Dentures or ‘false teeth’ are a prosthetic device used to replace missing teeth. Two types of dentures are available — complete and partial dentures. Complete dentures are used when all the teeth are missing, while partial dentures are used when some natural teeth remain. Dentures have many benefits. They provide a natural fuller appearance to the face, support of lips and cheeks. They enable one to chew efficiently and accurately pronounce words. There often provide additional indirect benefits such as improved self-esteem and social interaction.
Complete dentures can be either ‘conventional’ or ‘immediate’. Immediate dentures are delivered immediately after the teeth have been removed and the gum tissue will heal under it. The work for a conventional denture is started in the mouth about eight to 12 weeks after the teeth have been removed. Immediate dentures are made in advance and can be positioned as soon as the teeth are removed. As a result, the wearer does not have to be without teeth during the healing period. However, bones and gums shrink over time, especially during the healing period following tooth removal. Therefore a disadvantage of immediate dentures compared with conventional dentures is that they require more adjustments/ relines to fit properly during the healing process and generally should only be considered a temporary solution until conventional dentures can be made.
A complete denture is a prosthesis that includes all teeth for the upper and/or lower arch. The upper denture can often be reliably crafted so that it will remain in place with slight suction to the upper arch. The lower denture is more difficult as the ridge of bone that supports it, now lacking teeth, will be reabsorbed over time. This alters the topography of the lower jaw, reduces the area of support diminishing the likelihood of achieving suction to hold it in place. Thus eating an apple can be a challenge to the wearer of a complete denture without anchors.
A common method to add stability to the lower arch is to place two implants in the front of the lower arch for support. This 2-implant overdenture can be snapped into place by the patient and removed for cleaning. It is regarded as a standard of care by the American Dental Association.
Does insurance cover the cost of dentures?
Most dental insurance providers cover some but rarely all of the cost of dentures. However, with an insurance pre-approval form filed by Advanced Dentistry of Richmond, it is easy to find out the specifics of your policy will cover.
How are dentures made?
The denture development process will take a few weeks and several appointments. Once Dr. Klostermyer determines what type of appliance is best for you, the general steps are to:
- A series of impressions of your jaw has to be taken and measurements of how your jaws relate to one another and how much space is between them. High-quality denture teeth matching each patient will be chosen from a variety of choices/forms/shades/shapes.
- Models in plaster are fabricated. A wax form, and/or plastic patterns in the exact shape and position of the denture is to be made. This model denture will be tried in several times during the wax stage and will be assessed for color, shape, function (speech) and fit before the final denture is prepared.
- Pressing of a final denture will be performed by a dental laboratory
- Adjustments will be made on the day of delivery of the denture and at following appointments as necessary
What do new dentures feel like?
Until the muscles of the cheeks and tongue learn to keep new dentures in place they may feel a little odd or loose for a few weeks to the wearer and during that time he/she becomes more comfortable inserting and removing them. Also, it is not unusual for minor irritation or soreness to occur and for saliva flow to increase during the period of adaptation, but these problems will diminish as the mouth adjusts.
Will wearing dentures make a person look different?
Usually, there is quite a change in the appearance of an edentulous person wearing a denture as opposed to not wearing one. Teeth play a key role in supporting the facial structure. A lack of teeth lets the facial structures around the lips and cheeks collapse. Dentures should be made to closely resemble natural teeth thus minimizing a change in facial appearance. In fact, dentures will improve your smile and enhance your facial appearance.
Will eating with new dentures be difficult?
Eating with new dentures will take a little practice and may be uncomfortable for some wearers for a few weeks. To get used to the new denture, it is recommended to start with soft foods cut into small pieces. Chew slowly using both sides of the mouth. As one gets used to new dentures, other foods can be added until a normal diet is achieved. Caution should be taken with hot or hard foods, sharp-edged items such as shells as well as small seeds. Foods that are extremely sticky or hard should be avoided. Chewing gum is not recommended for denture wearers.
Will dentures change a person’s speech?
To pronounce certain words, in the beginning, might be difficult. It might be helpful to practice by saying the difficult words out loud. With time and practice, one will become accustomed to speaking properly with dentures.
Dentures should not “click” while talking; if so – they will need adjustment. Dentures may occasionally slip when you laugh, cough, or smile. Reposition the dentures by gently biting down and swallowing.
Should dentures be worn 24 hours a day?
During the first several days after receiving your denture, a patient may be asked to wear it all the time, including during sleep. Although this may lead to temporary discomfort, it is the quickest way to identify the areas on the denture that may need adjustment. Once adjustments are made, one should remove the dentures before going to bed. This allows the gum tissues to recover and receive normal stimulation and allows cleansing by the tongue and saliva. The denture can be used again in the morning.
Should the use a denture adhesive be considered?
One may use denture adhesive:
- To enhance satisfaction with a properly constructed denture. Adhesives enhance retention, stability, bite force, and an individual’s sense of security.
- To assist individuals with dry mouth conditions that lessen denture adherence, such as individuals taking cold medications, those with neurologic disabilities including strokes, and the elderly.
- To provide added stability and security for those who place unusual demands on facial muscles, such as public speakers or musicians.
When shouldn’t denture adhesives be considered?
There are situations when denture adhesives should not be used. Those cases include:
- When it is used as a “fix” for ill-fitting or poorly constructed dentures. If dentures begin to feel loose, are uncomfortable or cause sores to develop, they should be professionally adjusted.
