Partial & full dentures by Advanced Dentistry Of Richmond

What are dentures?

Dentures or ‘false teeth’ are a prosthetic device used to replace missing teeth. A dentures offers a prosthetic gum material, teeth, and a surface to anchor it to the underlying arch. Two types of conventional dentures are available — complete and partial dentures. Edentulous patients need complete dentures.  Those with some healthy teeth are candidates for partial dentures. Dentures have many benefits. They provide a natural fuller appearance to the face, support of lips and cheeks. They enable one to chew well and to better pronounce words. Dentures often provide indirect benefits such as improved self-esteem and social interaction.

What’s the difference between full and partial dentures?

Patient missing all teeth are candidates for full or complete dentures. A complete denture includes all teeth, gum and anchoring surface for the upper and/or lower arch. For those missing a few teeth, a partial denture is the most suited prosthesis.

How are dentures attached?

Dentures are available in fixed or removable forms. Fixed dentures screw  into implants. Removable dentures attach with suction, adhesives, clasps to teeth or snap onto implants.

Immediate vs. Final

Dentures are either immediate or final. Fabrication of final dentures occurs once the underlying tissues have healed. Use of immediate dentures occurs following a tooth extraction or implant placement.

Overview of different complete or partial and fixed or removable denture solutions.

Implant
Supported
Fixed or Removable

Denture

Partial (some teeth remaining)Full or Complete (no teeth remaining)
NoRemovable partial denture held with claps on remaining teethFull arch conventional denture held with suction
YesRemovable Implant supported Removable Partial Denture (RPD) held in place with retaining attachment on implantComplete denture held in place with retaining attachments on an implant. This is called an implant supported overdenture.
Fixed Crowns or bridges.Arch is screwed into place can only be removed by a dentist. This is called a Hybrid.

How is a conventional full denture be held in place?

The upper denture is designed so that it will remain in place with slight suction to the upper arch. The lower denture is more difficult to hold in place. The ridge of bone that supports it, now lacking teeth,  reabsorbs over time. This alters the bony topography of the jaw and reduces the area of support. Thus eating e.g. an apple can be a challenge to the wearer of a complete denture without anchors

Conventional denture for the lower arch dentist richmond va
Conventional denture for the upper arch.

Conventional denture for the lower arch.

Implant supported full, removable denture for the lower arch.

Implant supported full, removable denture for the lower arch.

How are implants used to hold a full denture in place?

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 snaps into place by the patient. It’s removed for cleaning.

How are implants used to hold a full denture in place?

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 snaps into place by the patient. It’s removed for cleaning.

What are a Removable Partial Dentures (RPD)

Removable Partial Dentures (RPD) are as common as complete dentures. They replace only some of the teeth. Retentive clasps hold removable partial dentures in place on the remaining teeth. Removal of cleaning is easy.  Often the surface of adjacent/ abutment teeth must be slightly modified. This enhances and anchors the clasp mechanism of the RPD.  Denture teeth, matching the remaining teeth in shape and shade, fill edentulous spaces.

Flexible Partial Dentures  (FPD) use flexible materials

Flexible Partial Dentures  (FPD) use flexible materials to attach to adjacent anchor teeth. These attachments have gum-colored plastic clasps. The manufacturer promotes them as being more esthetic than metal clasps. FPDs are generally regarded as a non-permanent prosthesis.

Denture should fit precisely

A removable partial denture should fit precisely. It’s held in place by clasps to the remaining teeth and sits on soft tissue. A flexible partial will reduce bone structure much faster than a fixed denture. This is due to its uneven pressure points on the underlying bone. Flexible partial dentures provide only a temporary prosthetic solution.

A flexible partial denture - ideally for short term wear.

A flexible partial denture – ideally for short term wear.

A partial denture with clasps.

A partial denture with clasps.

Locator implant-supported removable partial denture

Locator implant-supported removable partial denture

What is a hybrid fixed denture?

