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DENTURES

A denture is a removable replacement for missing teeth and adjacent tissues. It is made of acrylic resin, sometimes in combination with various metals. Complete dentures replace all the teeth, while a partial denture fills in the spaces created by missing teeth and prevents other teeth from changing position. Complete dentures are either "conventional" or "immediate." A conventional denture is placed in the mouth about 3-6months after all the teeth are removed to allow for proper healing, whereas an immediate denture is placed as soon as the teeth are removed. The drawback behind an immediate denture is that it may require more adjustments after the healing has taken place as the bone and tissues shrink and change shape when they heal.

A denture improves chewing ability and speech, and provides support for facial muscles. It will greatly enhance the facial appearance and smile.

What happens when you get a denture?

A dentist can make a full conventional denture when all teeth have been lost or all extraction sites have healed (up to eight weeks or longer.) The denture process takes about 4-5 appointments, 1-3 weeks apart as the work we do to make the denture is done in conjunction with a labatory. Firstly the initial diagnosis is made; an impression and a wax bite are then made to determine vertical dimensions and proper jaw position; a "try-in" is then made and placed to assure proper color, shape and fit, you will get to see it at this point to check that you are happy with it’s appearance; then at the final appointment the denture is placed, following any minor adjustments.

New denture wearers need time to get accustomed to their new "teeth" because even the best fitting dentures will feel awkward at first. While most patients can begin to speak normally within a few hours, many patients report discomfort with eating for several days to a few weeks and you may need to come back to us a couple of times to have them adjusted, as like a pair of shoes, they need to be worn and used first.

To get accustomed to chewing with a new denture, start with soft, easy-to-chew foods. In addition, denture wearers often notice a slight change in facial appearance, increased salivary flow, or minor speech difficulty.

Acrylic Dentures
• Used in full and partial dentures
• Easy to adjust, reline and add to as teeth are lost
• Economic
• Can be used as immediate dentures, being fitted the same day teeth are extracted so avoiding a time with missing teeth
• Tends to be thick to increase strength and usually needs to cover the palate
• Poor temperature transmission when eating and drinking

A (lower) acrylic

A Partial (upper)
denture with clasps acrylic denture

Cobalt-chrome Dentures
• Precision made and close fitting so more retentive than acrylic
• Used in thin section and still strong
• Excellent temperature transmission improving sensation when eating and drinking
• Can avoid palatal coverage in some cases
• Used for partial dentures and upper full dentures
• Much lighter and smaller to wear than acrylic dentures

Upper chrome denture (view from underneath) View from front

A lower partial chrome denture

The Standard Denture
As you can see from the picture below, the back of a standard denture ends just behind the hard bone in the roof of the mouth. They do this because they require as much surface area as possible to maximize retention and stability. In the case of people who gag, the back of the denture can be cut forward making the denture base look more and more like an arch. However, the more it is cut back, the less stable and retentive it will be!

Standard dentures are made for people who are already missing all their teeth. The top denture relies on "suction" to retain it, and the hardness of the underlying tissues for its stability. It generally takes 4 or sometimes more appointments to make a set of standard dentures.

Immediate Dentures
Immediate dentures (sometimes called temporary dentures) are actually made BEFORE the natural teeth are extracted. The patient walks into the office with natural teeth, and walks out with false teeth. The teeth are extracted, and a prefabricated denture is inserted directly over the sockets. Generally, most patients do not complain of much pain after their teeth are extracted and the immediate denture is inserted. The denture acts like a band aid and reduces pain.

The construction of an immediate denture requires only one or two preliminary appointments before the insertion date, depending on how many natural teeth the patient has left. The bone that supported the original teeth is still intact, and the gum tissue is firm. For the first week or so, the denture remains stable and reasonably retained.

There can be a few problems associated with immediate dentures. These problems account for the alternate name; "temporary dentures":

1. If the patient has more than one or two remaining front top teeth, it is usually impossible to do a wax try in. The denture teeth are placed in about the same position as the natural teeth before extraction. Even though the denture teeth will be straight, and clean, their position may not be ideal because there is no way to preview them as we do with a standard denture. For this reason, not everyone will be happy with the final appearance of their immediate denture, and may wish to invest in a new one at the end of about a year when most of the healing has taken place.