- When the dentures have not been evaluated for a long time. Dentures rest on gum tissue and the jawbone, which shrink and deteriorate, respectively, over time. Therefore, the real problem might be a need for a denture adjustment or new dentures.
- When oral hygiene practices cannot be sustained.
- When adhesives have been used for a long time, especially when visits to the dentist are infrequent, and when the frequency and volume of the adhesive use increases. These developments may indicate the need for a denture adjustment or new dentures.
- When any known allergy exists to the adhesive’s ingredients.
How are denture adhesives applied?
- The minimum amount necessary is being used to provide the maximum benefit. An application of a small amount should be started with, and then gradually increase the amount until one feels comfortable.
- The adhesive should be applied thinly and evenly on the tissue bearing surface of the denture.
- It should be applied or reapplied when necessary to provide the desired effect.
- The dentures should be always thoroughly clean before application.
- And again: adhesives work best with a well-fitting denture.
What are the types of denture adhesives?
Paste application: A small amount is applied to a dry or preferably wet denture. Placement of adhesive close to the denture borders should be avoided. If the adhesive oozes out less of the product should be used. For dentures on the upper jaw, three short strips of adhesive should be applied — or a series of small –pea size- dots — along with the ridge area and one down the center. For dentures on the lower jaw, three short strips of adhesive are recommended for application — or a series of small dots — in the center of the ridge area.
Powder application: A thin, uniform layer throughout the tissue-bearing surface of the denture should be sprinkled on it. Excess powder needs to be shaken off and then the denture gets pressed into place. Powders may be preferred over pastes because they are easier to clean off the denture and tissue. In addition, they don’t have the same tendency as pastes do to “shim” (keep the denture away from the tissue).
Are denture adhesives safe?
Dental adhesives are safe as long as they are used as directed. With well-fitting dentures the adhesive is only used to provide added stability, there should be no ill effects. If adhesives are used excessively to fill voids for an ill-fitting denture, they can be harmful to the underlying soft and hard tissues. Occasionally, in these cases, inflammation of the soft tissues can result. In addition, because of its movement on the soft tissue and underlying bone, an ill-fitting denture can cause bone loss. As a result of ill-fitting dentures often crack, fracture and break.
Partial removable dentures (RPD)
Partial removable dentures are as common as complete dentures and cover the replacement of some of the teeth. Removable partial dentures (RPDs) are held in place with retentive clasps on the remaining teeth and can be removed for cleaning. Often the surface of adjacent/ abutment teeth will be slightly modified to enhance and anchor the clasp mechanism of the RPD. The edentulous spaces will be filled with denture teeth matching the shape and shade the remaining teeth.
Flexible partial dentures utilize flexible materials to anchor teeth, often on surrounding adjacent teeth, for added support. They are advertised as being more esthetic with gum colored plastic clasps instead of metal clasps. They lack the firm adjustable clasps of FPDs and are generally regarded as a non-permanent prosthesis.
A removable partial denture should fit snug, tight, and firmly and evenly rest in the remaining teeth and soft tissue whereas a flexible partial will reduce bone structure much faster due to its uneven pressure points on the underlying bone. If flexible partial dentures are utilized –- this should only be in a situation requiring a temporary prosthesis.
Partial denture before and after
A complete set of high quality upper or lower prosthetic teeth can be immediately fixed on a minimum of four or more dental implants that have been securely anchored in the jaw. This is what is known as a fixed hybrid restoration or fixed hybrid denture, and it is recommended for those who have lost or are about to lose all of their upper or lower teeth. As in the case of a complete denture, the hybrid restoration supplies both new prosthetic teeth and gum tissue. This procedure provides a permanent functional dental restoration with unsurpassed esthetics, resulting in a dramatic quality of life improvement for patients.
The specialized implants are designed for immediate function and typically eliminate the need for bone grafting should sufficient bone be available. Because the fixed hybrid restoration does not cover the palate of the mouth, patients are better able to enjoy the taste and temperature of foods. Especially those patients who are prone to gagging with a complete upper denture will find great relief with a palate-free restoration.
If a patient still has a few of his/her natural teeth, they will be removed in the same surgery as the placement of the implants, and on the same day, the new “fixed” restoration will be secured on the implants. The entire process, including any necessary extractions, can be completed in one day, typically using I.V. sedation, with minimal recovery time. Patients receive a provisional fixed hybrid dental restoration on the day of surgery, and this provisional restoration is replaced by a permanent restoration approximately three months later. During the time the provisional is worn, the function and appearance of the restoration are observed and fine-tuned so that when the permanent restoration is fixed on the implants, it meets all expectations for best function and esthetics.
The immediate delivery of an implant-supported hybrid restoration is an advanced procedure that is typically performed by a qualified interdisciplinary team, including an Implant Surgeon, a Prosthodontist, and Dental Technician. The procedure is variously referred to as “all-on-four dental implants,” “all-on-four dentures,” “one-day teeth replacement,” and often in dental marketing as “same day smile” or “smile in a day.”
The only disadvantage with the all-on-four approach is, that if one implant does not osseointegrate (grow into the bone), and this case is on a hold, as on 3 implants it would be overloaded. This risk can be mitigated by placing more than the minimum number of implants per arch.
Final hybrid restorations should be delivered in ceramic, as denture teeth over years have the tendency to wear off and create problems like teeth fracturing off and the loss of the vertical dimension.
Denture home care
12/26/2015 by Dr. Ursula Klostermyer