All About Dentures

Find out all you need to know on the types of dentures there are. How to care for your dentures. More.

Caring for your dentures

Proper denture care is important for both the health of your dentures and mouth.
Here are some tips.

Handle dentures with great care. To avoid accidentally dropping them, stand over a folded towel or a full sink of water when handling dentures. Brush and rinse your dentures daily. Like natural teeth, dentures must be brushed daily to remove food and plaque. Brushing also helps prevent the development of permanent stains on the dentures. Use a brush with soft bristles that is specifically designed for cleaning dentures. Avoid using a hard-bristled brush as it can damage or wear down dentures.

Gently brush all surfaces of the denture and be careful not to damage the plastic or bend attachments. In between brushings, rinse your dentures after every meal.

Clean with a denture cleaner. Hand soap or mild dishwashing liquid can be used for cleaning dentures. Household cleansers and many toothpastes may be too abrasive for your dentures and should not be used. Also, avoid using bleach, as this may whiten the pink portion of the denture. Ultrasonic cleaners can be used to care for dentures. These cleaners are small bathtub-like devices that contain a cleaning solution. The denture is immersed in the tub and then sound waves create a wave motion that dislodges the undesirable deposits. Use of an ultrasonic cleaner, however, does not replace a thorough daily brushing. Products with the American Dental Association (ADA) Seal of Acceptance are recommended since they have been evaluated for safety and effectiveness.

Denture care when not being worn. Dentures need to be kept moist when not being worn so they do not dry out or lose their shape. When not worn, dentures should be placed in a denture cleanser soaking solution or in water. However, if your denture has metal attachments, the attachments could tarnish if placed in a soaking solution. Your dentist can recommend the best methods for caring for your particular denture. Dentures should never be placed in hot water, as it can cause them to warp.

More about dentures

Dentures are prosthetic devices constructed to replace missing teeth, and which are supported by surrounding soft and hard tissues of the oral cavity. Conventional dentures are removable, however there are many different denture designs, some which rely on bonding or clasping onto teeth or dental implants. There are two main categories of dentures, depending on whether they are used to replace missing teeth on the mandibular arch or the maxillary arch. Patients can become entirely edentulous (without teeth) due to many reasons, the most prevalent being removal because of dental disease typically relating to oral flora control, i.e. periodontal disease and tooth decay. Other reasons include tooth developmental defects caused by severe malnutrition, genetic defects such as Dentinogenesis imperfecta, trauma, or drug use. Advantages

Dentures can help patients in a number of ways:

1. Mastication - chewing ability is improved by replacing edentulous areas with denture teeth.

2. Aesthetics - the presence of teeth provide a natural facial appearance, and wearing a denture to replace missing teeth provides support for the lips and cheeks and corrects the collapsed appearance that occurs after losing teeth.

3. Phonetics - by replacing missing teeth, especially the anteriors, patients are better able to speak by improving pronunciation of those words containing sibilants or fricatives.

4. Self-Esteem - Patients feel better about themselves.

Types of dentures

Removable partial dentures
Removable partial dentures are for patients who are missing some of their teeth on a particular arch. Fixed partial dentures, also known as “crown and bridge“, are made from crowns that are fitted on the remaining teeth to act as abutments and pontics made from materials to resemble the missing teeth. Fixed bridges are more expensive than removable appliances but are more stable.

Complete dentures
Conversely, complete dentures or full dentures are worn by patients who are missing all of the teeth in a single arch (i.e. the maxillary (upper) or mandibular (lower) arch).

Partial Dentures

Dentures need special attention and same goes with your oral health. According to the American Dental Association, the following are some of the basic oral care procedures to ensure your dentures are in perfect condition and your gums are in the pink of health.

* Make sure that you brush your gums, tongue and palate every morning before you insert your dentures. This stimulates circulation in your gums.
* Dentures are delicate and fragile. Try not to drop it when you are not wearing them.
* Brush your dentures regularly. This will prevent the occurrence of stains and plaque. Use a soft-bristled toothbrush to clean your dentures.
* Some denture wearers use mild hand soap or dish-washing liquid to clean their dentures. These are acceptable alternatives to regular dentures cleaning agents. Avoid using powdered cleansers and bleach as these are too abrasive on dentures.
* Do not let the dentures dry out when you are not wearing them. It may lose its shape as a result. Soak it in a dental cleanser solution or water instead.

Regular dental check-ups are also important. Your dentist needs to examine your dentures to see if they fit properly and if the dentures need to be relined, rebased or replaced due to normal wear. Loose and ill-fitting dentures breed infections and mouth sores. So the minute you feel discomfort in your dentures, visit your dentist immediately. For more information about dentures and partials, consult with our Fort Lauderdale dentist for details.

