Tooth Replacements: Dentures
Tooth loss can have a profound effect on your health and well-being. Even though diseases leading to tooth loss are largely preventable, 46 percent of Americans ages 65 and older have lost six or more teeth, and 20 percent have lost all of their natural teeth due to decay or gum disease.
Research shows that it takes 20 well-placed teeth to preserve your normal chewing function. As the number of teeth decreases, the quality of a person’s diet drops. Missing teeth can also make speaking difficult and can make you self-conscious about your appearance. In addition, an empty space in the dental arch destabilizes the teeth that remain. The consequences can be tooth shifting, bone loss, and bite problems.
Although nothing can truly take the place of healthy natural teeth, several replacement options are available. They can improve your functioning and your appearance, as well as help you preserve surrounding teeth. One such option is removable prostheses, or dentures.
In certain situations, removable prostheses (either partial or full dentures) may be the best option for regaining some level of oral functioning. They are usually the treatment of last resort because they can be uncomfortable. If they aren’t made properly and checked regularly, they may accelerate bone loss in the jaws.
There are several risks associated with full dentures. Once all the teeth are gone, the supporting alveolar bone reabsorbs into the body. The pressure from the dentures often hastens this process. As the bone disappears, the position of the dentures shifts, causing the teeth to meet unevenly and making chewing difficult. In addition, the dentures exert considerable pressure on underlying nerves, which are now unprotected. This can make chewing extremely painful. Even partial dentures can stress the alveolar bone. Partial dentures and overdentures may also lead to irritation and sores in the mouth. In addition, bacteria can collect around the dentures, increasing the risk for oral infections and root decay in any remaining teeth.
This type of prosthesis is recommended if you need to replace several teeth in a row or your remaining teeth are not strong enough to support a fixed bridge. Removable partial dentures consist of acrylic or ceramic artificial teeth embedded in a gum-colored plastic base that is form-fitted to the underlying mouth tissues. Inside the prosthesis is a framework of light, noncorroding metal that makes it strong and stiff.
Partial dentures are usually attached to your adjacent teeth by clasps that hook around the outside of the teeth. Precision attachments are a stable and more aesthetically pleasing alternative. These devices require placing crowns or inlays with vertical grooves on abutting teeth. The denture is fitted with matching ridges that dovetail with the grooves. The connecting mechanism is nearly invisible when the prosthesis is in place.
Full dentures are generally reserved for elderly people who’ve lost all their natural teeth and whose health or finances preclude implants or implant-based fixed appliances.
Full dentures consist of a pink acrylic base holding a complete arch of teeth. On an upper denture, the base conforms to the dental ridge at the front of the mouth and extends over the palate. On the lower jaw, the base is constructed in a horseshoe shape to leave room for the tongue. More than one in three people have difficulty tolerating lower dentures because of the size, shape, or position of their tongues.
Full dentures are sometimes difficult to keep in place. The lower denture is especially difficult to manage. Adherence of the upper denture depends on surface tension between the base and underlying oral mucosa. On the lower jaw, the denture is kept in position by pressure from your cheeks and tongue. Because dentures can tolerate less chewing force than natural teeth, many people find two matching dentures easier to use than a single one. But this may mean having some good teeth extracted in order to have a matching set.
Traditionally, all remaining teeth had to be pulled and the mouth left to heal before dentures could be placed. But you and your dentist can now opt to place immediate dentures the same day your teeth are removed. The obvious advantage of this technique is that you don’t have to go toothless while the dentures are being fitted. In addition, the tooth sockets actually heal more comfortably when the denture base covers them. However, as your mouth tissues adjust, the dentures must be refitted or a new set made. This usually happens within a few months of receiving the dentures.
Overdentures are a variation on full dentures. If you have a few remaining teeth, their roots may offer enough support to sustain anchoring devices that can be used to support the dentures. One of the primary advantages of this technique is that it preserves the roots, thereby preventing loss of the alveolar bone that supports the dentures. Overdentures also provide a more natural chewing sensation than traditional complete dentures.
Source: Dental Health for Adults: A Guide to Protecting Your Teeth and Gums. Copyright © by Harvard University. All rights reserved.