Framingham Cosmetic Dentistry - Helpful Information & Instructions For The Denture Wearers

Options For Replacing Missing Or Lost Teeth:

Implant - It’s a titanium tooth root (screw-shaped) that is surgically anchored into a sufficient jaw bone. It resembles the feel of real tooth, and can be flossed and cleaned pretty much like a natural tooth, but it tends to be expensive. It takes around six months to be stabilized n the jaw bone before it can be restored or mounted with a crown.

Bridge - It is a combination of a few attached crowns which is anchored on periodontally healthy and strong teeth immediately next to the missing tooth. It can be made a lot quicker than implants, yet it is a lot more expensive than a denture.

Denture - Not everyone is a candidate for the first two options which are fixed. This is a removable replacement for missing teeth. It is also a lot less expensive and is relatively quick. In some cases, dentures can even be used as a temporary solution, and be upgraded to one of the two fixed alternatives later on, if the condition in the mouth is suitable and if financially possible.

Combination - This option might also be possible in some cases.

Learn More About Dentures
	Tooth Replacement
	Flexible Partial Denture
	Full Denture Arch
	Over Denture
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Importance Of Replacing Missing Teeth:

Dentures not only restore and improve form (facial esthetic), function (speech, chewing ability), comfort and confidence, but also provide support for facial muscles, preventing sagging of the cheeks and collapsing of vertical dimensions of jaws. Therefore they can minimize premature wrinkling of the facial skin as well as fungus infection at the corners of the lips due to drooling of saliva. A denture can greatly enhance a patient’s facial appearance and smile. In the case of partial dentures, they also prevent adjacent and opposing teeth from shifting or supra-eruption (upper teeth moving downward).

Partial vs Complete Dentures:

Cast Metal - This is the most strong and stable one in the mouth, because of its metal framework and retentive metal arms which hug few anchoring teeth, and affix the partial to hose adjoining natural teeth. This makes it not to be considered esthetically attractive by some patients.

Flexible Valplast - This may be considered the most esthetic one of the three. It has no metal or wire component to it and it is bendable. Dipping it in hot a hot water container for a few seconds makes its insertions and molding around existing teeth in the mouth easier. It is considered the most resistible to breakage.

Acrylic - The least expensive and the least stable one of the three. However, it has wire clasps that can by pushed in and tightened by your dentist for added retention and stability. It can be additionally secured in the mouth by the use of some kind of denture adhesive. The main advantage to this partial denture is that it can be easily repaired when broken and it is possible to add more denture teeth to it, if needed in the future. This may not be always be as easily possible for the other two types of partial dentures. In general, the more remaining teeth, especially for the lower jaw, the more supported and stable the partial denture would be. Also, always bi-lateral (extended to both sides of the mouth) partial denture are more stable than those partials replacing teeth only on one side of the mouth (uni-lateral).

Conventional vs Immediate Dentures:

A conventional denture is placed in the mouth after all the teeth have been removed and the extraction sites have healed. However, an immediate denture is placed as soon as the teeth are removed. The advantage to this procedure is the fact that the patient can leave the dental office with a new set of teeth and that is esthetically more acceptable. The disadvantage to this procedure is the need for more future adjustments or relines.

Upper vs Lower Dentures:

Retention (staying in place) and stability (not moving or rocking) are always the two most common problems with dentures, although food impaction under the dentures is also another issue. Most denture wearers have problems with their lower dentures. This is due to the difference between the upper and the lower jaws. The lower jaw is the one which is moving as the patient talks or chews, yet the upper is the one which is stable. Also, the roof of the mouth (palate) is broad and hard which help create suction under the denture improving its stability and retention, yet floor of the mouth includes less surface area for the denture to rest on and is also soft. Moreover, the tongue which is a very strong muscle constantly moves during chewing or talking, which consequently contributes to a lesser retention and stability as compared to the upper jaw.

Recall, Maintenance & Care For Dentures:

Proper fitting, periodic adjustment and relining in addition to usage of denture adhesives (paste, powder, or tape) can improve stability and retention. Also, in case of some partial dentures, metal clasps can be carefully tightened by your dentist to enhance stability and retention. No matter how well a denture is made or how ideal its initial fit is, using denture adhesive will help maintain denture stability and confidence. In general, the more bone height for the denture to rest on or the more remaining natural teeth, the better stability and retention can be achieved. Weight loss or an overly thin or low ridge height of supporting bone may also affect denture fit and require the help; of an adhesive.

Adjustment - Since jaws continually undergo changes especially after teeth are removed, (old) dentures become ill-fitting causing irritation to the soft tissues and developing sore spots in the mouth. If war-water-salt rinse a few times a day won’t heal these sores, it is necessary for the mouth to be examined and the denture to be adjusted. If the dentures are not adjusted or refitted, damage to the mouth can occur, ranging from chronic sore spots to oral cancer. Periodic warm-water-salt rinse can help cleanse the mouth and heal any denture-related mouth sore.

