supported replacements. Dentures tend to be bulky and will move some while chewing and speaking. They require adjustments, relines, and repairs.
How Are Dentures Made?
Making a denture involves several steps. In the first appointment, an impression is made of the jaw or remaining teeth. At the second appointment, a bite is made and then tooth color and shape are selected. The lab places the teeth in wax to give an idea of what the teeth’s shape, color, and placement will look like. During the third appointment, the teeth that had been set in wax are tried in the mouth to check the appearance and the bite. For the last appointment, the final denture is placed in the mouth and adjusted.
Living With Dentures
Initially, there will be an adjustment period ranging from days to weeks, and speech will be temporarily affected. Chewing with dentures will be a new learning experience. Sore spots usually occur in the mouth and will require some adjustment. Alternatives to complete dentures involve dental implants and alternatives to partial dentures involve fixed dental bridges or implants.
Are Your Dentures Killing You?
Many of our elderly are suffering needlessly. They are becoming weak and their life spans are being shortened due to malnutrition. Some are rapidly declining, while others are declining slowly and subtly. It is happening in our nursing facilities and in our homes. This malnutrition comes from an inability to chew food adequately due to poor fitting dentures. The jawbone shrinks from years of wearing dentures. Now the dentures move and there is little bone to hold them in place. Meats and high fiber foods like vegetables and breads are avoided because the chewing force is not strong enough, leaving the high fatty foods for consumption. Studies have shown that this type of diet can limit one’s lifespan and increase the risk of illness. This tragedy can be prevented by placing “implants” (titanium cylinders) in the remaining bone. Attachments are placed in the denture which fit over the implants. This will hold the denture in place where greater biting forces can be generated. Many times this can be accomplished in one dental visit. In other instances, it may take a number of visits over a period of time. My greatest reward is when patients tell me how they are now able to eat foods that they hadn’t been able to eat in years. Don’t let yourself or your loved ones suffer from malnutrition due to poor fitting dentures. Enjoy the foods you once loved and the better health that modern dental implants can offer.
Conventional complete dentures, or full dentures, are supported by the tissues. Their resistance to dislodgement from sticky foods is prevented by three factors; the suction contact of the denture base and the underlying tissue, the tongue’s ability to hold it in place, and the seating of the denture when closing.
Benefits of Conventional Dentures
Upper dentures have suction, but lower dentures usually don’t. That is why people tend to like their upper and hate their lower. The resistance to biting forces is from the underlying bone and gums. The thicker and harder the bone and tissue, the better the resistance. The thinner the bone and tissue, the worse the resistance. The jawbones resistance to biting forces was designed to be internal from the roots of the teeth imbedded in the bone. It was not designed to resist forces on top of the tissue and bone. Therefore, all tissue supported dentures will cause pressure resorption: the dissolving of the gum and tissue over time under a denture. This is why the older a denture is, the less tightly it fits. People spend over half of a billion dollars every year on denture adhesives. Alternatives to denture adhesives would be a denture reline: an implant retained denture or root retained denture would have better retention and resistance to pressure resorption.
A complete or partial denture can be supported by leaving roots in the bone that the denture fits over. Usually, two to four roots are left on each side of the upper or lower jaw. Root canals are performed on the teeth; the teeth are trimmed so they are even with the gum line and then a post is cemented into the roots. This post has an attachment that partners with an attachment in the denture. In this way we have made the denture more resistant to dislodging forces, as well as more resistant to biting forces. It stays in place better and you can bite harder. One disadvantage is that the roots can still get cavities. Pressure resorption is also much less than on tissue borne dentures so the bone is preserved for possible implant placement later.
An immediate denture is a process where the denture is made before the teeth are extracted. The denture is placed immediately after the extractions. This can be done on the upper or lower jaw, or both. The advantage to this method is that you don’t have to go around with missing teeth. The disadvantage is that this method is not as accurate as the traditional method of extracting the teeth and healing for 6 to 8 weeks before making the denture. There will be more sore spots under the denture and it will be more difficult adjusting to the denture. So you will probably need one or more relines to compensate for shrinkage. The other disadvantage is that you cannot try the denture to look at the size, color and how the teeth are set prior to receiving it. At Delmarva Dental Services, many times your dentist will make a more cosmetic denture in about a year after the immediate.