Dentures
What are dentures?
Dentures are considered as a last resort for many people. Several people think that they will need dentures when they grow old but losing teeth is not a normal part of the ageing process. If you take care of your teeth well and if you guard against periodontal disease or gum disease then you should be able to keep your teeth for the rest of your life.
When you save a few natural teeth then you are certainly better off than those who lose all their teeth. Natural teeth or even parts of natural teeth should help you retain bone in your jaw. This can act as stable support for bridges, overdentures, and removable partial dentures. Your dentist will always make it a point to save as many natural teeth as possible.
Dentures are made for people who have lost all their teeth. These dentures are called complete dentures. Complete dentures can be given additional support by placing the implants in the bone under the denture.
The good news about dentures is that they aren't what they used to be. With newer materials and improved technology, dentists can make dentures that fit comfortably, appear natural, and help you stay healthier. Denture problems like clicking, slipping, frequent gum irritation, and foul odour, are signs that your dentures are not fitting properly. They may have to be adjusted, realigned, or remade.
Dentures may look like your natural teeth but they will not work exactly like them. When you speak or eat, your mouth may feel different. You will have to learn how to use and how to adjust your dentures. This may take a few months of getting used to.
What are the types of dentures?
Complete Dentures
Complete dentures will cover your entire jaw. A complete denture will cover either the upper or lower jaw. Some people will call them plates. Complete dentures rest right above the gum that covers the bone. Occasionally, one or more natural teeth are kept when dentures are made. These teeth usually go through root canal treatment and are shortened in order to fit right under the denture. This type of denture is called an over denture.
Maintaining a few natural teeth and replacing missing teeth with an over denture has a lot of advantages and they are
- the ability to keep your natural teeth and preserve the bone
- the remaining natural teeth bear some of the chewing pressure which reduce the pressure on the areas of the jaw
- the remaining natural teeth will improve the stability of the denture. It will make it less likely to shift in your mouth
- you will have a better sense of where your jaw is when you still have natural teeth as opposed to losing all of your natural teeth
- keeping some of your teeth can help you psychologically accept your new denture
Lower dentures are harder to keep in your mouth than the upper dentures. Thus, an over denture will be particularly helpful for the lower jaw. It is one of the options for people who have a few teeth remaining. However, the teeth that will be preserved must meet certain standards. Canines and premolars are the most common teeth selected because of the length of their root and their position in the jaw.
The teeth must be shaped in order to fit the denture. Since the shaping will expose the living pulp of the tooth, root canal treatment may be needed. This will remove the pulp and replace it with filling material.
The teeth will be covered in metal castings called copings. They will fit into the openings of the denture. Attachments can also be made on the copings so that the denture can be better retained in the mouth. Occasionally, a natural tooth can be kept in the mouth without metal coping and if this is done, it is important that fluoride drops are applied. This will prevent decay of the underlying tooth structure when the over denture is placed.
Over dentures can fit over implants instead of natural teeth. In fact, implants were initially developed to provide people with artificial roots on which the bridges and dentures are placed. Dentures can fit directly over implants. In some cases, metal bars can link the implants together. This will provide support for the denture.
Partial Dentures
Removable partial dentures are made of a metal framework with plastic teeth and gum areas. This framework has metal clasps and other attachments. They hold the dentures in place. However, the partial dentures are removed easily when they have to be cleaned. Fixed partial dentures or what some people know as bridges, are cemented in place and better simulate natural teeth. Bridges are more expensive than removable partial dentures although they require healthy adjacent teeth to support them.
Two types of attachments are used in partial dentures and they are metal clasps and precision attachments. Metal clasps are C-shaped, I-shaped, and Y-shaped parts of the denture framework. They fit around the neighbouring natural teeth. These teeth may have to be shaped in order to hold the clasps and keep the denture in place. A precision attachment is like a key fitting into a keyhole and you should think of this analogy when you have dentures and crowns. The crown that is placed over your tooth acts like a keyhole. The denture that will be placed in your mouth acts like a key. When they are put together, they will fit as exactly as possible. This kind of denture looks better because there are no clasps and the fit is much tighter. However, you will need more skill to place it in your mouth because keys have to fit exactly into their keyholes in order to work.
Are there special types of dentures?
A Nesbit denture can replace one or more back teeth that have been lost. Metal clasps are fit around the teeth on either side of the space however, since the Nesbit denture is not supported by the teeth on the other side of the mouth, it can put a lot of pressure on the clasped teeth. Moreover, there is also a danger of dislodging the Nesbit denture and swallowing it. Most dentists do not recommend Nesbit dentures because they think that a bilateral partial denture is much better. This is supported by both sides of the mouth even if the missing teeth are on one side of the jaw.
A flipper denture is made of acrylic and it replaces one or more teeth temporarily. This is an intermediary solution because the patient has to decide whether to have bridges or implants installed. This kind of denture can be placed immediately even after the tooth has been extracted although this is not considered a permanent solution.
How do you get your dentures?
After your teeth have been taken out and after your gums have healed, conventional dentures may be inserted in your mouth already. It usually takes around four to five appointments to have a conventional denture made. This process takes about a month or two. First, your dentist will have a discussion with you and recommend which kinds of dentures are best for you. On your later visits, impressions of your mouth will be taken. Your bite will be established. Your bite is the way your teeth come together. You and your dentist will select the most appropriate teeth for your denture. The size, shape, and colour of your teeth will depend on many factors like reference points in your mouth, your skin tone, the shape of your skull, photographs, and personal preferences.
During your trial fitting, your teeth will be set up and tried in your mouth. You will see how the denture will look and you will have a feel of how it will be in your mouth. Your dentist will make sure that the denture fits and functions properly. Your dentist will also check if the denture is in harmony with your face. This denture preview is a trial period and if it goes well, you will get the complete denture on your next visit already. Your dentist will also give you instructions on proper eating, speaking, denture care, and oral hygiene. Lastly, you may have to see your dentist for a series of follow-up visits during the next few months in order to make sure that your dentures are working properly.
If you are having a complete denture made and if you need teeth to be extracted then you must have at least four weeks of healing time before your denture can be made. Your dentist will suggest that you have an interim denture or temporary denture first. This denture is called an immediate denture and it is inserted at the time of extraction of the teeth. You will be able to eat and speak without problems while the complete denture is being made. As your mouth heals, the gums and the bones will shrink and the immediate denture will have to be relined. During this process, the fit of the denture will be adjusted.