When the majority of teeth are affected by advanced periodontal disease, decay, or other problems, extracting them may be the only option. Removing diseased teeth is often the best way to eliminate infection and restore the gums and the supporting bone to a healthy condition.
The traditional method for replacing the teeth is with dentures. There are different types of dentures: partial dentures, over dentures, and immediate or complete dentures. The most common of these is the complete denture.
What is a denture?
A denture is a removable replacement for missing teeth and adjacent tissues. It is made of acrylic resin, sometimes in combination with various metals. 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. Complete dentures are either "conventional" or "immediate". A conventional denture is placed in the mouth about a month after all of the teeth are removed to allow for proper healing, whereas an immediate denture is placed as soon as the teeth are removed. The drawback behind an immediate denture is that it may require more adjustments after the healing has taken place.
Who needs a denture?
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.
The Procedure - Before the teeth are extracted, impressions of the upper and lower jaws are taken. Precise models will be made from these impressions by the dental lab. Your dentures will be created using these models.
Your dentist will work closely with you to select the appropriate shape and colour of the teeth to be crafted into your dentures.
Once the lab has completed the dentures, all of the teeth will be extracted, and the new dentures will be put in place.
Initially the dentures will feel tight and uncomfortable because the gums are swollen and sore (a result of extracting the teeth). As swelling reduces over the next few days, and as the underlying bone heals over the next few months, the denture may feel loose and somewhat awkward. During this period, your dentist will periodically reline your dentures to correct the fit.
When the gums and bone have completely healed, and the upper and lower jaws have arrived at their final shape, your dentures will be removed and another set of impressions will be made. Your dentures and the new impressions will be returned to the lab.
When the gums and bone have completely healed, and the upper and lower jaws have arrived at their final shape, your dentures will be removed and another set of impressions will be made. Your dentures and the new impressions will be returned to the lab.
Your newly relined dentures should now fit very comfortably.
What happens when you get a denture?
A dentist can make a full conventional denture when all teeth have been lost or all extraction sites have healed (up to eight weeks or longer.) 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 colour, shape and fit; and the patient's final denture is placed, following any minor adjustments.
New denture wearers need time to get accustomed to their new "teeth" because even the best fitting dentures will feel awkward at first. While most patients can begin to speak normally within a few hours, many patients report discomfort with eating for several days or a few weeks. To get accustomed to chewing with a new denture, start with soft, easy-to-chew foods. In addition, denture wearers often notice a slight change in facial appearance, increased salivary flow, or minor speech difficulty.
How do you care for a denture?
A denture is fragile, so it is important to handle it with care. Remove and brush the denture daily, preferably with a brush designed specifically for cleaning dentures, using either a denture cleanser or toothpaste. Never use harsh, abrasive cleansers, including abrasive toothpastes, because they may scratch the surface of the denture. Don't sterilize your denture with boiling water because it will cause it to become warped. If you wear a partial denture be sure to remove it before brushing your natural teeth.
When not is use, soak it in a cleanser solution or in water. Get in the habit of keeping the denture in the same safe and handy place to reduce the likelihood of misplacement.
Should a denture be worn at night?
While you may be advised to wear your new denture almost constantly during the first two weeks - even while you sleep - under normal circumstances it is considered best to remove it at night. Research has shown that removing the denture for at least eight hours during either the day or night allows the gum tissue to rest and allows normal stimulation and cleansing by the tongue and saliva. This promotes better long-term health of gums.
Continue seeing your dentist regularly?
It is important to continue having regular dental checkups so that a dentist can examine oral tissues for signs of disease or cancer. As you age, your mouth will continue to change as the bone under your denture shrinks or recedes. To maintain a proper fit over time, it may be necessary to adjust your denture or possibly remake your denture. Never attempt to adjust a denture yourself and do not use denture adhesives for a prolonged period because it can contribute to bone loss. When in doubt, consult your dentist.
Partial Dentures
If only a few teeth are missing, or if most of the teeth may be left in place, a partial denture is a common alternative to the complete denture. The process for creating the partial is essentially the same as for the complete denture, but the final partial denture is fitted to and among the remaining teeth.
Taste and enjoyment may be affected because, particularly with complete upper dentures, the denture may cover taste buds on the roof of the mouth. Dentures may become painful as a slight shifting of position can create sore spots on the gums, or extreme bone recession can expose portions major nerves.
Some people find that dentures, no matter how well-crafted, cause them to gag. As most of these potential problems usually occur later in life, they can challenge the ability to maintain good health, when eating a proper healthful diet is essential.
Dentures can be used to replace missing teeth. The art of making a comfortable, well retained, aesthetic denture is in the planning.
In the example below, the patient below the patient presented with worn teeth and large gaps. The patient did not want dental implants.
We built up the worn teeth using crowns and then made a denture than clipped into one of the crowns so the patient did not show any clasps when she smiles.
Options - If disease or injury are not too great, or if cost is not the most significant factor, there are perhaps better alternatives to dentures. These include crowns, bridges, implants, aggressive periodontal therapy, and endodontic treatment. With current treatment options, the selection of dentures is becoming less common.
