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Questions about Dentures

  1. I have full dentures and they slide around in my mouth no matter how much adhesive I use – what can be done about that?
  2. I have a lot of missing teeth – what is the least expensive way to replace them all?
  3. Does everyone get used to partial or full dentures easily?
  4. If the dentist makes a denture for me to use immediately after I have the rest of my teeth extracted – how can it fit well?
  5. How soon can I get final dentures after extractions?
  6. Should I get plastic or porcelain teeth in my dentures?
  7. For partial dentures – I’m having trouble getting them in – why is that?
  8. My partial dentures tend to slip up every once in a while – why is that?
  9. One of the clasps of my partial denture is very visible, can it be done differently?
  10. Why are there so many steps required to make full dentures?
  11. Are full dentures becoming a thing of the past?
  12. I’ve heard that sometimes dentures are supported on implants – is that a good idea?
  13. The adhesive I use doesn’t work as well as it used to and I have to reapply it after a meal, whereas it used to last for several days. What is going on?
  14. I am getting dentures for the first time – what am I to expect?
  15. The dentures I got feel like they are pushing out my upper lip – is this normal or typical?
  16. When I had my dentures made the dentist just took an impression and the next visit the dentures were there. The dentist seemed rushed and didn’t want to answer any questions or explain anything, but the dentures felt strange and different from my last set. What could explain this?

Answers about Dentures:

  1. I have full dentures and they slide around in my mouth no matter how much adhesive I use – what can be done about that?  This is common for people that have been wearing dentures for a long time.  The culprit is generally the lower jaw.  When the bone of the lower jaw has not had teeth in it for a long period of time, the part of the bone which would support the teeth, the alveolar crest, resorbs.  This resorption makes the lower jaw more FLAT and the denture will sit on it, more than hold onto it.  Hence the sliding around.  There is nothing that can be done to remedy this, except put something in the remaining bone that the denture can connect to.  It is a fairly simple procedure to place a few small implants in the bone toward the front of the mouth near the chin, and embed small clips in the denture so it will snap down on these implants.  It is an in-office procedure that can be expensive, but it is WELL worth it!………………..BACK to questions
  2. I have a lot of missing teeth – what is the least expensive way to replace them all?  Since you still have remaining teeth, IF they are solidly anchored into the bone, it is likely that a PARTIAL DENTURE can be made that will connect to the remaining teeth, and put artificial teeth in places where teeth are missing.  This is a removable appliance that is taken out at night.  It is a lot like an orthodontic retainer that you might have had in your youth.  You can just snap it in place and you are good to go.  It is quite possible that it can be made so that the clasps that secure it to the remaining teeth are not visible conversationally, and the cost is FAR less than for bridges and implants…………………BACK to questions
  3. Does everyone get used to partial or full dentures easily?  Some easier than others, but I have never seen a patient that had difficulty getting comfortable with a well made denture.  The dentist I worked for when I was first out of dental school was careless when he made dentures, and I remember one case where the denture didn’t really fit – it was poorly made mostly at the fault of the dentist.  I saw the patient who was clearly upset and told them a new denture would need to be made.  The dentist/owner interceded and told the patient they would eventually get used to it!  They would not!……………….. BACK to questions
  4. If the dentist makes a denture for me to use immediately after I have the rest of my teeth extracted – how can it fit well?  It won’t.  The use of an IMMEDIATE DENTURE to replace your newly missing teeth and to permit the healing of the tissues under the denture to take a particular form, is common but often misunderstood by patients.  It will NOT be a particularly well-made denture, it is temporary.  Once the teeth are extracted, it is not desirable to have you walking around with no teeth in your mouth, and perhaps many areas that are healing and bleeding.  The denture cannot be made to fit the tissues over the bony ridge that supported the teeth because the tissues have not healed to their final shape yet.  It will not adapt to the remaining ridge anywhere near as for a denture made to fit healed tissue, but since there is generally plenty of ridge for it to “hold onto” it will remain well in place for you until you heal and a permanent denture can be made…………………BACK to questions
  5. How soon can I get final dentures after extractions?  It will be a few months.  The space created at the extraction site needs to fill in with new tissue, and this tissue needs to have a firm and relatively stable form…………………BACK to questions
  6. Should I get plastic or porcelain teeth in my dentures?  It is your choice.  The advantage of the porcelain teeth is that they look more natural typically.  Their disadvantage is that they are HARD materials and if your dentures move around in your mouth, there can be a CLICKING sound as they contact each other in an uncontrolled way, which can be audible to your friends.  If your denture fits well and stays in place solidly in function, porcelain can be just fine.  It also depends on how well the denture is made.  It can be solidly anchored to the ridges, but if they were made a little too thick, so your vertical dimension is slightly more than what it should be, as your jaws are at REST, the teeth might touch when they shouldn’t.  Again, clicking from the porcelain. For partial dentures there is the possibility that the porcelain of the replacement tooth will abrasively grind away any natural tooth which opposes it…………………BACK to questions
