Dentures................
What are Dentures?
Dentures are replacements for missing teeth that can be
taken out and put back into your mouth. While dentures take
some getting used to, and will never feel exactly the same
as one's natural teeth, today's dentures are natural looking
and more comfortable than ever.
There are two main types of dentures:
full and partial. Your dentist will help you choose the
type of denture that's best for you based on whether some
or all of your teeth are going to be replaced and the cost
involved.
Denture Relines
Denture relining serves the need to periodically replace
the hard and soft tissues that were lost as a result of
dentures eroding more bone due to movement and friction
of the denture.
Dentures that loosen over time are
typically due to 2 problems. First, the bone loss is so
significant that there is not enough bone to "grip"
the denture. Second, the bite is off and the lower teeth,
denture, partial are hitting in the wrong places or at the
wrong times.
A denture is essentially a piece
of acrylic fitted with denture teeth that covers an entire
palate (upper jaw) or ridge (lower jaw). The denture is
held in place with some suction if a good impression is
made and possibly with the use of denture adhesive and bracing
with the tongue and opposite arch.
Denture movement that slowly increases
over time invariably leads to more bone loss, further instability
and sore gums. The sore tissues are a result of uneven pressure
which will cause pain, swelling, worsening denture fit and
will ultimately compromise one's ability to chew normally.
Uneven occlusal planes - how teeth
or dentures fit together can lead to a "teeter totter"
rocking of the teeth, pressure spots, painful ulcerations
or epuli or denture sores. Dentures that are not relined
on a routine basis that addresses this issue frequently
cause tissue disparities that create these occlusal or bite
problems which perpetuates the cycle of continued hard and
soft tissue deterioration
The fabrication process used to manufacture
a denture product can also be responsible for the soreness
factor. Many dentures are made quickly and inexpensively,
with a shrinkage effect that is entirely due to the curing
process used in manufacture of the denture.
Ivocap processing or injection molded
acrylic are popular denture fabrication processes that will
result in less than .1 shrinkage, thereby producing a more
comfortable denture with less need for adjustments.
The quality of the impression making
process can be critical for some patients. If a dentist
takes an impression for a denture on inflammed puffy tissues
the result will be a less than wonderfully fitting set of
dentures as well.
In a similar fashion, for the lower
jaw... if the impression is made on an inadequate or sickly
ridge the denture will be sickly.
The idea of a reline is to make dentures
fit better. The reline or rebase of a denture every 3-5
years is to keep the fit good and the movement or wear to
the ridge at a minimum.
With today's advancements in denture
prosthetics and the availability of mini implants, it might
be more healthful to look at a denture as a temporary prosthesis
until implants can be placed to stabilize the bone, prevent
bone loss and sinus expansion in the upper arch, and create
teeth that are fixed solutions.
The cycle of loose fitting dentures
and increasing bone loss can be a relentless event. In extreme
cases, the wear and tear can cause deterioration that is
so significant the comfortable use of dentures can become
impossible.. along with the impossibility of placing implants.
Patients who sense their relinings
are not as effective as they once were, should consult with
their dentists to investigate more sensible alternatives
that will either halt hard and soft tissue loss.. with the
possibility of augmenting need bone structures.
Dentures:
Bargain versus Sensible
Comfortable Dentures Do Exist
Comfortable dentures seems like an oxymoron to most denture
wearers. Denture patients are often embarrassed to talk
about their problems. They resign themselves to using a
lot of denture goop and face the prospect of eating in public
with trepidation at times.
"My neighbor/husband/wife can
eat anything with dentures why can’t I?" Often the
dentist is blamed for this series of problems. "My
dentures click, they pop out easily when I yawn, they rock,
I have constant sores in my mouth" .... are all problems
that dentists hear.
Occlusion Dynamics and Dentures
The truth is that some of these problems are not avoidable
but most are. Denture occlusion is the culprit with unsuccessful
dentures most of the time. Most dentists make dentures in
2-3 visits and fail to do steps needed to balance the occlusion
and zero in the bite.
Dentists usually need to take Facebow
Transfers (a device to orient the upper jaw to an articulator),
and mount models on an articulator to try and duplicate
a patients jaw relationship for purposes of setting denture
teeth ideally.
Bite-registrations record these maxillo-mandibular
relationships (upper to lower jaw relationships) so teeth
can be put in a favorable position for chewing.
Common Errors in Denture Fitting
Most dentists were and continue to
be taught to set denture teeth over existing bone. This
may be common sense for a patient that recently lost their
teeth, but what about a patient that’s had 2 previous sets
of dentures dating back 20 years!
Do you think they have lost bone?
Of course they have. People lose about 4 mm of bone in the
first year after having teeth removed and may lose up to
60% more bone over the course of the next 5-7 years.
So it’s axiomatic that putting teeth
over the bone will continue to drive teeth further and further
backwards in someone’s face over a period of years if this
criterion for tooth placement is followed.
According to well known Specialists,
teeth need to be set for ideal esthetics, phonetics (speech),
and function.
Placement of denture teeth in ideal
locations can leave lips full and sexy, decrease wrinkles,
improve speech and give a proper drape to a person’s lips,
and surrounding skin.
As can be seen in the adjacent photo,
a pronounced underbite can result in an older facial appearance,
decreased esthetics, and poor function.
Placing the teeth where Mother Nature
intended can give a youthful appearance, improved facial
profile and contour and result in a gorgeous, functional
bite that will result in less denture movement, less bone
loss secondary to denture movement and a more successful
denture experience.
Dentures made by artisan labs can
perform denture esthetics that is indistinguishable from
real teeth. Blood vessels, pigments in the gums, roots of
teeth are all possible. Dentures can be made to be as realistic
as the patient wants. Putting in fillings in denture teeth,
installing gold teeth or porcelain crowns in dentures can
make them look extremely natural.
What sets these dentures apart from
ordinary dentures is the time spent with the patient to
achieve the degree of natural appearance desired. Whether
people had gaps in real life before dentures, or slightly
rotated front teeth, these effects are all possible in dentures.
In our practice dentures are the
same as full mouth reconstructions - the difference is we
can do it faster and customize all steps to our patients
in search of a Makeover Experience. Below you can see the
detail that is achievable with Prosthodontic quality denture
art.
Dentures are a lost art, unfortunately
for a lot of denture sufferers.
Dentists that understand denture
occlusion, the value of superlative denture expert labs,
and taking the time to give people the best can insure that
denture wearers won’t feel like cripples missing a limb
for which there is little help.
Treatment Time Frames for Sensible Dentures
Often times, economy dentures can
be made from start to finish in about two weeks. Cosmetic,
artisan grade dentures can take a month or two depending
on the number of alterations required to generate a truly
customized fit.
Turbyfill Dentures (prosthodontic
quality) typically start with soft liners to condition ill
fitting dentures to allow gum tissues to rest.
Dentures that have an initial impression
taken on sore gums will replicate the soreness in the new
dentures. It is important and essential to take the load
off of the ill-fitting dentures to allow the gums to rest
prior to fabricating a new denture.
Secondly, the inial impressions can
be made with the patient's denture or a custom tray that
is designed specifically for that patient's mouth. Then
comes tooth selection, bite registrations and the artistic
setting of the teeth.
As the time needed is invested, the
natural nuances of lip support (critical for showing off
lots of pretty teeth) and smile design can be achieved.
These are a few of the reasons the more advanced dentures
can take up to two months to make.
COSMETIC DENTISTRY - DENTURES