Prosthodontic principles of dentures

Support
Support is the principle that describes how well the underlying mucosa (oral tissues, including gums and the vestibules) keeps the denture from moving vertically towards the arch in question, and thus being excessively depressed and moving deeper into the arch. For the mandibular arch, this function is provided by the gingiva (gums) and the buccal shelf (region extending laterally (beside) from the posterior (back) ridges), whereas in the maxillary arch, the palate joins in to help support the denture. The larger the denture flanges (part of the denture that extends into the vestibule), the better the support. This last sentence requires comment and correction, it reveals some misunderstanding by the author as flanges usually provide stability and not support. Indeed, long flanges beyond the functional depth of the sulcus are a common error in denture construction, often (but not always) leading to movement in function.

Stability
Stability is the principle that describes how well the denture base is prevented from moving in the horizontal plane, and thus from sliding side to side or front and back. The more the denture base (pink material) runs in smooth and continuous contact with the edentulous ridge (the hill upon which the teeth used to reside, but now consists of only residual alveolar bone with overlying mucosa), the better the stability. Of course, the higher and broader the ridge, the better the stability will be, but this is usually just a result of patient anatomy, barring surgical intervention (bone grafts, etc.).

Retention
Retention is the principle that describes how well the denture is prevented from moving vertically in the opposite direction of insertion. The better the topographical mimicry of the intaglio (interior) surface of the denture base to the surface of the underlying mucosa, the better the retention will be (in removable partial dentures, the clasps are a major provider of retention), as surface tension, suction and just plain old friction will aid in keeping the denture base from breaking intimate contact with the mucosal surface. It is important to note that the most critical element in the retentive design of a full maxillary denture is a complete and total border seal (complete peripheral seal) in order to achieve “suction“. The border seal is composed of the edges of the anterior and lateral aspects AND the posterior palatal seal. The posterior palatal seal design is accomplished by covering the entire hard palate and extending not beyond the soft palate and ending 1-2 mm from the vibrating line.
As mentioned above, implant technology can vastly improve the patient's denture-wearing experience by increasing stability and saving his or her bone from wearing away. Implant can also help with the retention factor. Instead of merely placing the implants to serve as blocking mechanism against the denture pushing on the alveolar bone, small retentive appliances can be attached to the implants that can then snap into a modified denture base to allow for tremendously increased retention. Options available include a metal hader bar or precision balls attachments, among other things.

Complications and recommendations
The fabrication of a set of complete dentures is a challenge for any dentist, including those who are experienced. There are many axioms in the production of dentures that must be understood; ignorance of one axiom can lead to failure of the denture case. In the vast majority of cases, complete dentures should be comfortable soon after insertion, although almost always at least two adjustment visits will be necessary to remove sore spots. One of the most critical aspects of dentures is that the impression of the denture must be perfectly made and used with perfect technique to make a model of the patient's edentulous (toothless) gums. The dentist must use a process called border molding to ensure that the denture flanges are properly extended. An array of problems may occur if the final impression of the denture is not made properly. It takes considerable patience and experience for a dentist to know how to make a denture, and for this reason it may be in the patient's best interest to seek a specialist, either a prosthodontist or perhaps even a denturist, to make the denture. A general dentist may do a good job, but only if he or she is meticulous and usually he or she must be experienced.
The maxillary denture (the top denture) is usually relatively straightforward to manufacture so that it is stable without slippage.
A lower full denture should or must be supported by 2-4 implants placed in the lower jaw for support. A lower denture supported by 2-4 implants is a far superior product than a lower denture without implants, because
1) It is much more difficult to get adequate suction on the lower jaw.
2) The functioning of the tongue tends to break that suction, and
3) Without teeth the ridge tends to resorb and provides the denture less and less stability over time. It is routine to be able to bite into an apple or corn-on-the-cob with a lower denture anchored by implants. Without implants, it is quite difficult or even impossible to do so.
Some patients who believe they have “bad teeth“ may think it is in their best interests to have all their teeth extracted and full dentures placed. However, statistics show that the majority of patients who actually receive this treatment wind up regretting they did so. This is because full dentures have only 10% of the chewing power of natural teeth, and it is difficult to get them fitted satisfactorily, particularly in the mandibular arch. Even if a patient retains one tooth, that will contribute to the denture's stability. However, retention of just one or two teeth in the upper jaw does not contribute much to the overall stability of a denture, since a full upper denture tends to be very stable, in contrast to a full lower denture. It is thus advised that patients keep their natural teeth as long as possible, especially their lower teeth.

