Traditional removable dentures
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Most people have heard of false teeth. These replace missing teeth, either completely, or partially. The correct dental term for these teeth replacements is dentures and they come in two types: complete dentures, for when the patient has no natural teeth, and partial dentures, for when the patient has some natural teeth remaining.
Dentures are perhaps the oldest form of teeth replacement, but the materials and technology used in their manufacture has developed significantly over the years. Complete dentures are sometimes made before the patient has his or her teeth removed. These are known as immediate dentures and are advantageous because patients can have the dentures fitted as soon as the teeth are removed, so they do not have to go for any period of time without any teeth. The drawback with immediate dentures is that quite often the gums and bones shrink over time, so the immediate dentures often need adjusting or replacing over time. This often means that immediate dentures are normally seen as only a temporary replacement until conventional dentures are fitted.
Conventional dentures on made after the teeth have been removed and the gum tissue has healed. This means that the patient does have to go without teeth for a while – usually one to three months – but temporary or immediate dentures can be fitted during this time. Unlike immediate dentures, conventional dentures don’t require adjustments.
For patients with some natural teeth remaining, a removable partial denture that consists of replacement teeth on a plastic base can be fitted between the existing teeth. This not only provides replacement teeth for those that are missing, but also prevents existing teeth from moving. Sometimes it is possible to fix a partial denture permanently by placing crowns on existing teeth and anchoring the replacement teeth to them. This treatment is known as a bridge.
Having dentures fitted
Having dentures fitted does require several visits to the dentist, and the whole process may take several weeks. It is perhaps best to visit a specialist in dental replacement, known as a prosthodontist, or a dentist experienced with dentures, who will be best able to determine the type of denture to suit your requirements.
The first step to having a denture fitted involves the dentist taking impressions of the jaw and making measurements. This is necessary to ensure the dentures will fit properly. Normally a model denture made from wax or plastic is moulded into the shape of your mouth. The dentist will then adjust this model to ensure it is a perfect fit, before sending it off to a dental laboratory where the dentures will be made.
After the dentures are ready, which normally takes about four weeks, the dentist will fit them and make any necessary adjustments. This may involve several repeat visits.
Because dentures are a replacement for missing teeth they should restore your natural smile and it shouldn’t be possible for people to tell you are wearing dentures. However, dentures can take some time to get used to. Sometimes, dentures may feel a little loose at first until the muscles and mouth tissues adapt to them. Dentures may also cause a little irritation or soreness after first being fitted, but this should soon pass. It also takes some time to get used to eating with dentures. Most patients stick to soft foods for the first few weeks until they are used to eating with them. It is also best to chew food slowly and use both sides of the mouth. Once you get used to eating with dentures, you can slowly introduce new foods and eventually return to a normal diet.
However, some foods should be avoided altogether when wearing dentures. Anything too sticky, such as chewing gum, can cause dentures to dislodge, while very hard or sharp foods can damage
dentures so care needs to be taken when eating such things. Also, you shouldn’t use food picks, bite nails or chew pens when wearing dentures. Because dentures have a plastic base that covers the natural tissues of the mouth it can be sometimes hard to judge when food is too hot, which could lead to burns of the mouth or throat, so care needs to be taken when eating hot food.
Dentures mat affect your speech slightly at first too. You may struggle to pronounce certain words, but with practice, your speech should soon return to normal. However, if you notice a clicking sound when talking, it could be a sign that your dentures are slipping, so you should contact your dentist. Your dentures may occasionally move when laughing or coughing. This is normal, and you can reposition the dentures by biting down gently and swallowing.
Many patients find it uncomfortable to sleep while wearing dentures and removing them each night gives your gums a chance to rest. However, when you first have dentures fitted, your dentist may ask you to keep them in when you go to bed. This is speed up the process of identifying whether the dentures are sitting properly and if they need any adjustments.
As with normal teeth, dentures should be regularly cleaned to remove bacteria and food, and prevent gum disease. The best way to keep them clean is to remove them, and brush and soak them regularly. Specialist denture cleansers are available, but you must take care when cleaning dentures as they can break.
Sometimes is may be necessary to use a denture adhesive. Adhesives keep dentures more stable in the mouth, increase bite force and improve confidence for patients who worry that dentures are slipping slip. For patients with certain medical conditions, adhesives are necessary because they have less adherence in the mouth and their dentures slip more easily. However, adhesives should not be used to cure poorly fitting dentures. If dentures feel loose or are slipping regularly, your dentist should be consulted as soon as possible as poorly fitting dentures can damage the gums and tissue of the mouth.
Adhesives should also be avoided when wearing new dentures as it may prevent your dentist from spotting problems in the proper alignment and fit of the dentures. Adhesive use should not be overdone. If you find you are increasing the amount of adhesive you would normally use, it could be a sign your dentures need adjusting. In some rare circumstances, patients may find themselves allergic to dental adhesive, in which case your dentist should be consulted for advice on a substitute.
There are two types of denture adhesive: paste and powder. Denture paste can be applied to either dry or wet dentures, although it is most effective when used with wet dentures. The paste should not be over done and to avoid overspill should be kept away from the edges of the denture. Three short strips of adhesive should be enough for both the upper and lower jaw. Alternatively, you can apply the paste in dots in the centre of the ridge area. Powdered adhesives are less messy and its use makes dentures easier to clean. The powder is sprinkled in a thin, uniform layer over the dentures, which are then shaken to remove any excess. When using either type of adhesive, the minimum amount should always be used and adhesives should only be applied to clean dentures.
