Dentures

Introduction

Dentures are false teeth, made mostly of plastic, that replace missing or lost teeth. Dentures are a solution of last resort. Many people assume that they will need dentures as they age, but losing teeth is not a normal part of the aging process. If you care for your teeth well and guard against periodontal (gum) disease, you should be able to keep your teeth for a lifetime.

Saving even a few natural teeth is often better than losing them all. Natural teeth or even parts of natural teeth help retain bone in your jaw. They also can act as stable supports for bridges, overdentures or removable partial dentures. Your dentist will try to save as many of your natural teeth as possible.

Dentures can be either complete or partial. Complete dentures are made for people who have lost all of their teeth. They can be given more support by placement of implants in the bone under the denture. Partial dentures are used to replace only a few teeth. They hook on to to nearby teeth for stabilization..

The good news is that dentures aren't what they used to be. Newer materials and technology have allowed great improvements. Now dentists can fashion dentures that fit comfortably, appear natural and help you stay healthier.

Denture problems still can occur, of course. But problems such as clicking, slipping, frequent gum irritation and odor may be signs that your dentures don't fit well. They may need to be adjusted, relined or remade.

Although dentures may look like your natural teeth, they cannot work like them. Simple actions such as speaking and eating may feel different. You will have to learn how to use and adjust to your dentures. For some people, this can take up to several months.

Types of Dentures: Complete or Partial

Complete Dentures

Complete dentures cover your entire jaw, either upper or lower. Some people call them "plates." Complete dentures rest directly on the oral tissue that covers the bone.

Complete dentures are custom made for you. The typical process involves multiple appointments, usually about five. The dentist first takes impressions of your mouth. This can be done with impression materials that are placed in your mouth or with an intraoral digital scanner. At later visits, you and the dentist select the size, shape and color of the artificial teeth.

Learning to chew food with complete dentures takes patience and practice. You might have to cut your food into smaller pieces than you did when you had your natural teeth.

On occasion, one or more natural teeth are kept when a denture is made. These teeth usually have root canal treatment and are shortened to fit under the denture. This type of denture is known as an overdenture.

Dentists like to maintain a few natural teeth and replace the missing teeth with an overdenture if possible. This has several advantages:

Your natural teeth help preserve bone.
Your natural teeth bear some of the chewing pressure. This reduces pressure on other areas of the jaw.
Your remaining teeth make the denture more stable and less likely to shift in your mouth.
You feel a better sense of where your jaw is in space and the pressure you are placing on the denture if you have not lost all of your teeth.
You may find it easier to accept wearing dentures if you have kept some teeth.
Lower dentures tend to be more difficult to keep in your mouth than upper dentures. That's because the surface area of the lower jaw is much smaller than the top jaw. An upper denture covers the entire palate, which helps it stay in place. Therefore, an overdenture can be most helpful for the lower jaw. However, it is an option for almost anyone who has a few teeth remaining.
Teeth that will be preserved with an overdenture must meet certain standards of health. Canines and premolars are the most common teeth selected because of their root length and position in the jaw.
The teeth will have to be shaped to fit the denture. Shaping may expose the tooth's living pulp. For this reason, the teeth usually need root canal treatment. This removes the pulp (the nerve of the tooth) and replaces it with filling material.
The teeth that will remain are covered with thin metal castings called copings. They fit into openings in the denture. Attachments also can be put on the copings to help retain the denture in the mouth. On occasion, a natural tooth can be kept in the mouth without a metal coping. If this is done, the dentist will prescribe fluoride drops. These should be used in the overdenture to prevent decay of the tooth.
Overdentures also can fit over implants instead of natural teeth. In fact, implants were first developed to give people "artificial roots" for bridges or dentures in the lower jaw. The denture can fit onto the implants directly, or onto a metal bar between implants.

Partial Dentures

Removable partial dentures consist of a metal framework (or sometimes a special acrylic material) with plastic teeth and gum areas. The framework includes metal clasps or other attachments that hold the denture in place. However, partial dentures are removed easily for cleaning.

