How to Choose Good Dentures

If your mouth is shared between your own teeth and perhaps a partial denture and/or bridge(s), maintaining your oral hygiene takes on an additional financial incen­tive. It is important to keep the remaining teeth for as long as possible. Not only are your own teeth better at biting and chewing, but the remaining teeth may be vital to the stability and retention of an existing denture, and certainly a bridge. There may even be metal clasps of a partial denture around some of your own teeth. Although it is possible to add teeth to a denture, the entire denture may have to be redesigned and remade. This can be both expensive and time-consuming. The same applies to a tooth to which a bridge is attached. Once that has been lost, the bridge is also lost. So it is more efficient, cheaper and easier to ensure that the teeth next to the denture, or those that support bridges, are pristine. They must be kept plaque-free.

 

Both full and partial dentures may well be ‘immedi­ate’ dentures. That is to say that the denture has been made before the teeth are extracted, and fitted immediately after extraction, at the same appointment. Within six months, the part of the gum where the extraction took place, which is now in contact with the fitting surface of the denture, will have ‘shrunk’. The denture starts to feel loose, rather like a dress or pair of trousers after a bout of slimming. This is called bone resorption and is perfectly natural. It generally means that either the denture will have to be re-based or you will need a new one. Resorption is a more difficult problem with full dentures, as the poor fit becomes far more notice­able. At one time people who needed full dentures were made to wait for almost six months while the bone ‘shrank’ before a dentist would make them. Today, immediate dentures are more common.

 

There are various types of dentures and other tooth replacements. It is worthwhile outlining the salient points.

 

– All dentures are removable.

– They either replace some teeth (partial) or all the teeth (full).

– They can be made of plastic or metal (generally cast chrome-cobalt steel).

– The upper ones can cover the entire roof of the mouth, or be in ‘skeleton’ form.

– The teeth are usually made of plastic.

 

Dentures are never as good as your own teeth. In par­ticular, full upper and lower dentures can be difficult to keep stable. This can make eating difficult. Partial dentures fill gaps between teeth. Because of this, and unlike full dentures, they vary widely in type and con­struction. There may be as many as three or four differ­ent sections of false teeth on the plate, separated by the natural teeth, or it may be a single tooth replacement. There are also metal partial skeleton dentures, which cover less gum and roof of the mouth, but have metal arms extending around the cheek surfaces of the back teeth. Other partial dentures have clasps onto teeth, and may be extremely small.

 

Dentures are made to fit each individual mouth. Lower full dentures sit on a narrow ridge and can be difficult to control; upper dentures are more stable as they have suction imparted by the hard palate. Some people cope with their dentures from day one, but others never come to terms with them. The difference is often psychological rather than physical or mechanical, although controlling the tongue in order to stop it dis­lodging the lower denture requires perseverance.

 

While appearance is important, you have to eat with dentures, not just look as though you have all your own teeth. Denture fixative is used by many people, but only works on the upper denture. So most people with full dentures have to learn to adapt their diet. Apples and other hard foods may need to be pre-cut or sliced. Chewy meats are likely to be forsworn, as are foods with small pips, which can find their way under dentures and cause irritation.

 

Dentures should be removed from the mouth and cleaned daily. Cleaning is in two parts. All dentures should be scrubbed carefully with a hard brush, reach­ing into all the nooks and crannies to remove plaque. They should also be cleaned by a soaking in a com­mercial denture cleanser, although it is not necessary to leave your dentures to soak overnight. Never use bleach or other self-selected cleaning agents as these tend to damage the plastic. Very small dentures should be re­moved at night – or when playing energetic sports – as they can get dislodged and obstruct the airway.

 

The gums on which dentures rest also have to be kept in good condition, and this includes brushing the roof of your mouth and gums with a toothbrush and tooth­paste. Sore spots or ulcers should be treated speedily, especially if they follow the fitting of new dentures. However, the denture may well need ‘easing’ by the dentist, and a chlorhexidine mouthwash or gel is useful in helping the gums recover. This also applies to aphthous ulcers. It is also possible for the root of a long-forgotten tooth, which has been buried in the bone pain­lessly for many years, to work its way to the surface of the mouth. This will cause pain under a denture and it should be removed by the dentist. Some people never come to terms with their dentures, especially full sets. In such cases, other forms of replacement might be indi­cated, such as implants.

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