The Fitting and Care of Dentures
As we age, our teeth gradually deteriorate. Ageing teeth become brittle and crack or chip more readily. Deep decay adds to the problem.
If present, sever gum disease may damage gums and jawbone, leading to tooth loss. If teeth are badly affected by wear, trauma, decay or gum disease, your dentist may suggest extraction as the best treatment option.
Even at a relatively young age, some people have extensive loss of teeth. When teeth are lost or extracted, A denture may have to be fitted to maintain chewing, bitting, speech and the appearance of the upper and lower jaws.
A denture is called a prosthesis, and the fitting of a denture is called denture prosthodontics.
Types of Dentures
Partial Denture: a partial denture is made to fill the space left by a few missing teeth. To hold the partial denture in position, clasps are used to secure the denture to nearby natural teeth.
Full Denture: a full denture is made when all the natural teeth are missing. It is fitted to replace the upper, lower teeth or both.
Immediate Denture: the dentist inserts an immediate denture at the same appointment as the teeth are extracted. The advantage is that the patient avoids a period without teeth.
Over-denture: an over-denture is one that fits over the top of remaining teeth, over tooth roots that have had root canal treatment, or by attachment to dental implants. Remaining teeth or dental implants act as anchors to secure it in place.
Materials: Dentures can be made out of acrylic or metal material.
Making and Fitting the Dentures
Dentures are composed of artificial teeth bonded to a plastic base. The dentist makes an impression of the dental arch and any remaining teeth, using special impression material. The colour and shape of the artificial teeth can be closely matched to those of your own.
The dentist will help you with these decisions. The dental laboratory uses the impressions and the dentist’s specifications to make the dentures.
our dentist will advise you about how long to wear your new dentures each day. A few days or weeks are needed to become accustomed to the denture.
Over the first few days:
The denture may feel tight and uncomfortable
May feel bulky as if crowding the mouth
Your gums may feel sore
Some people experience a gagging sensation at the back of the throat
You may notice an increase in the amount of saliva in your mouth
Eat soft foods
Speech may be affected but will improve.
After some time, the denture may feel loose and awkward. our dentist can adjust the fit. This is done by placing an inner lining in the denture. Several adjustments may be required before the final fit is satisfactory for the longer term.
Over- dentures and partial dentures usually need fewer adjustments than full dentures. People who have retained some natural teeth usually have less gum shrinkage and fewer changes in the underlying jawbone, so their dentures may retain a good fit for longer.
Loose dentures can cause irritation and ulcers of the gums that are painful and may become infected. If you dentures become loose, see our dentist to have them adjusted.
Do not try to adjust your own denture. Home repairs will cause more harm than good.
Cleaning Your Dentures
Clean your dentures after each meal or at least twice a day. Remove them, and rinse away any food particles with warm or cold water or mouth wash.
If you have a partial denture, be sure that you thoroughly clean it to reduce the risk of losing more teeth. Your dentist can show you how to use a toothbrush and dental floss correctly so you can efficiently remove food particles and plaque from remaining teeth.
Brush both the inside and outside surface of your dentures with a soft toothbrush and unperfumed, mild soap or other approved denture cleaner. Many good products are available in pharmacies and supermarkets. It is best to avoid the use of standard toothpastes as many brands are too abrasive.
Do NOT use:
Hot or boiling water because the denture will warp.
Other strong spirits of any kind
Daily Living With Dentures
Insertion and Removal
Your dentist will show you how to place and remove your dentures. Never use force to remove a denture.
Comfort and Adaptation
Even if you have worn dentures before, your new dentures may feel uncomfortable at first. Your mouth needs time to adapt to them.
Eating with Dentures
Learning to eat with dentures takes practice and time, after the first few days of eating soft foods; you will want a wider range of foods. Cut foods into small pieces, take small mouthfuls, and chew slowly. This helps to keep the dentures in place.
Avoid biting with the front teeth because this can cause the dentures to tip and may places excess pressure on the gums. Instead, bite with the canine teeth.
Until you get used to sensing the temperature of hot food, treat hot food with caution. Avoid sticky food and sharp or hard food, such as nuts or raw carrots.
As you gain confidence with your dentures, widen your diet to ensure a healthy nutrition.
After the first week, most people find that dentures do not interfere significantly with speech. Sometimes certain words may be difficult to pronounce at first.
If you dentures “click” when you talk, try to talk more slowly. If your denture slips when you speak gently bite down to reposition and swallow. Your tongue and cheek muscles will learn to keep it in place. If you have a persistent problem with speech, inform your dentist.