  7. For partial dentures – I’m having trouble getting them in – why is that?  You have to consider the design of the dentures and the location of the clasps that retain the denture in relation to the shape of the teeth that the clasps fit against.  There is a bulge on the tooth that the clasp is supposed to slide OVER as you insert the denture, and upon seating of the denture completely, the clasp comes to rest in an UNDERCUT area under the bulge.  The amount of undercut is measured carefully by the dentist and laboratory technician to make sure the clasp doesn’t have to flex TOO much to get over the bulge.  One reason it can be difficult to insert the denture is if the bulge is too great and the increased flexure of the clasp requires too much force on your part.  Another reason the denture may not seat easily is that the DIRECTION you need to push to get it to seat – called the path of insertion – is difficult for your fingers to manage.  This you can generally get used to, if you have a basic level of manual dexterity.  For people that don’t have much dexterity the dentist should have designed the denture somewhat differently, so that you, personally, can manage it…………………BACK to questions
  8. My partial dentures tend to slip up every once in a while – why is that?  This is likely due to retaining clasps that have somewhat changed shape over the years.  The retaining clasps might not grip the tooth as well as it was designed to do.  SOMETIMES the dentist can slightly bend the clasp back to its original position, but this is hazardous in that the clasp might well break.  Sometimes a new clasp can be made in a slightly different place using wire that is embedded into a plastic part of the partial denture and bent around another tooth.  This is a chair-side procedure.  Depending on the design of the denture and the location and shape of your teeth, the solution to this problem may be readily apparent, or not.  Sometimes a new denture would have to be made if the slippage is too annoying………………… BACK to questions
  9. One of the clasps of my partial denture is very visible, can it be done differently?  Sometimes it can.  The design of the denture can often be done in such a way as to avoid visible clasps, but not always.  It just depends on WHERE the teeth are that will be used for retention, and where the lips are in talking and smiling and how much of that tooth can normally be seen.  Sometimes the dentist can shift the clasp to another tooth that is less visible.  Sometimes the dentist can bring the clasp into the undercut area from another direction, instead of curving around from the top of the tooth, he can bring it in from the bottom, near the gumline, and have it just touch the tooth in the undercut close to the gingiva – less visible usually.  But, given that your denture is already made, there is only the possibility of replacing this annoyingly visible clasp with one made of wire that is embedded in the denture by the dentist.  This is a risky procedure in that it requires the irreversible removal of the visible, cast clasp, before it can be determined that the new wire clasp will function as well mechanically…………………BACK to questions
  10. Why are there so many steps required to make full dentures?  There are many things that need to be controlled in the process.  The location of the teeth has to be checked for appearance by putting them in temporary wax rims that simulate the final denture.  The teeth may need to be removed to meet your satisfaction.  The position of the front teeth needs to be checked to see if the lip support is adequate for you.  Also, even before the wax rims are used for the positioning of the teeth, the denture HEIGHT is checked by building it up with wax.  Also, it is important to check that the upper and lower dentures will come together in just the right way WHILE the joint is hinging in its most favorable position.  There is much to get right, and it requires several procedures to make sure everything IS right!……………….BACK to questions
  11. Are full dentures becoming a thing of the past?  That depends on the socio-economic level in your demographic area.  In many place people simply cannot afford to get implant-supported fixed prosthetics – in other words, if you have no teeth and want to replace them “permanently” so it seems you have teeth again and no removable appliance to take in and out, you need to have a number of implants placed in your jaws and a framework of metal anchored to them which supports artificial teeth.  This is VERY expensive.  But the other reason full dentures are less common these days is that people are retaining their teeth longer.  Now, again, that depends on where you life.  In many places dentures are common because there is less care of the teeth and less money for expensive restorations.  The Nevada state dental licensure exam in the 90s was challenging to many candidates because it required that you make a full set of dentures for a patient DURING the exam.  This recognized that in the Las Vegas area there were many people that had lost all their teeth and didn’t have the money to get permanent restorations on implants………………… BACK to questions
