Dr. Maneesh Rai, Dentist, Bhopal

Subtitle

Removable Dentures

Removable Dentures- Introduction

 
Summary: When a patient looses some or all of their teeth a denture will restore their appearance and function during speech and eating. A denture may have a metal or plastic base, usually though an upper denture will have a plastic base.

When teeth are to be extracted an immediate denture allows the teeth to be replaced on the same day as they are pulled out. A denture of this type though needs to be replaced after six months as it will become loose as the gums shrink during healing.

When the patient has no teeth in an arch the usual treatment is to provide a full denture. Many patients have difficulty adapting to full dentures as they are held in place by relatively weak forces when compared to real teeth.
The upper denture is held in place by suction, the saliva acts as a seal. The muscles of the cheeks also help to a lesser degree.

The lower denture is held in place by gravity and mainly by the muscles of the cheeks and the tongue. When the denture is removed from the mouth and empty space exists between the tongue and cheeks , the denture is designed to sit in the space with the muscles on either side acting as support.

When a patient has teeth, the dentist may construct a partial denture which fits false teeth inbetween the standing teeth.

The base of these dentures may be plastic acrylic or a metal called 'cobalt chromium'. The advantage of a plastic base is that it can easily have teeth added later. This is of particular importance with patients who have gum disease.

The metal bases allow a thinner base which is less obtrusive to the patient and also having the advantage of transmitting heat when food or drink is taken.

When you lose teeth, the bone that supported them disappears with time. This leads to problems later as dentures may start to rock, your face may appear to become sunken and eating may become difficult.

One solution is not to extract certain teeth which are decayed, but instead to cut the crown off and root fill the root section. The tooth then acts as a support under the denture and also decreases the level of bone loss. Treatment with these dentures tends to be more expensive than a partial denture as teeth need to be root filled and small fillings placed on the top.

When a patient has to have teeth taken out, a decision must be made whether the space is left empty or a artifical tooth used to fill the gap.

An immediate denture is placed in the patients mouth at the time of the extraction so that they don't need to walk around with a space which may be visible. Impressions are taken before that appointment and the lab technician has to estimate how the gum will be once the tooth is removed.

After immdiate dentures are placed they may become lose after a month or so, this is because the gum and underlying bone shrink after they heal. This produces a space under the denture which allows it to tip. The solution is for your dentist to 'reline' the denture, usually you will have to be without your denture for 24hours while it is sent back to the lab.

 

Complete (Full) Dentures

 
COMPLETE (FULL) DENTURES

When a person has had all of their teeth removed we must make complete dentures for the person to wear. Dentures are an acceptable solution, but no match for our real teeth! Hence we always try to save natural teeth. When the teeth are removed we are left with a ridge of bone on the upper and lower parts of our mouth, that we can use to put false teeth on. The lower denture always takes a little more work for most patients to get used to for two reasons: lack of height of bone and presence of the tongue. The tongue increases in size in an edentulous mouth and it resists any new encumbrance to its unchallenged domain. In the upper ridge however there are no such interferences .

 


Advantages

  • long term experience over the years

  • relative low cost

  • predictable results

  • tolerated well by most people

  • restores missing teeth and lost ridge or gums

  • function and appearance is restored

  • aesthetically good where lip and cheek support is inadequate

  • can be fabricated fairly quickly

Disadvantages

  • cause pressure that results in underlying bone resorption and soreness

  • removability- not fixed like natural teeth

  • bulk

  • instability because it is removable and underlying progressive bone resorption

  • looseness as it can only sit atop the gums- especially lowers

  • only low chewing or biting forces can be produced

  • speech problems due to a large appliance in your mouth and it may move

  • taste problems

  • longevity- the need to reline to fit or wearing out 

  • covering the roof of the mouth which can result in gagging problems

  • risk of breakage
     

 

Removable Partial Dentures

 REMOVABLE PARTIAL DENTURES
 

An important step in maintaining a healthy smile is to replace missing teeth. When teeth are missing, the remaining ones can change position, drifting into the surrounding space. Teeth that are out of position can damage tissues in the mouth. In addition, it may be difficult to clean thoroughly between crooked teeth. As a result, you run the risk of tooth decay and periodontal (gum) disease, which can lead to the loss of additional teeth. In situations where only some teeth are missing we can also use a Removable Partial Denture.

