A denture is a removable replacement for missing teeth and surrounding tissues. Two types of dentures are available – complete and partial. Complete dentures are used when all the teeth are missing. Partial dentures are used when some natural teeth remain.
. Complete dentures
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 8 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. To fit properly, immediate dentures will need more adjustments compared with conventional dentures. Immediate dentures should only be considered a temporary solution until conventional dentures can be made.
. Partial dentures
A removable partial denture usually consists of replacement teeth attached to a pink or gum-colored plastic base. This base is usually connected by metal framework that holds the denture in place in the mouth. There are also materials available that allow the partial denture to be made without a metal framework. This option should be discussed with your dentist. Partial dentures are used when one or more natural teeth remain in the upper or lower jaw. A fixed (permanent) partial denture 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.
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Dentures are made to closely resemble your natural teeth, so there should be no noticeable change to your appearance. In fact, dentures may even improve your smile and fill out your facial appearance.
A denture adhesive may be considered under the following circumstances:
. To improve your satisfaction with a properly constructed denture. Adhesives enhance retention, stability, bite force, and sense of security.
. To assist people with dry mouth conditions that lessen denture adherence, such as those taking cold medications, have neurologic disabilities including strokes, and the elderly.
. To provide added stability and security for those who place unusual demands on their facial muscles, such as public speakers or musicians.
A denture adhesive should not be considered under the following circumstances:
. When used as a “fix” for ill-fitting or poorly constructed dentures. If your dentures begin to feel loose, cause discomfort or cause sores to develop, call your dentist as soon as possible.
. When a dentist has not evaluated your dentures for a long time. Dentures rest on gum tissue and your jawbone, which shrink and deteriorate, respectively, over time. Therefore, the real problem might be a need for a denture adjustment or new dentures.
. When oral hygiene practices cannot be maintained.
. 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 increase. These developments may indicate the need for a denture adjustment or new dentures.
. When any known allergy exists to the adhesive’s ingredients.
Here are some tips to consider when applying denture adhesives:
. 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.
. Place three small dots of adhesive in the ridge area of the denture. Wet your finger and spread the adhesive evenly on the tissue-bearing surface of the denture.
. Apply or reapply when necessary to provide the desired effect.
. Always apply the adhesive to a thoroughly clean denture.
. Remember adhesives work best with a well-fitting denture.
. Paste application: Apply 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 center. For dentures on the lower jaw, apply three short strips of adhesive, or a series of small dots in the center of the ridge area.
. 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 to “shim” (keep the denture away from the tissue).
Dental adhesives are safe as long as they are used as they were meant to be used. If the denture is well-fitting and the adhesive is only used to give added stability, there should be no problems. 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.
The denture development process takes about two months and several appointments. Once your dentist or prosthodontist (a dentist who specializes in the restoration and replacement of teeth) determines what type of appliance is best for you, the general steps are to:
. 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.
. 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 color, shape, and fit before the final denture is cast.
. Make adjustments as necessary.
Yes, dental implants can be used to support a permanently cemented bridge, eliminating the need for a denture. The implants can also be used as extra retention for a “snap” fit of a conventional denture. Usually they cost more, but implants and bridges feel more like real teeth. Dental implants are becoming the alternative to dentures, but not everyone is a candidate for implants. Consult your dentist for advice.
New dentures may feel a little odd or loose for a few weeks until the muscles of your cheek 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 decrease as your mouth adjusts to the new denture.
Your dentist or prosthodontist will tell you how long to wear your denture and when to remove it. During the first several days after receiving your denture, you may be told to wear it all the time, including while you sleep. This is usually the case with immediate dentures.
Although this may be temporarily uncomfortable, it is the quickest way to identify the areas on your denture that may need adjustment. Once adjustments are made, you should remove your denture 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 your mouth in the morning after proper cleaning has been completed.
Eating with new dentures will take 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 or thin strips as opposed to a small chunk. Chew slowly, using both sides of your mouth. As you get used to your new dentures, add other foods until you return to your normal diet. Be cautious with hot or hard foods and sharp-edged bones or shells. And, avoid foods that are extremely sticky or hard. Don’t chew gum. Also, don’t use toothpicks while wearing dentures.
You may have difficulty pronouncing certain words. If so, practice by saying the difficult words out loud. With practice and as time passes, you will be able to say those difficult words with greater ease.
If your dentures “click” while talking, call your dentist. Your dentures may occasionally slip when you laugh, cough, or smile. Reposition the dentures by gently biting down and swallowing. If any speaking problems continue, call your dentist or prosthodontist.