Dentures are likely the most difficult part of dentistry for both patients and dentists. The reason why most dentists don’t like them is that they are a compromise in every single way and despite doing everything right, many times patient’s struggle to adjust to dentures. They oftentimes blame the dentist for the problems, not realizing that the problem is the simple fact that dentures aren’t easy to get used to. Dentures are NOT a replacement for teeth. They are replacement for no teeth. Let’s take a look at the different types of dentures…
Complete dentures are made after you have had all your teeth removed. Complete dentures for your top teeth generally do pretty well as they develop suction that keeps them in place. Complete dentures for bottom teeth are FAR more challenging than top dentures. They do not develop suction and simply sit on the tissue. Anytime the tongue moves it tends to pop the denture up.
Here is a set of dentures made for a patient of mine. This is pretty typical of what you’ll see for a set of dentures. The gums and teeth are usually both made of an acrylic material (yep, same kind of stuff used on fake nails).
Partial dentures are made when someone is missing multiple teeth but have some remaining teeth that are strong enough to anchor a partial denture. Partial dentures work far better that complete dentures because the remaining teeth give the denture something to anchor onto. The two main types of partial dentures are cast metal frame partials and flexible partials. The cast metal frame partials have a metal substructure and acrylic tissue and teeth bonded on top. Flexible partials are made of a nylon type material that is flexible and uses the gum tissue to create retention for it to stay in place. Cast metal partials are heavier and don’t look as good but are much easier to repair. Flexible partials look better and weigh less but are more difficult to adjust and repair.
Implant Retained Dentures
For people who aren’t able to adjust to complete dentures, we recommend having implants placed that the dentures attach to. Attachments are placed in the denture and it can be snapped in and out. Implant retained dentures do far better for people than traditional complete dentures. Below are a couple of pictures of clear model of a lower jaw with implants placed. As you can there are two implants right around where the canine teeth should be the bottom denture has several attachments that will allow it to snap on to these implants. This provides much better function than a regular bottom denture.
Fixed Hybrid Denture
A fixed hybrid denture is the Cadillac option of dentures with a similar price tag. Four to six implants are placed in each arch and a denture is made that is attached to the implants. It stays in place and can only be removed by your dentist. It restores your ability to function and chew as closely as possible to what you would have with your own teeth. As you can see from the pictures, the denture really only extends far enough to hold the teeth in place, unlike a traditional denture that has to extend much further. This makes it much less bulky and much more comfortable. You can see the screw holes that attach the denture to the implants in these pictures. Your dentist would cover these areas after tightening everything down so that you wouldn’t feel them. This type of denture can be more challenging to clean since you can’t take it out yourself. Usually we recommend a Waterpik as the easiest way to keep these clean.
Problems With Dentures
It isn’t unusual to have problems with your dentures, especially right after having them made and also after you’ve had them for a long time. Many of these problems are minimized if you use an implant retained denture.
Sores and Irritations
When you first have your dentures made, you’ll likely need several adjustment visits. New dentures sometimes create pressure spots that turn into sores or irritated areas in your mouth. Your dentist will mark these pressure spots and then remove a small amount of material on the denture to relieve the pressure. Make sure and wear your dentures at least 24 hours prior to your adjustment appointment so that your dentist can see exactly where the irritated spots are. If they can’t see them, it is very difficult to adjust the denture accurately.
Complete dentures without implants are never very stable. Top dentures usually do OK because they create a seal that keeps them in place. Lower dentures are never very stable because they don’t have suction. They basically sit on your gum tissue and have a tendency to lift up when you move your tongue. I highly recommend to all my patients to get a couple of implants in the lower jaw to stabilize their denture if it is any way in their budget. If your dentures are brand new, give them a little time to settle into place. The muscles and tissue will adjust slightly to having them there within a couple of days to weeks. If your dentures are old and are less stable than they used to be, it might be time for you to get a reline.
Eating With Dentures
Eating with dentures can be challenging, especially at first. Everyone adjusts a little differently to them and has a different tolerance to what they can eat. The most important things to remember when eating with dentures are to not use the front teeth for eating (only the back teeth), cut up food first, start with a soft diet, and chew food on both sides at the same time to keep them stable. Over time you’ll get better at eating with a denture and will start to eat more challenging foods.
Talking With Dentures In
When you first get dentures you may speak funny and this is perfectly normal. When speaking your tongue likes to touch the roof of your mouth and behind the front teeth. Both of these positions change slightly with dentures and so your tongue has to get used to this new position. Practice speaking with no one around and you’ll improve quickly. Most people are talking normally again within 1-2 weeks.
Some people have a very strong gag reflex and struggle putting their dentures in. Most people are able to adjust to this with some time. Practice putting them in while breathing in and out through your nose and staying calm. Much of your gag reflex is mental and takes some time to retrain.
A very small percentage of people in the population are allergic to one or more ingredients used to make dentures (acrylic). There are different materials that can be used in these rare cases.
Other Denture Tips
Always take your dentures out a night. Wearing dentures all night would be like wearing your shoes all day and then going to bed with them on. Your mouth needs time to breathe!
Clean your denture everyday. Using a denture brush with soap and water is best for most people. Don’t use toothpaste as this will scratch the surface. Dentures that aren’t cleaned can cause you to develop infections in your mouth under your denture. Another option is to use an ultrasonic cleaner. This is what we use in the dental office to clean your denture. It vibrates at an extremely high rate of speed which removes any debris.
Try using a denture adhesive for better retention. I’ve found that Fixodent powder works best for most people but everyone is a little different in what they prefer. Fixodent gel also works well.