Alternatives to Dentures
While dentures provide a method of replacing missing teeth, not all patients want dentures. Dentures have to be regularly removed for cleaning, and adhesives or cement is often needed to keep the denture in place and stop any movement. Furthermore, while dentures can replace the surface tooth, they can’t replace the root, which means the bones of the jaw starts to deteriorate, which can affect facial structure.
Dental implants are by far the best from of tooth replacement as they replace not just the tooth, but also the root. Dental implants look and act just like real teeth. Tooth replacement treatments, such as bridges, can also be anchored to dental implants. Dental implants do cost more than conventional dentures and not everybody is able to have dental implants fitted. However, they are by far the most effective method of replacing lost teeth and more and more people are requesting dental implants. For more information about dental implants, consult an experience dental implant dentist.
Metal Partial Dentures
Patients with missing teeth that still have some natural teeth remaining are suitable for partial dentures. A partial denture, often called a removable prosthetic, contains replacement teeth but unlike a conventional (full) prosthetic, is usually secured to natural teeth by means of clasps that clips on to special metal alloy structures on the teeth. This not only provides a secure form of denture that doesn’t move or slip when a patient eats or speaks, but also the denture remains removable so can be cleaned.
Benefits of a partial denture
While both partial and full dentures replace missing teeth, a partial denture is more secure allowing patients to speak and chew food with more confidence. A partial denture also enables a patient to enjoy certain foods that normal denture wearers have to avoid. Furthermore, partial dentures help preserve the existing natural teeth and support the facial structure.
A partial denture offers patient’s more confidence too and patients with partial dentures often have more confident smiles, improved speech and better self-esteem. Partial dentures are also flexible. If a patient loses another tooth, the denture can be modified to accommodate a new replacement tooth. They are also easy to repair and are cheaper than other forms of tooth replacement such as dental implants.
The aesthetics of partial dentures
While partial dentures provide an aesthetically pleasing from of tooth replacement, the clasps used to affix the dentures to the natural teeth can sometimes be visible. In these instances, it is sometimes possible to replace the conventional clasps with specially designed partial dentures. These are known as precision of semi-precision partial dentures, and are a bit more complex in their design and so usually cost a little more to have fitted.
Conventional partial dentures
Conventional partial dentures use clasps that are thin, finger-like projections made from a metal alloy, or occasionally plastic. They are attached to the natural teeth and extend below the tooth where there is a natural bulge. Sometimes, it is necessary to reshape the tooth or affix a crown to ensure there is enough of a bulge in which the clasps can sit.
The clasps gently spring over the tooth bulge when the partial denture is inserted into the mouth clipping the denture to the natural tooth. This provides a secure fixture when eating and speaking, although the partial denture can easily be removed due to the design of the clasp, which will spring back when the denture is removed.
However, despite several clasp designs, sometime clasps become visible in the mouth. For some patients, this doesn’t matter, but for others this provides a problem with confidence as it can indicate a person is wearing a prosthetic. Furthermore, in some cases where the natural tooth structures are not adequate enough to contain conventional clasps or the location the teeth makes conventional clasps less secure, it may be necessary to have precision or semi-precision attachments fitted.
Semi-precision and precision partial dentures
Precision and semi-precision partial dentures replace the need for clasps and provide a better aesthetic result in cases where conventional clasps are visible in the mouth. Semi-precision partial dentures have a specially shaped extension to the denture itself, which fits into a special crown in the natural tooth. The extension is made from a metal alloy, which interlocks over the natural tooth. Precision partial dentures are very similar except that they are made to withstand higher tolerances, and as the name suggests, are manufactured more precisely to provide a better fit.
Both precision and semi-precision partial dentures provide a better aesthetic result than conventional partial dentures as there are no metal clasps. They also blend in with the natural conformity of the existing teeth and can function under better tolerances than a conventional partial denture. However, they are more costly to produce and usually involve some teeth needing crowns. Furthermore, they are more difficult to realign and adjust over time, so some components may need periodic replacements.
Longevity of partial dentures
Usually, partial dentures last about five years depending on how well they are looked after and the oral hygiene of the patient. Of course, accidents can happen and partial dentures can break, wear or the clasps can fracture. Normally, these problems can often be repaired. Sometimes a patient’s mouth can change over time, requiring adjustments to the partial denture. However, sometimes the only way to rectify some problems is to have a new set of partial dentures made.
A dentist will check partial dentures regularly, as least every six months. Even small problems can develop into major issues if left unchecked and the sooner problems are spotted, the less likely a patient will need to have a replacement set of partial dentures fitted. Furthermore, most people’s mouths are continually changing, so partial dentures may need to be occasionally modified to ensure a correct fit. This realignment is usually needed every 12 months, although some patients may need it more or less frequently, depending on the changes in their mouth structure.
Partial Plastic Denture
A partial denture is a form of tooth replacement used on patients who have missing teeth but still have several natural teeth in place. A partial denture consists of a plate with several false teeth attached, which is secured to existing teeth using clasps. Usually, partial dentures have a metal base made from alloys such as chromium and cobalt, which makes them strong. However, some partial dentures are made entirely of plastic, which are less expensive.
Plastic partial dentures are not as strong as metal ones and unless they are designed very carefully can damage the teeth to which they are attached. However, they do provide an alternative to patients who maybe cannot afford a metal partial denture, or want something temporary.