2. After the natural teeth are extracted and the immediate denture is inserted, there is a relatively fast loss of the bone that used to hold the natural teeth in place. By the end of three weeks, enough bone has been lost that there may be space between parts of the denture and the healing gums. This leads to rapidly increasing looseness and sore spots which must be removed frequently. You may require a temporary "soft" reline at about one month after the extraction/insertion date. This is a simple way to tighten the denture against the gums, and since the material is a bit rubbery, and frequently medicated, it makes the denture much more comfortable until enough healing has taken place to do a permanent "hard" reline and then eventually a new denture, if required.

Overdentures
Overdentures are defined as any removable tooth replacement device that is inserted over existing teeth or their remnants, replacing these teeth with false teeth. Prior to modern dentistry, overdentures were very nearly the universal tooth replacement device since surgical removal of teeth was painful, dangerous, and frequently impossible without modern anesthetics. In those days, dentures were made to fit over the rotting stumps of decayed or broken teeth.

Today, non restorable teeth are generally removed prior to the placement of a removable prosthesis, however, there are still instances where these teeth can be maintained to the patient's advantage. The most frequently seen overdenture today involves teeth that have had root canal therapy. If the roots of these teeth are still serviceable, the crown may be cut off at gum line and a removable appliance may be placed over the stumps. Sometimes, the stumps are themselves covered with filling material or cast metal copings in order to protect them from decay. The advantage to this is that the roots of these teeth can maintain the bone that supports them. This bone would otherwise resorb away leaving less tissue to support the denture. In addition, the root itself can serve as a "rest", or a vertical support for the denture allowing for more stability than would otherwise be available.
Overdentures are great for patients who wish to have implants sometime in the future and need to keep the bone because if the bone is lost, implants will be a lot more difficult and may require bone grafting or simply may no longer be an option.

Implant Retained Dentures
Implants are quite effective in retaining an otherwise non retentive denture. An implant may support a porcelain tooth, or it may support an attachment for a denture. .

A minimum of 2 implants can maintain a lower denture which would not otherwise be tolerated by that patient. More than two implants are needed for upper implant retained dentures. Although the dentures that fit over implants are considerably more expensive than standard dentures, they offer the added advantage of allowing upper dentures to be built in the shape of an arch instead of having to cover the entire palate. This is of special significance to people who otherwise cannot wear full dentures because they make them gag.

Implant retained dentures have special significance for people who cannot wear lower dentures. As an edentulous (toothless) person ages, and the bone continues to resorb away, lower ridges frequently disappear entirely. Thus there is no vertical bone underlying the gums to stabilize a lower denture. These people frequently cannot wear a lower denture at all. The addition of two implants in the front of the lower jaw can make it possible to retain a lower denture which would otherwise be impossible for the patient to tolerate.

Valplast Dentures

The most recent advance in dental materials has been the application of nylon-like materials to the fabrication of dental appliances. This material (the most common name brand is ValPlast) generally replaces the metal, and the pink acrylic denture material used to build the framework for standard removable partial dentures. ValPlast is similar to the material used to build those fluorescent orange traffic cones you sometimes see on highways. It is nearly unbreakable, is colored pink like the gums, can be built quite thin, and can form not only the denture base, but the clasps as well. Since the clasps are built to curl around the necks of the teeth, they are practically indistinguishable from the gums that normally surround the teeth.

Even though this type of denture does not rest on the natural teeth like the metal framework variety, the clasps rest on the gums surrounding the natural teeth. This tissue, unlike the gums over extraction sites, is stable and changes very little over time which keeps this type of denture stable and unchanging similar to the cast metal variety. This type of partial denture extremely stable and retentive, and the elasticity of the flexible plastic clasps keeps them that way indefinitely. They have a lifetime guarantee against breakage.

A Valplast ‘flexible’ denture

Site designed by System 3 Business Solutions. Content by Mandy Rawson.