A removable partial denture fills in the space created by missing teeth and fills out your smile. It is usually used when the space without teeth is too large for a bridge, or there are no teeth on either side of the gap or for economic reasons. The partial denture locks into place with its metal clasps. A denture helps you to properly chew food, a difficult task when you are missing teeth. In addition, a denture may improve speech and prevent a sagging face by providing support for lips and cheeks. There are two types of these: ones made fully of plastic acrylic) or ones having a metal framework for rigidity and the teeth are the same kind used in full dentures. The latter ones are called CAST partial dentures and are much better and expensive.

These particular partials replace some upper teeth. The metal you see will fit across part of the palate.


FAQ ABOUT REMOVABLE PARTIAL DENTURES

How do you wear a removable partial denture?

Removable partial dentures usually consist of replacement teeth attached to pink or gum-colored plastic bases, which are connected by metal framework. Removable partial dentures attach to your natural teeth with metal clasps or devices called precision attachments. Precision attachments are generally more esthetic than metal clasps and they are nearly invisible. Crowns on your natural teeth may improve the fit of a removable partial denture and they are usually required with attachments.

How long will it take to get used to wearing a denture?

For the first few weeks, your new partial 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. Follow all instructions. Your denture should fit into place with relative ease. Never force the partial denture into position by biting down. This could bend or break the clasps.

How long should I wear the denture?

We will give you specific instruction about how long the denture should be worn and when it should be removed. Initially, you may be asked to wear your partial 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. Then we need to adjust the denture to fit more comfortably. After making adjustments,we will normally recommend that you take the denture out of your mouth before going to bed and replace it in the morning.

Will it be difficult to eat with a partial denture?

Replacing missing teeth should make eating a more pleasant experience. 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 foods that are extremely sticky or hard. You may want to avoid chewing gum while you adjust to the denture.

Will the denture change how I speak?

It can be difficult to speak clearly when you are missing teeth. Consequently, wearing a partial denture may help.If you find it difficult to pronounce certain words with your new denture, practice reading out loud. Repeat the words that give you trouble. With time, you will become accustomed to speaking properly with your denture.

How do I take care of my denture?

Handling a denture requires care.Brush the denture each day to remove food deposits and plaque. Brushing your denture helps prevent the appliance from becoming permanently stained. Rinse the denture under water after meals to remove loose food debris. Brush regularly after each meal, or at least before bed. Brush with water, soap, or a mildly abrasive toothpaste, or denture paste. Scouring powders or other abrasive cleaners should not be used because they scratch the denture. Scratches make the denture more susceptible to collecting debris, plaque and stain. You can use a denture brush or a regular soft toothbrush to clean the denture, but use a separate brush for cleaning any natural teeth you have. It's best to use a brush that is designed for cleaning dentures. A denture brush has bristles that are arranged to fit the shape of the denture.A regular, soft-bristled toothbrush is also acceptable.Avoid using a brush with hard bristles, which can damage the denture.Clean your dentures by thoroughly rinsing off loose food particles. Moisten the brush and apply the denture cleaner. Brush all denture surfaces gently to avoid damaging the plastic or bending the attachments.Make sure you reach all areas of the denture.When brushing the appliance do not hold it firmly or with pressure as this can break the denture. Clean the denture over a sink half filled with water and place a towel in the sink to act as a cushion in case the denture should drop. Do not soak or rinse the denture in hot water, this can distort the shape and fit of the denture. Never scrape the denture with sharp instruments in an attempt to remove hard deposits. Instead, take it to a dental professional for them to remove the deposits.

We can recommend a denture cleaner. Some people use hand soap or mild dishwashing liquid to clean their dentures, which are both acceptable. Other types of household cleaners and many toothpastes are too abrasive and should not be used for cleaning dentures. The denture can be soaked in a solvent (such as Efferdent, Polident) or a detergent with a chemical action that removes or loosens light stains and deposits. Rinse the denture with water afterwards. Chemical immersions can be done daily or several times a week. Ultrasonic cleaning is done during a dental appointment to remove heavy stain and calculus (tartar). The most effective way to keep your dentures clean is by daily brushing, in combination with soaking the dentures in a chemical solution.