  12. I’ve heard that sometimes dentures are supported on implants – is that a good idea?  Great idea but very expensive!  Depending on the way they are made and the materials from which the FIXED denture are made, an implant-supported fixed prosthesis can cost up to $100,000!  The number of implants varies from 8 to many more, depending on the level and position of your remaining bone.  The artificial teeth can be handcrafted to fit the metal framework just like crowns fit on prepared natural teeth, and this gives the highest level esthetic result, but is costly.  For most people, if implants are going to be used to support dentures, they will be normal plastic removable dentures with some small implants placed that can clip into them.  Basically a stabilized routine denture that has to be removed at night, other than the fixed framework that is left in all the time like normal teeth, but the cost difference is staggering.  Typically, if you have lost your teeth because of lack of care, even if you have the money now to pay for implant-borne fixed framework dentures, if your level of care has not significantly improved, it might be a waste of money…………………BACK to questions
  13. The adhesive I use doesn’t work as well as it used to and I have to reapply it after a meal, whereas it used to last for several days. What is going on? What can be done? When you use an adhesive it needs to fill the space between the denture and your tissues. Originally you should hot have had to use an adhesive at all, as the denture fit perfectly. As you age and the bone recedes away from the denture some space is created. When that space enlarges it requires a thicker adhesive to fill the space and that still might not work satisfactorily. The best thing to do is to fill the space with a more permanent material, so the denture is adapted perfectly to the tissues again. This technique is called RELINING the denture. This procedure can be done in the dentists office with a plastic material that sets in the mouth, or you can have a FUNCTIONAL RELINE done, where a softer material is placed which sets more firmly as you wear the denture for a day. Then this soft reline material is replaced in the lab with a hard plastic. The latter procedure requires waiting for the denture to be processed, but the results are generally superior and worth the wait…………………BACK to Questions
  14. I am getting dentures for the first time – what can I expect? This all depends on the thoroughness of the dentist and their level of concern for your comfort. The upper denture will cover your palate – and you will need some time to accustom yourself to the thickness. If the denture is made thin enough, it makes it easier – and this is up to the laboratory technician to polish it so there is just a thin layer left. On the other hand, if it is too thin, it will be liable to break if you do something careless with it outside the mouth. The lower denture must fit between the tongue and the alveolar ridge. Your tongue is not used to having its space infringed upon – and may rebel for a while before settling down. The front part of the upper should NOT push out the upper lip in an uncomfortable way – but it may HAVE to more than the natural teeth you had. There are designs that can minimize this, but mostly the thickness of the denture between the ridge and the upper lip will take some time to get used to. There are VERY few people that do not get used to full dentures in a pretty short period of time. You should experience longer and longer periods where you don’t notice them at all………………… BACK to Questions
  15. My dentures feel like they are pushing out my upper lip – is this typical and necessary? Strangely enough, I was just talking with an old friend today that has worn complete dentures for many years. He said that his last set were made thicker in the front and felt like they were pushing out his lip. He got used to them after a while, but his friends noticed that there was a difference in his appearance. The dentist was not interested in talking about is concerns. In fact, the dentist that made the dentures did NOT go through all of the steps that are generally used – including the important step of trying in a wax rim model of the denture to test the lip support and the bite. I have had patients where their appearance in profile would have been negatively impacted by a denture that was thick in the upper front. In fact, sometimes you CANNOT make a denture that is thin enough in the front to give a good esthetic result, unless you eliminate the flange of the denture in that area completely. It is possible to do this, but takes dedication on the part of the dentist to get the fit so perfect that it will stay in with adequate suction even though it is not fully extended upward in the front to where the lip joins the ridge. So, the short answer, it is a common problem, but not a necessary one………………… BACK to Questions
  16. The dentist is rushing through the procedure and the dentures feel strange. In dental school students are taught the complete set of procedures to make a set of full dentures that will be optimum for the patient in every way. It is POSSIBLE to cut corners and make some guesses, and the laboratory technician may be willing to help with that – but the result is not guaranteed to be suitable for the patient. The bite can be off. The lip support can be awkward and bad looking. The joint may not be seated completely when you bite down completely, and this can give a sore joint. The length of the teeth relative to the lips when smiling may be different from how it was before, either with natural teeth or an earlier denture. When I ask a denture wearer about the procedures in the dental office that the dentist did to make the dentures, it is not unusual to find that steps were skipped – and often there is some form of discomfort as a result. If you know the steps of denture fabrication, you can find out from your dentist if he will skip any, and this may be a good reason to find another dentist! ……………….. BACK to Questions