Reline - a) Hard vs. Soft:
The bony ridge that a denture rest on shrinks over time, and continues throughout life when natural teeth are not present. A denture can stay the same, considering normal wear and tear, whereas the body (gums, teeth, jaws) continually change daily due to aging, improper oral hygiene and gaining or losing weight, which ultimately causes shifting of teeth and changes in volume and contour of the gum and jaw bone. These changes cause poor adaption (gaps or spaces) between the denture and the oral tissues, producing an ill-fitting denture. Therefore, dentures in those cases need to be relined, pretty much like a cushion placed in a larger shoe worn, to maximize an even surface area contact and adaptation between dentures and oral tissues. These reline material can be either soft (temporary) or hard (permanent). In case of sore mouth condition, sometimes a dentist decides to reline the dentures temporarily with a softer white tissue conditioning materials (to restore a physiologically healthy condition).
b) Chair-side vs. in-Lab:
Soft reline and tissue conditioning is always done in the office, whereas a hard reline can be done either in the office or sent to a dental laboratory, which requires more time and is normally more expensive, and normally with a lot better quality than the office chair-side procedure.

Repair - (Chips, Cracks, Breaks, Tooth Replacement or Addition, etc.): Most repairs are easily and quickly done, yet most of the times, dentures need to be sent to an outside laboratory for repairs. Dentures can also break inside of the mouth, if they are ill-fitted or too loose. Therefore relining them can prevent future cracking or breakage. Some patients may have a second set (spare) of dentures, so they do not have to be without teeth for a while, as their dentures are being sent to a lab for repair or reline.

Replacement - Even with the best care, natural changes in the mouth may make it necessary to have dentures remade after a number of years, ideally between 5-10 years.

Cleaning & Home Care - To avoid misplacing them, store them in the same place after removal preferably in a denture box. Remove dentures for at least a few hours each day or preferably while sleeping. Dentures should be kept in a safe place inaccessible to children or house pets (e.g. dogs). Store them in a water bath overnight to keep it from drying out. This will also allow the gum tissue to rest regularly and permit for normal stimulation and cleansing of the mouth by the tongue and saliva, which promotes better long-term health of the gums. Partial dentures should be removed prior to tooth brushing. Remove the dentures after every meal, rinse in water, and clean them with a denture brush (an extra soft bristle and not a toothbrush). They can also be soaked in water (not hot) and polident (bubbling denture cleansing tablets) daily, for 10 minutes, for stain and odor eliminations. Avoid using bleaching agents, chlorine, conventional toothpastes, vinegar, peroxide, or soap to clean your dentures. Dentures can be also professionally cleaned in the dental office.

Routine Professional Check-ups - Regular dental visits are extremely important to help maintain dentures as well as oral health. During checkups, a dentist will thoroughly examine the lining of the mouth, condition of the oral mucosa, tongue, palate, jaws, ridges that support dentures, denture fit, occlusion and wear to ensure they remain healthy. Then any recommendation of necessary is made to help achieve well-fitted, healthy mouth, and moreover a comfortable condition.

Accept The Facts & Lower Expectation, Yet Practice, Be Patient And Get Used To It:

Let’s face it! Dentures are artificial resin-based set of teeth, replacing lost natural teeth. It can be fabricated and fitted as best as possible, yet it is still false and can never be as good as one’s natural teeth, just like any other man-made prosthetic body part. Everyone varies with their ability to adapt to dentures. Dentures in the beginning may feel large, pushing lips forward, causing gag reaction, or increase the amount of saliva. New denture wearers have to deal with two main issues. First, they need to get used to and tolerate this piece of foreign object inside their mouth. Then, they need to learn how to function (chew and speak) with it. In addition, new denture wearers or those getting a new denture replacing one worn for many years, need time to get accustomed to their new teeth. Normal speaking ability, usually resumes shortly after the final denture placement. It is recommended to initially speak slowly and start with soft easy-to-chew foods, yet do not expect the same efficiency as with natural teeth. Expectations should be lowered as practicing makes perfect with time.

The only thing a dentist can do to help is to adjust the dentures to prevent sore spots, yet no one can help a denture wearer to get used to and to function with dentures except the patient him/herself. Unfortunately, natural teeth are gone and this is the least expensive way of replacing them. Therefore, being patient and learning how to work with these artificial teeth is the best and the only way to go. Continued wearing of dentures will help the patient adjust to them more quickly and easily. Going through this transition may not seem easy in the beginning, but just like so many other people, with a little patience and practice, any patient will feel confident and secure with his/her new dentures. Dentures CAN and HAVE worked for many people. In fact, one out of five adults or near 44 million American adults wears dentures. SO CAN YOU adjust to your dentures.