A denture is a removable replacement for missing teeth and surrounding tissues.
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.
Complete dentures can be either “conventional” or “immediate”.
Made after the teeth have been removed and the gum tissue has begun to heal, a conventional denture is ready for placement in the mouth about eight to 12 weeks after the teeth have been removed.
Unlike conventional dentures, 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 to fit properly during the healing process and generally should only be considered a temporary solution until conventional dentures can be made.
A removable partial denture or bridge usually consists of replacement teeth attached to a pink or gum-colored plastic base, which is connected by metal framework that holds the denture in place in the mouth. Partial dentures are used when one or more natural teeth remain in the upper or lower jaw. A fixed (permanent) bridge replaces one or more teeth by placing crowns on the teeth on either side of the space and attaching artificial teeth to them. This “bridge” is then cemented into place. Not only does a partial denture fill in the spaces created by missing teeth, it prevents other teeth from changing position. A precision partial denture is removable and has internal attachments rather than clasps that attach to the adjacent crowns. This is a more natural-looking appliance.
Yes, dental implants can be used to support permanently cemented bridges, eliminating the need for a denture. The cost is usually greater, but the implants and bridges more closely resemble the feel of real teeth.
Dental implants are becoming the alternative to dentures but not everyone is a candidate for implants. Consult your dentist for advice.
Most dental insurance providers cover some or all of the cost of dentures.
However, contact your medical aid service provider to find out the specifics of what they will cover.
The denture development process takes about three to six weeks and several appointments.
Once your dentist or prosthodontist (a dentist who specialises in the restoration and replacement of teeth) determines what type of denture appliance is best for you, the general steps are:
1. Make a series of impressions of your jaw and take measurements of how your jaws relate to one another and how much space is between them.
2. Create models, wax forms, and/or plastic patterns in the exact shape and position of the denture to be made. You will “try in” this model several times and the denture will be assessed for colour, shape, and fit before the final denture is cast.
3. Cast a final denture.
4. Adjustments will be made as necessary.
New dentures may feel a little odd or loose for a few weeks until the muscles of the cheeks and tongue learn to keep them in place and you get comfortable inserting and removing them. Also, it is not unusual for minor irritation or soreness to occur and for saliva flow to increase when you first start wearing dentures, but these problems will diminish as the mouth adjusts.
Dentures are made to closely resemble your natural teeth so there should be no noticeable change in appearance. In fact, dentures may even improve your smile and fill out your facial appearance.
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, start with soft foods cut into small pieces.
Chew slowly using both sides of your mouth.
As you get used to new dentures, add other foods until you return to a normal diet. Be cautious with hot or hard foods and sharp-edged bones or shells.
And, avoid foods that are extremely sticky or hard. You may want to avoid chewing gum while you adjust to the denture. Also, don’t use toothpicks while wearing dentures.
After getting dentures, you may have difficulty pronouncing certain words.
If so, practice by saying the difficult words out loud. With practice and with time you will become accustomed to speaking properly with dentures.
If dentures “click” while you’re talking, contact your dentist.
Dentures may occasionally slip when you laugh, cough, or smile.
Reposition the dentures by gently biting down and swallowing. If any speaking problem persists, consult your dentist or prosthodontist.
Your dentist or prosthodontist will instruct you as to how long to wear dentures and when to remove them.
During the first several days after receiving your denture, you may be asked to wear it all the time, including while you sleep.
Although this may be temporarily uncomfortable, it is the quickest way to identify the areas with the denture that may need adjustment.
Once adjustments are made, you should remove dentures before going to bed.
This allows gum tissues to rest and allows normal stimulation and cleansing by the tongue and saliva.
The denture can be put back in the mouth in the morning.
A denture adhesive may be considered under the following circumstances:
1. To enhance satisfaction with a properly constructed denture.
Adhesives enhance retention, stability, bite force, and an individual’s sense of security.
2. 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.
3. To provide added stability and security for those who place unusual demands on facial muscles, such as public speakers or musicians.
There are situations when denture adhesives should not be used.
These cases include:
1. When it is used as a “fix” for ill-fitting or poorly constructed dentures.
If dentures begin to feel loose, cause discomfort or cause sores to develop, contact your dentist as soon as possible.
2. When a dentist has not evaluated dentures 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.
3. When oral hygiene practices cannot be sustained.
4. 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.
5. When any known allergy exists to the adhesive’s ingredients.
Here are some tips to consider when applying denture adhesives:
1. Use the minimum amount necessary to provide the maximum benefit. Apply less than you think you need, and then gradually increase the amount until you feel comfortable.
2. Distribute the adhesive evenly on the tissue bearing surface of the denture.
3. Apply or reapply when necessary to provide the desired effect.
4. Always apply the adhesive to a thoroughly clean denture.
5. Remember adhesives work best with a well-fitting denture.
1. Paste application. Apply this denture adhesive to a dry or preferably wet denture. Avoid placing adhesive close to the denture borders. If the adhesive oozes, use less of the product. For dentures on the upper jaw, apply three short strips of adhesive — or a series of small dots — along the ridge area and one down the centre. For dentures on the lower jaw, apply three short strips of adhesive — or a series of small dots — in the centre of the ridge area.
2. Powder application. Sprinkle a thin, uniform layer throughout the tissue-bearing surface of the denture. Shake off excess powder and press the denture 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).
Dental adhesives are safe as long as they are used as directed. If the denture is well-fitting and the adhesive is only used to give 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.