Complete Denture Book
Cristoforo Kanoy
A denture is a removable replacement for missing teeth and surrounding tissues. Two types of dentures are available -- complete and partial dentures. Complete dentures are used when all the teeth are missing, while partial dentures are used when some natural teeth remain.
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 eight 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 following tooth removal. Therefore a disadvantage of immediate dentures compared with conventional dentures is that they require more adjustments to fit properly during the healing process and generally should only be considered a temporary solution until conventional dentures can be made.
A removable partial denture or bridge usually consists of replacement teeth attached to a pink or gum-colored plastic base, which is sometimes connected by a metal framework that holds the denture in place in the mouth. Partial dentures are used when one or more natural teeth remain in the upper or lower jaw. A fixed bridge 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. A precision partial denture is removable and has internal attachments rather than clasps that attach to the adjacent crowns. This is a more natural-looking appliance.
Yes, dental implants can be used to support cemented bridges, eliminating the need for a denture. The cost is usually greater, but the implants and bridges more closely resemble the feel of real teeth. Dental implants are becoming the alternative to dentures but not everyone is a candidate for implants.
The denture development process takes a few weeks 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:
New dentures may feel a little odd or loose for a few weeks until the muscles of the cheeks 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 diminish as the mouth adjusts.
Dentures are made to closely resemble your natural teeth so there should be only a small noticeable change in appearance. In fact, dentures may even improve your smile and fill out your facial appearance.
Eating with new dentures will take a little 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. Chew slowly using both sides of your mouth. As you get used to new dentures, add other foods until you return to a normal diet. Be cautious with hot or hard foods and sharp-edged bones or shells. And, avoid foods that are extremely sticky or hard. You should also avoid chewing gum while you wear the denture. Also, don't use toothpicks while wearing dentures.
After getting dentures, you may have difficulty pronouncing certain words. If so, practice by saying the difficult words out loud. With practice and with time you will become accustomed to speaking properly with dentures.
If dentures "click" while you're talking, contact your dentist. Dentures may occasionally slip when you laugh, cough, or smile. Reposition the dentures by gently biting down and swallowing. If any speaking problem persists, consult your dentist or prosthodontist.
Your dentist or prosthodontist will instruct you as to how long to wear dentures and when to remove them. During the first several days after receiving your denture, you may be asked to wear it all the time, including while you sleep. Although this may be temporarily uncomfortable, it is the quickest way to identify the areas on the denture that may need adjustment. Once adjustments are made, you should remove dentures 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 the mouth in the morning.
Dental adhesives are safe as long as they are used as directed. If the denture is well-fitting and the adhesive is only used to give added stability, there should be no ill effects. 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.
After you get your dentures, you may need one or more follow-up appointments to get adjustments. Never attempt to adjust or repair dentures yourself. Never bend any part of the clasp or metal attachments yourself; this can weaken the metal structure. "Do-it-yourself" repair kits can permanently damage dentures, and over-the-counter glues may contain harmful chemicals.
Dentures that don't fit the way they should can cause irritation and sores in the mouth and on gums. Be sure to call your dentist if a denture breaks, cracks, or chips or if one of the teeth becomes loose. They can often make the adjustment or repair the same day. For some complicated repairs, your denture may have to be sent to a special lab.
Over time, dentures will need to be relined, rebased, or remade due to normal wear and natural age-related changes to the face, jawbones, and gums or if the dentures become loose. To reline or rebase a denture, the dentist or prosthodontist refits the base or makes a new base and reuses the existing teeth. Generally, complete dentures should be used for 5 to 7 years before you need a replacement.
Even with full dentures, it is important to brush your gums, tongue, and palate with a soft-bristled brush every morning before putting the dentures in. This removes plaque and boosts circulation in the mouth. Pay special attention to cleaning teeth that fit under the denture's metal clasps. Plaque that gets trapped under the clasps will raise the risk of tooth decay. If you wear a partial denture, be sure to remove it before brushing your natural teeth. Clean, rest, and massage your gums regularly. Rinsing your mouth daily with lukewarm salt water will help clean the gums. Eat a balanced diet to maintain proper nutrition and a healthy mouth.
If you have dentures, your dentist or prosthodontist will advise you about how often to visit, but every 6 months should be the norm. Regular dental visits are important so that your dentures and your mouth can be examined to ensure proper denture fit, to look for signs of oral diseases including cancer, and to have teeth professionally cleaned.
A complete denture (also known as a full denture, false teeth or plate) is a removable appliance used when all teeth within a jaw have been lost and need to be prosthetically replaced. In contrast to a partial denture, a complete denture is constructed when there are no more teeth left in an arch; hence, it is an exclusively tissue-supported prosthesis. A complete denture can be opposed by natural dentition, a partial or complete denture, fixed appliances or, sometimes, soft tissues.
Following the loss of teeth, there occurs a resorption (or loss) of alveolar bone, which continues throughout life.[3] Although the rate of resorption varies, certain factors such as the magnitude of loading applied on the ridge, the technique of extraction and healing potential of the patient seem to affect this.[4] The edentulous ridge can be classified according to the amount of bone in both the vertical and horizontal axes:[5]
Alveolar bone resorption is an important consideration when designing complete dentures. In the absence of natural dentition, such dentures rely completely on soft tissues for their support. As a consequence, the forces exerted on the mucosa are significant and may, in turn, lead to an increased rate of bone resorption. Therefore, in order to ensure an equal distribution of forces across the mucosa, complete dentures should have maximum extensions.[6]
Facial muscles on the cheeks and lips also lose their support as teeth are lost, contributing to an 'aged' appearance of the individual. Although complete dentures cannot prevent the loss in muscular tone (as they are not firmly attached to the skeletal system), they can nevertheless provide some artificial support to mask this loss in tone. Furthermore, perhaps the most noticeable effect of tooth loss from a patient perspective is the loss in masticatory (or chewing) efficiency. Teeth function to help with the chewing of food, breaking it down in small pieces that can be swallowed. Denture-wearing can bring some masticatory function back to normal. It cannot, however, fully compensate for the efficiency of the natural dentition because (1) dentures are not fixed in place like teeth are and so have to be actively controlled by the muscles and (2) biting forces are greatly reduced (about one-sixth of the natural dentition) as the dentures are impinging on soft tissues.[citation needed]
Complete dentures are prone to a variety of displacing forces of differing magnitude as they are resting on oral mucosa and are in close proximity with tissues that are constantly changing due to the action of muscles. Consequently, for complete dentures to be retentive and stable, the retentive forces that hold the dentures in place must be greater than the ones aiming to displace it. Obtaining maximum stability and retention is one of the biggest challenges in full denture construction.
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