Dentures or ‘false teeth’ have been used as a solution for missing teeth for hundreds of years and still continue to be a cost effective and viable option. There are two common types of dentures: full (complete) dentures which replace all of the teeth in one jaw, and partial dentures which replace only a few missing teeth.
Advances in dentistry means that the dentures we make today are more comfortable, better looking and are better equipped for eating than ever before. Despite this, issues still arise and I would like to discuss the most common ones which I see, and offer some solutions.
I always say that new dentures are like a new pair of shoes, it takes time to wear them in. They will inevitably feel strange at first and it takes time for your gums, cheeks, facial muscles and tongue to adjust. It is not uncommon that new dentures will need a few follow up appointments for minor adjustments to relieve ulcers or sore spots. If these sore spots develop then make sure you book a visit with your dentist, and that for the 24 hours prior to the appointment you wear the dentures. This may be uncomfortable, however, it will show your dentist exactly where the adjustment is required.
You must always take your dentures out at night whilst you sleep. This is very important because you need to let your gums ‘breathe’ so to say and this will ensure they stay healthy. Otherwise I commonly see oral thrush and ulcers in people who sleep with their dentures.
It commonly takes at least a few weeks for speech to adjust to new dentures. Certain words may be harder to pronounce than others and you can work on this by reading out loud and practicing the words which are challenging. I encourage my patients to read the morning paper out loud at the breakfast table or the current book which they are reading. You are re-training your tongue and this will take time.
Video Caption: Denture Care and Tips by from Houston’s Best Dentist Dr. Penchas of Midtown Dentistry.
While getting used to a new set of dentures I recommend eating small pieces of soft food. Try to chew the small portions on both sides of the denture at once which will help with balance. Also avoid any foods which are too sticky, crunchy or those that require too much chewing. As you learn to control and eat with your denture you can broaden your diet until it returns to normal. Your sense of taste may change a little during the adjustment phase, but will return to normal with time.
Dentures, like natural teeth develop stains, plaque and hard tarter. This causes bad breathe and an unhealthy environment in your mouth. Use a soft brush with denture cleaner paste twice daily to remove all plaque and food debri from the dentures. Nightly soaking of dentures in a denture cleaning solution is also handy to keep them fresh. If you do not have a denture cleaner then equal parts of white vinegar and water can be used.
At your regular check-up the dentist will use a steam cleaner and instruments to remove the plaque, tarter and stains which inevitably form on the denture (as it does on natural teeth).
It is very important to continue with daily hygiene, such as twice daily brushing of the inside of your cheeks, gums and tongue with a soft brush and toothpaste. Removing food, plaque and bacteria from these areas will help keep your breathe fresh and reduce your chance of developing any conditions such as oral thrush. If you have any remaining teeth then continue to brush them as per normal to prevent decay or gum disease.
Some nausea when first adjusting to an upper denture can be quite common. I recommend sitting down and slowing your breathing down when first putting the denture in, breathing in and out of your nose and relaxing your shoulders. The feeling is usually temporary however if it becomes an ongoing issue then your dentist may need to adjust the denture.
When a top denture falls down it may be due to a number of reasons and most are due to the inability of the denture to form a suction with the roof of the mouth. This suction is essential for top dentures staying in. The denture itself may be too long and poke into the gums hence not allowing it to seat and develop suction. There may be a high spot similarly not allowing it to seat. The denture may be too bulky and getting knocked out of position by the jaw muscles or jaw bone itself. These problems can be adjusted by your dentist quite simply in the chair. Top dentures also rely on the support of the cheek and lip muscles to hold it in position and with time these muscles will become stronger. People who lack saliva may require denture adhesive pastes or gels to assist with developing suction.
Full lower dentures are notoriously unstable, this is because unlike full upper dentures they do not have the roof of the mouth for suction. Therefore the tongue, cheeks and lips play a big role in controlling the position of the denture. Lower dentures have to be designed very carefully to make use of certain key anatomical areas to assist in keeping the denture stable. However there are some patients where a lower full denture is not a viable option unless they have dental implants to attach the denture to the bone and gums below.
With time the bone and gums underneath the denture naturally shrink. This happens because the only thing which stimulates bone levels to stay thicker are teeth (or dental implants). Shrinking bone and gum leads to dentures not fitting as perfectly as they once did, and this leads to issues with gum irritation, ulcers, dentures not sitting correctly or falling out, and poor eating function. I always monitor my patients bone and gum levels at their routine check-ups and to ensure a snug comfortable fit after one to two years we do a simple procedure called ‘relining’ where we add a small thickness of the pink acrylic to the underside of the denture so that it once again fits nicely onto the gums—this counteracts the gum shrinkage.
After five to ten years we see that the level of shrinkage and also the wear of denture teeth is best managed with new dentures- there comes a point where relining the denture is inadequate. Today’s dentures last much longer between ‘relining’ appointments and replacements due to advances in materials and techniques.
The key is to determine why the irritation is occurring in the first place. This may be due to several reasons, for example if the dentures are ill fitting and the gums have shrunk away or if the dentures are too long or sharp. Your dentist will determine the cause of the irritation and possibly adjust the denture. It is very important to note that if an ulcer prolongs for more than 2 weeks and the denture has been adjusted then see your dentist for a referral to an oral pathologist, there is always a chance that this may be oral cancer.