A denture is a removable option for missing teeth and adjacent tissues. It is made of acrylic resin, sometimes in combination with various metals. A denture is a prosthesis for teeth similar to a prosthetic arm or leg. Some people adjust easily to dentures, and some people never adjust.
Types of Dentures
Complete dentures include all the teeth, while a partial denture fills in the spaces created by missing teeth and utilizes the remaining teeth to distribute forces previously carried by missing teeth.
Candidates for complete dentures have lost most or all of their teeth. A partial denture is suitable for those who have some healthy, 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.
Complete or full dentures are made when all of your natural teeth are missing. You can have a full denture on your upper or lower jaw, or both.
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 will 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 months.
An overdenture is a removable denture that fits over a small number of remaining natural teeth or implants. The natural teeth must be prepared to provide stability and support for the denture. Implants provide the support for the denture. Most people are able to eat what they want with over dentures. The support from the implants or natural teeth also minimizes the destructive forces of a conventional denture or partial.
Partial dentures are often a solution when several teeth are missing.
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 are nearly invisible. Crowns on your natural teeth may improve the fit of a removable partial denture and they are usually required with attachments. Dentures with precision attachments generally cost more than those with metal clasps. Implants with a partial denture helps distribute the forces and can increase the lifetime of the natural teeth remaining. Implants also reduce the need for visible clasps.
How Are Dentures Made?
The denture process takes about 4-6 weeks 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 color, shape and fit; and the patient's final denture is placed, following any minor adjustments.
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 color 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 mold 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. Usually a “wax try-in” of the denture will be done at the dentist's office so any adjustments you desire can be done before the denture is completed. Sometimes a second try-in appointment is scheduled to make sure your smile is the best it can be before permanently processing the denture. (This is not possible with an immediate denture.)
The denture is completed at the dental laboratory using the “lost wax” technique. A mold of the wax-up denture is made, the wax is removed and the remaining space is filled with pink plastic in dough form. The mold is then heated to harden the plastic. The denture is then polished and ready for wear.
Duplicate Dentures (Back-up Dentures)
At the time your permanent dentures are made, it is fairly easy for a second set of “back-up” dentures to be made. It is also less costly. Some patients opt to have this second set to use during relines, fabrication of new dentures, or if you accidentally break or lose your denture.
Getting Used to Your Denture
Unfortunately, no denture or partial denture replaces your missing teeth as they were. They fill space and allow you to adjust to a different way of speaking, eating and functioning. Overdentures usually yield the best result.
For the first few weeks, a new denture may feel awkward or bulky. However, for the majority of denture wearers, 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 will 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.
Care of Your Denture
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. It is less likely to break if it lands on a towel. Brush the denture (preferably with a denture brush) daily to remove food deposits and plaque, and keep it from becoming permanently stained. Avoid using a brush with hard bristles or toothpaste, which can damage the denture. Look for denture cleansers with the American Dental Association (ADA) Seal of Acceptance. 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. This is the most common cause of loss of these teeth.
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. Not removing your denture at night leads to accelerated bone loss (leading to dentures which fall out) and fungal infections under your denture and in your mouth.
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.
Your denture will need to be relined every 3-5 years. Because the supporting bone and gums under the denture changes in this amount of time, the denture will start to “loosen” or become ill-fitting. A new denture is usually made at around 10 years, or when the teeth wear out. Gaining or losing weight will also affect the fit of your denture; it may need to be relined if you lose a significant amount of weight.
Even with dentures, you should maintain annual checkups with your dentist. At this time, the fit of the denture will be evaluated, and your dentist can check for any signs of oral cancer. It is life-saving to catch oral cancer early!
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. These glues also leave a residue preventing strong bonding for repairs or tooth replacement.
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.
Eating will take a little practice. Start with soft foods cut into small pieces. Chew slowly using both sides of your mouth at the same time to prevent the dentures from tipping. As you become accustomed to chewing, add other foods until you return to your normal diet.
Continue to chew food using both sides of the mouth at the same time. Be cautious with hot or hard foods and sharp-edged bones or shells.
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. Most people adjust quickly.
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.
You will notice excess salivation at first. This is because your mouth believes the denture is food, and tries to digest it. This will stop as your mouth adjusts to the denture.
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.