Your gums are important too:

Not only do your dentures need maintenance, but care also needs to be given to the tissues under your denture. The gums should be cleaned daily with a soft toothbrush or a washcloth. This removes the plaque and debris on the gums. It also massages and stimulates circulation of tissues. Massage your gums by placing the thumb and index finger over the ridge and use a "press-and-release" stroke.

Will my denture need adjusting?

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.Dentures that do not fit properly should be adjusted. Loose dentures can cause various problems, including sores or infections.If your denture no longer fits properly, if it breaks, cracks or chips, or if one of the teeth becomes loose,you need to see us immediately. In many cases, necessary adjustments or repairs can be made.

INSTRUCTIONS FOR PATIENTS WITH DENTURES

You've just received your new dentures. whether you're a seasoned veteran or a new denture wearer, we're sure there are many questions which may need to be answered. We hope that the following information will prove to be helpful during the next few weeks of your denture adjustment period.

 

  • Learning to wear a new denture can take time. Don't become discouraged if you find some difficulty in the beginning. YOU'RE NOT ALONE! Please do not listen to friends who tell you how easy it was for them to get used to their dentures and how they can eat everything and anything. They are either bragging, have greater bone and gum support or their memories may be poor.Your dentist will help you through any difficulties you may face or any situations that may arise during your adjustment period.

     
  • A lower denture usually takes more time to adjust to than an upper denture. The tongue may feel restricted and will tend to play, sometimes even subconsciously, with the new prosthesis. It will soon adapt to the restrictions and to the new feeling that a denture presents.

     
  • It is natural to experience fullness of the mouth with new dentures. Expect to have excessive flow of saliva. At first you will have a feeling of looseness, especially the lower denture. You will adjust to it.

     
  • Try to eat only soft foods for the first couple of days. Then, as you progress to more solid foods try to eat slowly and deliberately, attempting to place even amounts of food on both sides at the same time during the chewing cycle. By placing food on both sides of the mouth at the same time, you balance the biting forces on the new denture and will help to make it more stable. The longer you take to eat your meal, the faster you will learn to master your new prosthesis.

     
  • Try to take small bites at first. Cut all your food into small portions. If, and when, your gum tissues are strong enough to try foods which are bitten off (bread, corn on the cob, etc. ), try to press the food against the back teeth on the upper in order to stabilize the denture.

     
  • It is perfectly normal to experience some discomfort associated with sore spots during the adjustment period. Nature did not intend for us to wear hard plastic against soft gum tissue. It takes a while for the gum tissues to firm up and to accommodate to the hard plastic denture.

     
  • If sore spots should develop (and in some cases they do not), please be sure to wear the denture for at least 24 hours prior to your adjustment visit! If your dentist can't see the sore spot visually, it is sometimes impossible for him to make the necessary adjustments.

     
  • Reading aloud during the first couple of days will go a long way in reducing any minor speech problems which may result from wearing a new denture. If speech problems continue to persist, please let your dentist know.

     
  • An unclean denture is neither healthy, attractive or comfortable. Clean you new denture every morning and night with either a denture toothbrush and denture toothpaste ( if necessary, any toothpaste can be used ) or with one of the commercially available denture cleaners or soak them overnight in baking soda and water. Please be sure to check with your dentist to make sure that the commercial cleaner will not interfere with the type of denture liner you may have in your prosthesis. Permanent soft liners and temporary soft liners react poorly to most commercial cleaners.

     
  • We prefer that you leave out both of your dentures at night. This allows your gum tissues to breathe and also relieves them of the constant pressures of mastication. When left out of the mouth, all dentures should be left in water to prevent warpage.

     
  • Using excessive amounts of denture adhesive to retain ill-fitting dentures invites serious problems and more involved correction at a later date.

     
  • Gum tissues are in a constant state of change but dentures are not. Therefore, periodic relining of your dentures may be necessary. If you find your denture getting looser and mastication more difficult, this may be a sign that a reline may be needed. It is very important for your dentist to see you regularly to evaluate the state of your oral tissues and to determine if additional treatment is required. Dentures typically need to be relined or remade every 3-5 years.

     
  • NEVER try to adjust your dentures yourself ! Home remedies, although simple, will only lead to trouble.

    If any problems arise or if you have any additional questions, your dentist is available to help.

Welcome