Dentures adhesives can give you added confidence helping ensure that your denture will not slip out of place. Your dentist can advise you about the options for you. Denture adhesive is not the answer to poorly fitting dentures, if it doesn’t fit well see your dentist.
If soreness develops under a denture, call your dentist. The denture probably needs to be adjusted. If the soreness worsens, remove the denture for at least part of the day. Before your appointment, wear your dentures for at least 6 hours. This will help the dentist determine where adjustment is needed.
Be careful to maintain good hygiene of your mouth. This is best done with a wet toweling cloth, face washer or similar materials. Simply rub the gum tissue over which the denture fits, and also rub the top of the tongue.
Protect Against Breakage
Dentures are delicate and can break easily. When cleaning a denture, hold it over a towel or a basin of water to cushion the fall if you drop it.. Brush them gently
If you break a denture, stop wearing it and call your dentist for an appointment. Do NOT glue the parts together as the wrong material may damage the denture. Do NOT bend or modify a metal clasp of a partial denture as you may break it.
You should discuss with your dentist the advantages of removing your dentures before going to bed. Ideally, the dentures should be removed as this allows the gum tissues to rest. Removal of full dentures also prevents grinding and clenching of the teeth which may cause wear.
After thoroughly cleaning the dentures, place them in a special cleaning solution or water. Dentures should never be allowed to dry out as they can warp.
Regular dental check ups are a must for all denture wearers; your dentist will examine your mouth to make sure you denture fits well.
Visit your dentist immediately if you have any pain.
Instructions for Immediate Dentures
For the fitting of immediate dentures, the dentist takes impressions of the remaining teeth and dental arch while the teeth are still in place. After the teeth have been extracted, the immediate dentures are placed in the mouth while you are still in the dental surgery. This helps to keep the swelling of gums to a minimum.
Following extractions, rapid changes in the gums take place as the gum tissue and jawbone heal to form a firm base for the denture.
During the healing period, you may need to visit the dentist several times for small adjustments. As immediate dentures cannot be tested in the mouth before the teeth are removed, the fit and appearance of the dentures may need to be adjusted.
The gums and jawbone take about three months to heal completely. During the healing, the gums shrink and the fit of the immediate denture becomes loose. It then needs relining or possibly remaking. This is a good time to make changes to the aesthetics of the denture, if you wish. The old immediate denture can be kept as an emergency spare.
IMPORTANT POINTS ABOUT IMMEDIATE DENTURES:
While the local aneasthetic is still effective in the hours after extraction, be careful that you don’t bite your tongue, lips or cheek.
Do not drink hot fluids for at least four hours after the extraction.
Your dentist will give you instructions as to when you should remove your dentures for cleaning. In most cases, this advice will be that you leave them in place for at least 24 hours. An appointment will be made for the dentist to remove your dentures, attend to any problems, and give you further instructions.
If bleeding occurs in the early stages, bite firmly on a clean handkerchief or cotton wool pad for 20 minutes. This will usually help to stop any bleeding.
Eat soft foods. Do not eat hard foods until advised by your dentist.
If the denture becomes loose, put it back into place immediately if you can do so without discomfort or the use of force. Keep pressing it into place with your tongue. If you are unable to replace your denture, rinse it and keep it wet in a plastic bag. Make an appointment with your dentist at once.
Five hours after the extraction, rinse your mouth gently, leaving the dentures in. Use a mouthwash of salt and lukewarm water (one-half teaspoon of salt in a glass of water). For the next few days, rinse regularly and gently with the salt water.
While the gums are healing, do not smoke because it impairs healing. It is best to quit smoking.
If you have severe pain or other serious difficulty, telephone for advice or a further appointment.
Be certain to attend your review appointment because an adjustment is likely to be needed to improve comfort of the dentures.
Possible Complications of Dentures
Even the best fitting denture can feel awkward at first; it can take months for a denture to feel comfortable
Some people require several months before speech returns to normal
There can be additional costs when gums shrink more than expected. The denture may have to be relined or remade
There may be a change in facial shape due to the missing teeth and replacement by a prosthesis
The flow of saliva may temporarily increase
Denture prosthetics cannot perfectly reproduce your natural teeth
It is not uncommon to feel discouraged for a while when getting used to the feel and appearance of a new denture
As the shapes of gum and jaw bones change, and dentures wear out, they may need to be relined or remade every seven years
If dentures are not removed everyday and cleaned properly, a fungal infection (candida albicans) can develop in the gums
Over time, a badly fitting denture can cause chronic inflammation of the gum tissue called denture stomatitis
If you have a dry mouth, denture retention may be difficult