A denture is a removable device used to replace missing teeth when a bridge is unsuitable. A wide variety of denture appliances can be made.
The types of dentures used are:
Over dentures: Fit over a small number of natural teeth or implants. The natural teeth must be prepared to provide stability and support for the denture.
Partial denture: a plate with a number of false teeth on it. It is made of replacement teeth attached to a gum-coloured plastic base, connected by a metal framework. Metal clasps help to keep the denture in place, or more expensive devices called precision attachments can be used. The latter are nearly invisible. Crowns on your natural teeth can improve the fit of a partial denture. A partial denture is suitable for those who have some natural teeth remaining.
Complete dentures: Replace all the teeth. You can have a full denture on your upper or lower jaw, or both. Candidates for complete dentures have lost most or all of their teeth. A denture improves chewing ability and speech, and provides support for facial muscles. It will greatly enhance the facial appearance and smile.
Complete dentures are called ‘conventional’ or ‘immediate’ according to when they are made and when they are inserted into the mouth. Immediate dentures are inserted immediately after the removal of the remaining teeth. To make this possible, the dentist takes measurements and makes the models of the patient’s jaws during a preliminary visit.
An advantage of immediate dentures is that the wearer does not have to be without teeth during the healing period. However, bones and gums can shrink over time, especially during the period of healing in the first six months after the removal of teeth. When gums shrink, immediate dentures may require rebasing or relining to fit properly. A conventional denture can then be made once the tissues have healed. Healing may take at least 6-8 weeks.
The initial diagnosis is made.
An impression and a wax bite are made to determine vertical dimensions and proper jaw position. First, an impression of your jaw is made using special materials. In addition, measurements are made to show how your jaws relate to one another and how much space is between them (bite relationship). The colour or shade of your natural teeth will also be determined. The impression, bite and shade are given to the dental laboratory so a denture can be custom-made for your mouth. The dental laboratory makes a mould or model of your jaw, places the teeth in a wax base, and carves the wax to the exact form wanted in the finished denture.
A wax ‘try-in’ is placed to assure proper colour, shape and fit. The denture is completed at the dental laboratory using the ‘lost wax’ technique. A mould of the wax-up denture is made, the wax is removed and the remaining space is filled with pink plastic in dough form. The mould is then heated to harden the plastic. The denture is then polished and ready for wear.
The patient’s final denture is placed, following any minor adjustments.
For the first few weeks, a new denture may feel awkward or bulky. However, your mouth will eventually become accustomed to wearing it. Inserting and removing the denture will require some practice. Your denture should easily fit into place. Never force the partial denture into position by biting down. This could bend or break the clasps.
At first, you may be asked to wear your denture all the time. Although this may be temporarily uncomfortable, it is the quickest way to identify those denture parts that may need adjustment. If the denture puts too much pressure on a particular area, that spot will become sore. Your denture can be adjusted to fit more comfortably. After making adjustments, you may need to take the denture out of your mouth before going to bed and replace it in the morning.
Start out by eating soft foods that are cut into small pieces. Chew on both sides of the mouth to keep even pressure on the denture. Avoid sticky or hard foods, including gum. You may want to avoid chewing gum while you adjust to the denture.
Some people worry about how dentures will affect their speech. Consider how your speech is affected when you have a number of your natural teeth missing. Pronouncing certain words may require practice. Reading out loud and repeating troublesome words will help. If your dentures ‘click’ while you’re talking, speak more slowly. You may find that your dentures occasionally slip when you laugh, cough or smile. Reposition the dentures by gently biting down and swallowing. If a speaking problem persists, consult your dentist.
It’s best to stand over a folded towel or a sink of water when handling your denture, just in case you accidentally drop it. Brush the denture (preferably with a denture brush) daily to remove food deposits and plaque, and to keep it from becoming permanently stained. Avoid using a brush with hard bristles, which can damage the denture. Pay special attention to cleaning teeth that fit under the denture’s metal clasps. Plaque that becomes trapped under the clasps will increase the risk of tooth decay.
Hand soap or mild dishwashing liquid to clean dentures is also acceptable. Other types of household cleaners and many toothpastes are too abrasive and should not be used for cleaning dentures. A denture could lose its proper shape if it is not kept moist. At night, the denture should be placed in soaking solution or water. However, if the appliance has metal attachments, they could be tarnished if placed in soaking solution.
Even with full dentures, you still need to take good care of your mouth. Every morning, brush your gums, tongue and palate with a soft-bristled brush before you put in your dentures. This removes plaque and stimulates circulation in the mouth. Selecting a balanced diet for proper nutrition is also important for maintaining a healthy mouth.
Over time, adjusting the denture may be necessary. As you age, your mouth naturally changes, which can affect the fit of the denture. Your bone and gum ridges can recede or shrink, resulting in a loose-fitting denture. Loose dentures can cause various problems, including sores or infections. Dentures that do not fit properly can be adjusted. Avoid using a do-it-yourself kit to adjust your dentures, as this can damage the appliance beyond repair. Glues sold over-the-counter often contain harmful chemicals and should not be used on a denture.
If your denture no longer fits properly, if it breaks, cracks or chips, or if one of the teeth becomes loose, see your dentist immediately. In many cases, dentists can make necessary adjustments or repairs, often on the same day. Complicated repairs may require that the denture be sent to a special dental laboratory.
Over time, dentures will need to be relined, re-based, or re-made due to normal wear. To reline or re-base a denture, the dentist uses the existing denture teeth and refits the denture base or makes a new denture base. Dentures may need to be replaced if they become loose and the teeth show signs of significant wear.
Denture adhesives can provide additional retention for well-fitting dentures. Denture adhesives are not the solution for old, ill-fitting dentures. A poorly fitting denture, which causes constant irritation over a long period, may contribute to the development of sores. These dentures may need a reline or need to be replaced. If your dentures begin to feel loose, or cause pronounced discomfort, consult with your dentist immediately.