Dentures or false teeth are prostheses that act as a replacement for the missing teeth. They are one of the oldest dental prostheses in history and Italians were the first to make them. Gold or ivory were the main components of old dentures (1). As time went on, implementation of new materials such as cobalt-chromium and vulcanite in dentures became increasingly popular (1,2). Due to the cost and structural superiority, nowadays, resin-based compounds have become the material of choice for creating dentures (3).
Oral Assessment and Denture Fabrication
It is imperative that your dentist initially assess your oral health. He/she then treats any underlying condition that will interfere with having dentures. Your dentist will pay particular attention to your jaw bone if you require implant for a fixed denture. After obtaining all the relevant information, your dentist uses a mould or captures a 3D image (impression) of your oral cavity with the precise measurement of upper and lower jaw. These details help to determine the final shape and size of the prostheses. 3D imaging-fabricated dentures are more accurate and fit better on the surface of the gum than dentures constructed based on moulding (4). Once the denture is built, your dentist will ensure that it fits comfortably over your gum and obtains your feedback. If you feel uncomfortable and have any pains or inflammation as a result of wearing the dentures, you should consult your dentist.
How to Choose the Best Denture?
Dentures come in different forms and vary based on their materials, cost and assembly protocol. If you would like to decrease the cost of your treatment, you may opt for conventional dentures without implants. The main problem with these dentures is that you will need to wait for several months. This is because your gum and jaw need to heal and restructure after teeth removal. In comparison to conventional dentures, implant-supported dentures may not require that long wait and feel like natural teeth, once placed in the oral cavity.
Partial and Full Dentures
Depending on the number of removed teeth, you can select either a partial denture covering the upper or the lower jaw or a full set covering both regions. Partial dentures can include the full extent of the gum or part of it if there are teeth attached to the jawbone. If a few teeth are missing, then dental bridges may be a better alternative. Bridges usually require an attachment to the natural teeth and similar to partial dentures fill the empty space created by missing teeth. However, unlike partial dentures, which can be removable or fixed, dental bridges require permeant fixation.
Removable vs Fixed Dentures
3D fabricated partial or full conventional dentures can be either removable or fixed. These prostheses are cheap and do not require a surgical procedure for their positioning on the surface of the gum. Despite the widespread use of these prostheses, a recent study on removable partial dentures showed that around 40% of population discontinue to use them after 5 years (5). One of the central reasons for the patient’s dissatisfaction is poor retention. Hence, people who can afford a higher treatment cost, choose the option which consists of placing implants in their jawbone.
In comparison to the conventional dentures, implant-sustained dentures need surgery to place the implants in your jawbone. You may also require bone grafting based on the condition of your jaw-bone. However, the implant ensures that the denture(s) remains secured on top of the gum. This fixation also prevents oral discomfort; increases the denture retention and allows a more pleasant chewing experience. Patients who choose implant-supported dentures have the option of having them as either removable or fixed prostheses. support
Denture-Related Oral Issues
Discomfort and Pain
Once you start wearing your dentures, mouth cavity begins to change both physiologically and anatomically to accommodate the new prostheses. The associated pain of wearing dentures usually takes around a week to disappear. Sometimes pain persists after a week. This can be due to the wrong design of the denture which prevents it from adjusting to the biomechanical demands of the upper or lower jaw; damage to the denture which affects the adjacent soft tissue; or undetected underlying pathologies (6). Removable dentures may also have an unpleasant effect on swallowing function (7). You should consult your dentist regularly to check the status of your oral cavity and the denture itself as well as discussing any discomforts caused by wearing the dentures.
Retention and stability
Frequent displacement is the most reported problems associated with conventional dentures. A study of 64 patients using complete dentures showed that 85.9% of them had retention issues (8). The anatomy of the jaw is one of the critical reasons for poor retention of dentures to the lower jaw (9). Apart from anatomy, pathological processes that cause bone loss and deterioration such as resorption can destabilise the denture and affect its retention (10). If you have a loose fitting or unstable denture your should visit your dentist. This is because the mechanical damage caused by the loose denture can cause the formation of painful oral lesions and other diseases inside your mouth (11).
The most common infection-related disease affecting adults that use dentures is stomatitis. This condition is caused by the inflammation of the tongue or wall of the mouth due to bacterial and/or yeast growth. The stomatitis can also appear on the edges of patients lips (Chelitis). Lack of oral and denture hygiene can be responsible for both conditions whereas denture failure leading to the trauma of soft tissue inside the mouth can additionally contribute to the development of stomatitis (12,13). Denture cleansing agents are the most suitable approach to prevent the occurrence of stomatitis.
Denture and Pneumonia in Elderlies
Generally, you need to remove your dentures before sleeping and thoroughly clean them for later use. Cleaning not only helps the oral hygiene but also increases the durability of your dentures. Removing denture before sleeping needs to be specifically a routine practice for older individuals. There is a direct link between wearing your dentures overnight and poor oral health that leads to infection and inflammation of your mouth and lips (14). Elderly individuals who wear their dentures overnight risk to compromise their oral well-being and as a result, have a higher probability of developing pneumonia (15).
How to Look after your Denture
You should remove your dentures and clean them before you sleep. Initially, brush your dentures with toothpaste. You should then soak them in a solution containing cleansing agents such as sodium hypochlorite or you can use commercial brands such as Corega anti-bacteria denture cleanser tablets (16,17).
Some people argue that you can briefly place your dentures inside a microwave for disinfection. However, you should avoid this practice since this overheating may permanently change the shape and the function of your denture (18).
If you live in the UK, you may be entitled to receive the NHS funding for your treatment (19). The cost of private therapy often depends on the type and size of the denture. Partial dentures can cost between £400 to £1000 depending on the number of false teeth on the denture whereas the full set can cost around £1200 to £1800. If you require a dental implant for fixed dentures, then the cost can grow up to £800 per implant. Always check with your dentist to get the most applicable price for your treatment.
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