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Traditional full dentures are usually a last resort option.  At the stage where full dentures become a reality, most people are sad and disappointed that they’re now in a position where they will lose the rest of their teeth.  Most people know others who wear dentures that look fake or fall out of their mouths.  Dentures are definitely not the end of the world and if created properly, they can really enhance your smile and still allow decent chewing ability.  So if you’re missing most of your teeth and can’t afford or don’t want dental implants then a removable denture may be the best option for you.  Maybe your remaining teeth are in such bad condition that it would be better to remove them and get a full denture.  Or perhaps you already have a full denture and you really dislike how it looks.  It’s very possible to get a set of dentures or false teeth that look like real teeth.  If you have enough bone then it’s also possible to have a set of dentures that give you good chewing ability for many foods.  If you have horribly fitting dentures due to a lack of bone then you can try adding bone with bone grafting.  The cost of dentures will be the most affordable option compared to implants and implant supported options.  Dr. Tony Kim at Honolulu based Dental Day Spa of Hawaii Specialty Group is a dentures dentist who can give you both fixed and removable options.

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Here is a before and after of a denture that was made crooked.  She was living with this denture for years before she came to our office.  I’m guessing a step was skipped in the processing of the denture which resulted in the crooked result.  To prevent this type of result we do a trial try-in of the denture before it’s finalized so both you and I get a chance to look the teeth before they are finished.  This step helps avoids critical errors like that above.

So a removable denture is something that you can take on and off which replaces at least one but sometimes all of your teeth.  Partial dentures are used when some teeth are still remaining and full dentures replace all the missing teeth in an arch.  There are some definite advantages and disadvantages so let’s first discuss the types of dentures available.

Types of Dentures

  1. Traditional or conventional dentures are the types that most people think about when they think about dentures.  These replace all the teeth on either the upper or lower jaw and sometimes both arches.  They are mostly made out of an acrylic base which has color similar to the gums.  The teeth are attached to the acrylic base and can be made out of various acrylic, plastics (resins), or porcelain.  These are held in by suction for the upper dentures or by just gravity and the cheeks for the lower dentures.
  2. Partial dentures replace several missing teeth and are anchored onto remaining teeth.  The utilize frameworks which can be made out of metal or special acrylic.  The remaining teeth which are used as anchors will have to be adjusted to accept the attachments from the partial denture.  These have clasps and hooks which snugly hug the anchor teeth and these clasps are usually visible when smiling.
  3. Overdentures are dentures which fit on top of a few existing teeth.  The remaining teeth get root canals and then are specially prepared and have abutments attached to them.  The abutments then snap onto the overdenture which locks them into place.  Dental implants can also be used instead of natural teeth to snap in the overdenture.  This is a nice option because the dentures are securely attached into place.
  4. Precision attachment dentures require a few teeth to get specialized crowns made.  These crowns have slots where the denture can slide onto and lock into place.  This requires that the teeth are strong and healthy so sometimes this technique can’t be used if abutment teeth are too weak.  This method is the most cosmetic since no clasps are used but also costs more than other options.
  5. Immediate dentures are made when you know that you will be losing your teeth ahead of time.  Nobody wants to walk around without teeth so an immediate denture is made before any teeth are removed.  Once the immediate denture is created then an appointment is made where the remaining teeth are pulled out and then the immediate denture is placed on the patient.  This is a nice technique to use because you will always have teeth at all times and will never have a period of time where you don’t have teeth.  These dentures are exactly the same as traditional ones, and many times will become the final set for you.  But it is also a very good idea to make a final set once the body heals.  There is some guesswork when making immediate dentures so if they are not exactly how you’d like them, making another final set is a good idea.  Then you can use the immediate denture as a backup in case anything happens to your final set.
  6. Temporary dentures or stayplates are usually made when a few teeth are removed so that you can have teeth until your jaw is healed and ready to make a final set of dentures.  These are made mostly of acrylic and plastic denture teeth.  They may have thin metal wires which are weaker than those in a partial denture.  I’ve often seen patients wear these thinking that they are a final set of dentures but they are not designed to be used for long term.

Advantages of Dentures

  1. They can look great and just like real teeth.  A well made set should look like real teeth.  A talented denture lab can add subtle imperfections which add to the realism of the teeth.  So if you have dentures that look like false teeth then ask your dentist if something can be done to make a better set.  There are many different levels of quality in denture teeth too, the better ones usually look more realistic.
  2. Dentures are the most affordable way to replace missing teeth.  One upper or lower denture can replace all the missing teeth on that arch.  While dentures may not be inexpensive, compared to fixed bridges and implants they are definitely cost less then the alternatives.
  3. Removable dentures can support the cheek and facial structure.  When missing a lot of teeth, the cheeks sink in and make you look older due to the collapse of the facial appearance and more wrinkles around the lips and cheek areas.  By replacing the missing teeth with dentures, the face can appear full again and dramatically change your look.
  4. They can help eating and speaking.  If you have many missing teeth, it is usually very difficult to eat.  Also, many sounds when speaking will be negatively impacted too which can definitely affect speaking.  So, a proper fitting set of dentures can improve chewing and talking compared to the alternative of having empty spaces.