A hybrid fixed denture is also known as a fixed hybrid restoration. Dentists recommend this for those who have lost or are about to lose all their upper or lower teeth. Hybrid dentures screw into the implants set in the arch and only a dentist can remove it. A complete upper or lower denture can be immediately fixed on at least four or more dental implants. This solution is called an all an “all-on-four” or an “all-on-five”. The number refers to the number of implants on that arch that support the fixed denture.

Hybrid fixed denture also aka all on four.

Hybrid fixed denture also aka all on four.

How long is the placement and healing time for a hybrid?

If a patient still has a few of his/her natural teeth, they are removed before implant placement.  Designed for immediate function, specialized implants can reduce the need for bone grafting.  These are placed immediately following tooth extractions.  Finally, a new provisional fixed denture is secured to the implants.  Thus a hybrid denture is attached immediately following extractions and implant placement.  The entire process, including any necessary extractions, can be achieved in one day. During the next 12 weeks, the underlying gum tissue heals and adapts to the denture.  In a series of follow up appointments adjustments enhance the fit and function.    Most specialists use I.V. sedation to reduce patient discomfort during the procedure.

What kind of dentists do hybrid restorations?

The immediate delivery of an implant-supported hybrid restoration is an advanced procedure. This is typically performed by a qualified interdisciplinary team. It might include an Implant Surgeon, a Prosthodontist, an Anesthesiologist, and Dental Technician. The procedure is referred to as  “all-on-four dental implants”. “All-on-four dentures” or “one-day teeth replacement” are other common names.  Sometimes marketing lines including  “same day smile” or “smile in a day” are used.

What are some of the risks with a hybrid denture?

A risk with the all-on-four approach is if one of the implants does not osseointegrate (grow into the bone).  This overburdens the remaining 3 implants.  If this happens the case must be delayed, until another implant can be placed.  This risk can be mitigated by placing more than four, the least number of required implants per arch. Final hybrid dentures should be fabricated using ceramic. Ceramic teeth resist wearing, fracturing and the loss of the vertical dimension (length).

What are the pros and cons of implant supported dentures?

Implant supported dentures are less costly than replacing individual teeth with implants. Typically four to six implants per arch hold the denture firmly in place. This gives the wearer a high level of comfort and confidence. The implants end the need for suction or adhesives to hold the denture in place. They also transfer the stress from chewing to the underlying bone. This results in a slower rate of bone loss in comparison to a conventional denture solution. Implant placement is not cheap. Thus an implant supported denture has a higher price than a conventional denture.

What are some of the differences between a conventional and a hybrid denture?

A fixed hybrid restoration does not cover the palate of the mouth. Thus patients are better able to enjoy the taste and temperature of foods. Some patients, with a complete upper denture, are prone to gagging.  These, in particular, will appreciate a palate-free fixed restoration.

What is the difference between final and immediate dentures?

Complete or partial dentures can be either ‘final’ or ‘immediate’. The delivery of immediate dentures takes place immediately after the tooth extraction.  Gum tissue will heal under the newly placed denture. The work for a final denture starts about three to six months after the tooth extraction. 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 can shrink over time. This happens especially during the healing period following tooth removal. During the healing process, immediate dentures need many adjustments and reline to fit. They should only be considered a temporary solution until final dentures are made.

Does insurance cover the cost of dentures

Most dental plans contribute to the cost of a denture. The cost of a denture will likely exceed the annual policy limit of most dental insurance plans.

What are the steps to getting a denture?

You and Dr. Klostermyer must first determine what type of denture is best for you. The development and fitting process will take several appointments over a few weeks.

The general steps include:
A  series of impressions are taken of your arches. Measurements are taken to ensure a proper bite position.

  1. You approve high-quality, natural looking teeth that match your face and age. These are selected from a variety of forms/shades/shapes.
  2. Casts (plaster models) of your mouth are fabricated. The lab technician fabricates a wax denture. This will be tested for esthetics and speech function during a try-in appointment.
  3. The results of the try-in appointment must be satisfactory. Then the dental laboratory can manufacture the final denture.
  4. Dr, Klostermyer makes final adjustments to the denture on the day of delivery. Further adjustments can be made during follow-up appointments as necessary.