Fixed partial dentures, which most people call bridges, are cemented in place. They look more like natural teeth. Bridges cost more than removable partial dentures, however. They also have to be supported by nearby healthy teeth.

Bridges are made in several ways. Some are made entirely of porcelain. Some are made with porcelain covering a metal framework. Three types of attachments are used in partial dentures — metal clasps, precision attachments, and flexible plastic clasps.

Metal clasps are C-shaped, I-shaped and Y-shaped parts of the denture framework. They fit around neighboring natural teeth. These teeth may require shaping to help hold the clasps and keep the denture securely in place.

A precision attachment is like a key fitting into a keyhole. A crown that is placed over your tooth contains the "keyhole." The denture contains the "key." When you put in your denture, the "key" fits into the "keyhole" in the crown. This type of denture looks better because no clasps are visible. It also fits tighter. However, it does take more skill for the patient to place in the mouth because the "key" must fit exactly into the "keyhole."

Flexible plastic clasps are usually used when the metal clasp would cause cosmetic problems in the front tooth area.

Special Types of Partial Dentures

Nesbit denture — A Nesbit denture can replace one or more lost back teeth. Metal clasps fit around the teeth on either side of the space. However, because a Nesbit denture is not also supported by teeth on the other side of the mouth, it can place extreme pressure on the clasped teeth. Also, there is a danger of dislodging or swallowing a Nesbit denture in an accident. This is why most dentists do not recommend Nesbit dentures. Instead, consider a bilateral partial denture. This type is supported by teeth on both sides of the mouth, even if the missing teeth are on one side of the jaw.

Flipper denture — A flipper denture is made of acrylic with a flexible metal wire to clasp teeth and is intended to be temporary. It replaces one or more teeth until another form of treatment (bridge, implants) can be made or decided upon. Such a denture can be placed right away, or soon after a tooth is extracted. However, it is not meant to be a permanent solution.

Getting Your Dentures

Conventional Dentures

Conventional dentures are made and inserted after your teeth have been taken out and the gums have healed.

A conventional denture typically is made and fitted within five or more appointments over two or more months. The process starts with an appointment with your dentist for an exam. You also will talk about what will work best for you. In later visits, your dentist will take impressions of your mouth and establish the bite (the way your teeth come together).

You and your dentist will select the teeth for your denture. The size of the teeth will depend upon the size of your mouth and jaw, and how your upper and lower jaws come together when you bite down. If you liked the way your natural teeth looked, bring in a photograph of you smiling with your natural teeth. This will help your dentist and the dental laboratory that will make your dentures.

Your dentist will take impressions of your mouth and send them to the lab, along with a detailed prescription. A dental technician will then make your dentures. If the lab is not in your dentist's office, this process can take 6 to 10 business days between each visit. This is why appointments may be spaced a couple of weeks apart.

Once the denture is made, you'll have a trial fitting. Your dentist will set up your new denture and try it in your mouth. You'll be able to see how the denture looks and feels in your mouth. Your dentist can make sure that it fits, functions correctly and harmonizes with the rest of your face. This is your denture preview, or "try-in."

If the try-in goes well, you will receive the completed denture at the next visit. Your dentist will give you instructions on how to eat and speak with dentures. You'll also learn about how to take care of your dentures and your mouth and gums. Finally, you will need to see your dentist for a series of follow-up visits during the next few weeks and months. The dentist will check the fit and comfort of your denture.

Immediate Dentures

If you have teeth extracted, your mouth will need to heal for at least four weeks before a complete denture can be made. In some cases, your dentist may suggest that you use an immediate denture in the meantime. This denture is meant to be temporary. It may be helpful if you have a limited number of teeth extracted, particularly front teeth, and you do not want to go around without teeth. It will be inserted at the time of extractions. As your mouth heals, the gums and bones may shrink. The immediate denture will be relined to adjust the fit.

Updated- January 22, 2021