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What is a Periodontist Fee Guide & Payment options Opening Times Find us-Map and address Links	DENTURES A denture is a removable replacement for missing teeth and adjacent tissues. It is made of acrylic resin, sometimes in combination with various metals. Complete dentures replace all the teeth, while a partial denture fills in the spaces created by missing teeth and prevents other teeth from changing position. Complete dentures are either "conventional" or "immediate." A conventional denture is placed in the mouth about 3-6months after all the teeth are removed to allow for proper healing, whereas an immediate denture is placed as soon as the teeth are removed. The drawback behind an immediate denture is that it may require more adjustments after the healing has taken place as the bone and tissues shrink and change shape when they heal. A denture improves chewing ability and speech, and provides support for facial muscles. It will greatly enhance the facial appearance and smile. What happens when you get a denture? A dentist can make a full conventional denture when all teeth have been lost or all extraction sites have healed (up to eight weeks or longer.) The denture process takes about 4-5 appointments, 1-3 weeks apart as the work we do to make the denture is done in conjunction with a labatory. Firstly the initial diagnosis is made; an impression and a wax bite are then made to determine vertical dimensions and proper jaw position; a "try-in" is then made and placed to assure proper color, shape and fit, you will get to see it at this point to check that you are happy with it’s appearance; then at the final appointment the denture is placed, following any minor adjustments. New denture wearers need time to get accustomed to their new "teeth" because even the best fitting dentures will feel awkward at first. While most patients can begin to speak normally within a few hours, many patients report discomfort with eating for several days to a few weeks and you may need to come back to us a couple of times to have them adjusted, as like a pair of shoes, they need to be worn and used first. To get accustomed to chewing with a new denture, start with soft, easy-to-chew foods. In addition, denture wearers often notice a slight change in facial appearance, increased salivary flow, or minor speech difficulty. Acrylic Dentures • Used in full and partial dentures • Easy to adjust, reline and add to as teeth are lost • Economic • Can be used as immediate dentures, being fitted the same day teeth are extracted so avoiding a time with missing teeth • Tends to be thick to increase strength and usually needs to cover the palate • Poor temperature transmission when eating and drinking A (lower) acrylic A Partial (upper) denture with clasps acrylic denture Cobalt-chrome Dentures • Precision made and close fitting so more retentive than acrylic • Used in thin section and still strong • Excellent temperature transmission improving sensation when eating and drinking • Can avoid palatal coverage in some cases • Used for partial dentures and upper full dentures • Much lighter and smaller to wear than acrylic dentures Upper chrome denture (view from underneath) View from front A lower partial chrome denture The Standard Denture As you can see from the picture below, the back of a standard denture ends just behind the hard bone in the roof of the mouth. They do this because they require as much surface area as possible to maximize retention and stability. In the case of people who gag, the back of the denture can be cut forward making the denture base look more and more like an arch. However, the more it is cut back, the less stable and retentive it will be! Standard dentures are made for people who are already missing all their teeth. The top denture relies on "suction" to retain it, and the hardness of the underlying tissues for its stability. It generally takes 4 or sometimes more appointments to make a set of standard dentures. Immediate Dentures Immediate dentures (sometimes called temporary dentures) are actually made BEFORE the natural teeth are extracted. The patient walks into the office with natural teeth, and walks out with false teeth. The teeth are extracted, and a prefabricated denture is inserted directly over the sockets. Generally, most patients do not complain of much pain after their teeth are extracted and the immediate denture is inserted. The denture acts like a band aid and reduces pain. The construction of an immediate denture requires only one or two preliminary appointments before the insertion date, depending on how many natural teeth the patient has left. The bone that supported the original teeth is still intact, and the gum tissue is firm. For the first week or so, the denture remains stable and reasonably retained. There can be a few problems associated with immediate dentures. These problems account for the alternate name; "temporary dentures": 1. If the patient has more than one or two remaining front top teeth, it is usually impossible to do a wax try in. The denture teeth are placed in about the same position as the natural teeth before extraction. Even though the denture teeth will be straight, and clean, their position may not be ideal because there is no way to preview them as we do with a standard denture. For this reason, not everyone will be happy with the final appearance of their immediate denture, and may wish to invest in a new one at the end of about a year when most of the healing has taken place. 