What do new dentures feel like?

The muscles of the cheeks and tongue must “learn” to keep new dentures in place. They may feel a little odd or loose for a few weeks. During this time the wearer becomes more comfortable inserting and removing them. Also, minor irritation or soreness and increased saliva flow may occur. These problems will diminish as the mouth adjusts.

Will wearing dentures make a person look different?

Teeth play a key role in supporting the facial structure around the mouth. A lack of teeth lets the facial structures around the lips and cheeks collapse inward. The change in the appearance of a toothless person wearing a denture can be dramatic.

Dentures should resemble the shape, color, and position of natural teeth. This enhances a natural facial appearance. In summary, dentures will improve your smile and improve your facial appearance.

Will eating with new dentures be difficult?

Eating with new dentures will take a little practice.  some wearers may experience discomfort for a few weeks. To get used to the new denture, it is recommended to start with soft foods cut into small pieces. Chew using both sides of the mouth.

As one gets used to the 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?

At first, the pronunciation of certain words 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 clearly with dentures.

Dentures should not “click” while talking; if so – they will need to be altered. Dentures may slip when you laugh, cough, or smile. Reposition the dentures by gently biting down and swallowing.

Should dentures be worn 24 hours a day?

After receiving your denture, you may be encouraged to wear it all the time -even while sleeping.  This may lead to temporary discomfort. Yet it is the quickest way to identify the areas needing 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. It allows cleansing by the tongue and saliva. The denture can be used again in the morning.

Should the use of denture adhesive be considered?

Denture adhesive is used:

  • To enhance retention, stability, bite force, and an individual’s sense of security.
  • To assist individuals with dry mouth conditions that lessen denture adherence. Individuals taking cold medications. Those exhibiting neurological disabilities, stroke victims, and the elderly.
  • To provide added stability and security for those who place unusual demands on facial muscles. This includes public speakers or musicians.

What are the types of denture adhesives?

Dental adhesives come in both paste and power forms. A well-fitting denture needs little or no adhesive.

When shouldn’t denture adhesives be considered?

There are situations when denture adhesives should not be used. These cases include:

  • When it is used as a “fix” for ill-fitting or poorly constructed dentures. Loose, uncomfortable dentures can cause sores to develop. Have your dentist adjust them.
  • When the dentures have not been evaluated or adjusted for a long time. Dentures rest on gum tissue and the jawbone. These can shrink and deteriorate over time. Thus, 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. When visits to the dentist are infrequent. 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 adhesives’ ingredients.

How are denture adhesives applied?

  • The smallest amount necessary should be used to provide the greatest benefit. Start with a small amount and gradually increase the amount until comfortable.
  • The adhesive should be applied as a thin even coat on the surface of the denture contacting the tissue.
  • It should be applied or reapplied as necessary to provide the desired effect.
  • The dentures should be always thoroughly cleaned before application.
  • Note – adhesives work best with a well-fitting denture.

How does one apply a paste adhesive?

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 product should be used.  Apply three short strips or a series of pea size- dots on dentures for the upper jaw. Deposit them along the ridge area and one to the center palate (top of the mouth). For dentures on the lower jaw, three short strips or a series of small dots are used. These are placed in the center of the ridge area.  Always read and follow the label of the product you’ve selected.

How does one apply a powder adhesive?

Apply a thin, uniform layer across the tissue-contact surface of the denture. Remove excess powder then press the denture into place. Some prefer powders over pastes. This is because they can be easier to remove from both denture and gum. Also, they don’t have the same tendency as pastes do to “shim” (create a space between the denture and gum tissue).

Are denture adhesives safe?

Denture adhesives are safe as long as they are used as directed. With well-fitting dentures, the adhesive is only used to provide added stability. Avoid excessive use of adhesives, to fill voids for an ill-fitting denture.  This can be harmful to the underlying tissues. Occasionally inflammation of the soft tissues may result.

updated 2/4/2018 by Ursula Klostermyer, DDS PhD

published 12/26/2015