References
The inventions that changed the world, Reader's Digest (1982) [Portuguese edition of 1983]
Moriyama N, Hasegawa M. The history of the characteristic Japanese wooden denture. , Bull Hist Dent. 1987 Apr;35(1):9-16.
John Woodforde, The Strange Story of False Teeth, London: Routledge & Kegan Paul, 1968
S. E. Eden, W. J. S. Kerr and J. Brown, “A clinical trial of light cure acrylic resin for orthodontic use,“ Journal of Orthodontics, Vol. 29, No. 1, 51-55, March 2002


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List Of Questions

  • Q. Can I Adjust or Repair my Dentures?
    One or more follow-up appointments are generally needed soon after you receive your dentures so that your oral health care provider can make any necessary adjustments. Never attempt to adjust or repair your dentures yourself. Never bend any part of the clasp or metal attachments yourself; doing so can weaken the metal structure. "Do-it-yourself" repair kits can permanently damage your dentures and over-the-counter glues may contain harmful chemicals.
    Dentures that don't fit properly can cause irritation and sores in your mouth and on your gums. Be sure to contact your oral health care provider if your denture breaks, cracks, chips or if one of the teeth becomes loose. Oftentimes, he or she can make the necessary adjustment or repair on the same day. For some complicated repairs, your denture may have to be sent to a special dental laboratory.
  • Q. Will My Dentures Need to Be Replaced?
    Over time, dentures will need to be relined, rebased, or remade due to normal wear, natural age-related changes to your face, jaw bones, and gums, or if the dentures become loose. To reline or rebase a denture, the dentist or prosthodontist refits the denture base or makes a new denture base and reuses the existing teeth. Generally, complete dentures should be used for 5 to 7 years before a replacement is necessary.
  • Q. How Should I Care for My Mouth and Gums if I Have Dentures?
    Even with full dentures, it is important to brush your gums, tongue, and palate with a soft-bristled brush every morning before you put in your dentures. This removes plaque and stimulates circulation in the mouth. 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. If you wear a partial denture, be sure to remove it before you brush your natural teeth. Clean, rest, and massage the gums regularly. Rinsing your mouth daily with lukewarm salt water will help clean your gums. Eat a balanced diet so that proper nutrition and a healthy mouth can be maintained.
  • Q. How Often Should I See the Dentist if I Have Dentures?
    If you have dentures, your dentist or prosthodontist will advise you about how often you need to visit, but every 6 months should be the norm. Regular dental visits are important so that your denture and mouth can be examined for proper denture fit, to look for signs of oral diseases including cancer, and to have your teeth professionally cleaned.

Denture Cleaning

  • Denture soaks and cleaning solutions. - Commercial and homemade.
    After brushing, your denture needs to be soaked in a cleaning solution.

    Chemical cleansing and disinfecting is the second half of effective denture care. Due to the microscopic porosity of the surface of denture plastic, brushing, even in combination with the use of ultrasonic cleaning units, can only go so far in removing the micro-organisms (bacteria and fungal) that are harbored on false teeth. Chemical cleansing and disinfecting is required.
    No doubt you have seen advertisements for several different brands of effervescent denture cleaners. These products certainly can be a good choice but there are some common household compounds that can be effective denture cleaners too.
  • Effervescent denture cleansers.
    Effervescent denture cleaning products can be an effective way to chemically cleanse and disinfect your false teeth. While the specific ingredients found in the formulation each different brand's product will vary, you will typically find the following types of compounds in them.
  • Oxidizing (bleaching) agents
    Alkaline perborate, sodium perborate or postassium monopersulfate. These compounds remove staining and kill the bacteria harbored on a denture's surface.
  • Effervescing agents
    Perborate, carbonate or citric acid. Effervescing agents provide for the rapid disintegration of the product and also create a mechanical cleansing action.
  • Chelating agents
    EDTA. This type of compound helps to remove the tartar that has accumulated on a denture's surface.
  • Detergents and enzymes
    Sodium polyphosphate, everlace. These compounds assist in cleansing the denture.
  • Additional compounds
    Dye markers that provides a color change when the cleansing process has been completed. Flavorings and fragrances

Denture Pain

Anyone that has worn dentures is probably aware of the pain that they can cause. Most commonly, pain occurs in the first stages of denture wear, with the gum tissue of the mouth still sensitive from tooth removal, although discomfort and pain throughout denture use is common. Whatever pain dentures may bring the wearer, however, there are many available options to relieve the pain, aid in the healing of the mouth, and help prevent future pain. Even in later stages of denture-wearing, there are treatment options available to help relieve the pain and provide normal mouth function. Understanding how dentures work in the mouth and how personal behavior influences comfort or pain can greatly aid in understanding how best to treat denture pain.

The part of the mouth that often causes denture-wearers the greatest discomfort is the mucosa. The mucosa is the membrane lining the mouth and gums that help protect the mouth from irritants and helps the mouth absorb materials introduced orally. It is this membrane that is most easily irritated by dentures, and oral procedures such as tooth extraction are hard on the membranes of the mouth. It is this mucosa that really takes on the immediate stress of the dentures.

It is to this surface that the dentures adhere in the mouth. The mucosa covers the gums, with the dentures requiring so much suction to make a good hold. In the process, a mouth new to dentures can be unprepared for the surface contact, and the mucosa can take damage, be worn away, or be irritated, allowing pain to develop. The mucosa is the most prominent area of the mouth to take damage from dentures. Damage can be subtle, sometimes not even apparent, although injured tissue can lead to swelling, sensitivity, and sores, which can make denture wear excruciating.

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