2. After the natural teeth are extracted and the immediate denture is inserted, there is a relatively fast loss of the bone that used to hold the natural teeth in place. By the end of three weeks, enough bone has been lost that there may be space between parts of the denture and the healing gums. This leads to rapidly increasing looseness and sore spots which must be removed frequently. You may require a temporary "soft" reline at about one month after the extraction/insertion date. This is a simple way to tighten the denture against the gums, and since the material is a bit rubbery, and frequently medicated, it makes the denture much more comfortable until enough healing has taken place to do a permanent "hard" reline and then eventually a new denture, if required. Overdentures Overdentures are defined as any removable tooth replacement device that is inserted over existing teeth or their remnants, replacing these teeth with false teeth. Prior to modern dentistry, overdentures were very nearly the universal tooth replacement device since surgical removal of teeth was painful, dangerous, and frequently impossible without modern anesthetics. In those days, dentures were made to fit over the rotting stumps of decayed or broken teeth. Today, non restorable teeth are generally removed prior to the placement of a removable prosthesis, however, there are still instances where these teeth can be maintained to the patient's advantage. The most frequently seen overdenture today involves teeth that have had root canal therapy. If the roots of these teeth are still serviceable, the crown may be cut off at gum line and a removable appliance may be placed over the stumps. Sometimes, the stumps are themselves covered with filling material or cast metal copings in order to protect them from decay. The advantage to this is that the roots of these teeth can maintain the bone that supports them. This bone would otherwise resorb away leaving less tissue to support the denture. In addition, the root itself can serve as a "rest", or a vertical support for the denture allowing for more stability than would otherwise be available. Overdentures are great for patients who wish to have implants sometime in the future and need to keep the bone because if the bone is lost, implants will be a lot more difficult and may require bone grafting or simply may no longer be an option. Implant Retained Dentures Implants are quite effective in retaining an otherwise non retentive denture. An implant may support a porcelain tooth, or it may support an attachment for a denture. . A minimum of 2 implants can maintain a lower denture which would not otherwise be tolerated by that patient. More than two implants are needed for upper implant retained dentures. Although the dentures that fit over implants are considerably more expensive than standard dentures, they offer the added advantage of allowing upper dentures to be built in the shape of an arch instead of having to cover the entire palate. This is of special significance to people who otherwise cannot wear full dentures because they make them gag. Implant retained dentures have special significance for people who cannot wear lower dentures. As an edentulous (toothless) person ages, and the bone continues to resorb away, lower ridges frequently disappear entirely. Thus there is no vertical bone underlying the gums to stabilize a lower denture. These people frequently cannot wear a lower denture at all. The addition of two implants in the front of the lower jaw can make it possible to retain a lower denture which would otherwise be impossible for the patient to tolerate. Valplast Dentures The most recent advance in dental materials has been the application of nylon-like materials to the fabrication of dental appliances. This material (the most common name brand is ValPlast) generally replaces the metal, and the pink acrylic denture material used to build the framework for standard removable partial dentures. ValPlast is similar to the material used to build those fluorescent orange traffic cones you sometimes see on highways. It is nearly unbreakable, is colored pink like the gums, can be built quite thin, and can form not only the denture base, but the clasps as well. Since the clasps are built to curl around the necks of the teeth, they are practically indistinguishable from the gums that normally surround the teeth. Even though this type of denture does not rest on the natural teeth like the metal framework variety, the clasps rest on the gums surrounding the natural teeth. This tissue, unlike the gums over extraction sites, is stable and changes very little over time which keeps this type of denture stable and unchanging similar to the cast metal variety. This type of partial denture extremely stable and retentive, and the elasticity of the flexible plastic clasps keeps them that way indefinitely. They have a lifetime guarantee against breakage. A Valplast ‘flexible’ denture Site designed by System 3 Business Solutions. Content by Mandy Rawson.