Disadvantages of Dentures

  1. They loosen over time and if you don’t have enough bone, they will be loose from the very beginning.  A denture reline can help a loose denture feel more secure but the dentist will always be limited by the amount of bone that is present.  Loose false teeth will make chewing, speaking more difficult and increase the chance of getting denture sores in the mouth.
  2. Dentures can negatively impact eating and speaking.  You may have seen the first part where I mentioned that they can improve eating or speaking.  Well, they can do both.  If you have a full set of teeth now but have to lose them due to the severity of disease then you will find dentures will impact your chewing in a more negative way.  Also, because denture often cover the palate or roof of your mouth, speaking will change in the beginning.  Most times people will adapt and speech will return to normal but not always.  So depending on where you starting place is, dentures can either help speech and chewing or decrease your ability to do so.
  3. Your jawbone will slowly disappear over time when teeth are missing.  So dentures do not do anything to help maintain the bone.  This is why the fit decreases over time and why relines should be done every few years.  The bone loss can be slowed down or even stopped with dental implants but you can get more information on the consequences of missing teeth in the dental implants section of the website.
  4. There is an adjustment period to get used to them and to have them settle into place.  Once completed, your dentures may not chew well and cause sore spots from rubbing.  You have to go back to the dentist several times to adjust the fit so that the fit improves.  You also have to get used to having something foreign in the mouth, some people may feel like gagging, have excess saliva flow, and notice they can’t chew or speak well too.  These problems eventually get better but require that you visit your dentist multiple times in order to adjust them.  I’ve seen many cases where the client stops visiting the dentist for adjustments and just lives with ill fitting dentures.  It’s too bad because most problems can be improved.
  5. They can get loose enough to fall out when speaking, eating and especially sneezing.  If somebody has a set where this happen frequently, they will usually experience a loss of confidence and will usually avoid going out in public.  If you find yourself in this situation, please visit your dentist to see what can be done.  Many times, denture adhesives or glue can be used to help secure them in place.  Adhesives are not comfortable but they do work and can help keep the false teeth more stable.  Make sure you get a zinc free adhesive if you use them.
  6. It usually takes a month or longer to make a set of dentures.  So if you need teeth right away, you may have to make a temporary set first (these can be made in a week or less) and then make a final set later.  This increases the overall cost of treatment but you should remember that there are lots of measurements and steps required in the fabrication of the dentures.

Taking Care of Your Dentures

  1. Make sure you brush your dentures every day with a soft toothbrush and a nonabrasive toothpaste.  You also need to continue to brush your gums and cheeks to keep them clean.
  2. Use denture cleaners to help remove deposits which form over time.  You can also soak your dentures in lemon juice too to as an alternative.
  3. Don’t sleep with your dentures, take them off at night.  If you leave the dentures on 24/7, you may get a fungal infection and develop tissue irritation over time.
  4. You still need to visit your dentist every 6 months to make sure that the dentures are fitting well and to get an oral cancer exam.  Remember, denture fit decreases slowly over time and a reline may help really improve the fit.  The teeth also wear down over time so new dentures may have to be made when your old set gets worn down.
  5. Dentures usually loosen over time as the bone shrinks underneath.  It’s an unavoidable situation unless implants are placed to maintain bone.  A laboratory or in-house reline can help improve the fit and comfort of a denture that used to fit well.  A reline is the addition of extra pink denture material that helps fill in the gaps created when the bone shrinks away.  By filling in these spaces, the dentures most times feel like new again.  This procedure can be done as needed and it’s not uncommon to have them done every few years or so.

Steps for Full Denture Fabrication

It usually takes 4 visits to make a set of dentures.  There may be a visit or two more if things need to be altered.  Here are the typical steps:

  1. An impression needs to be taken of the arch that needs the denture and the opposing arch.  If you already have a set of dentures then we will take an impression of the old denture.
  2. A wax bite registration is next.  An acrylic plate and a rim of wax will be sent over from the lab.  We will heat up the wax on the plate, place it in the mouth and then have you bite down on the softened wax to mark the positions of the teeth.  We will also make a few measurements and markings that show the lab where the teeth need to be placed and how the smile should look.  The shade of the teeth and gums should be selected at this appointment too.
  3. A try-in with teeth is the next step.  A mockup of the denture teeth in wax will be tried in your mouth.  This appointment is critical to evaluate the esthetics of the smile and to evaluate the bite.  If there is something wrong with the shade selected or the bite is off then changes need to be made and a new try-in with teeth appointment will need to be scheduled.  The try-in will not be comfortable and will be loose but this is typical at this stage.  There is just enough material so that the teeth are held in the proper positioning for evaluation.
  4. Denture delivery is the next step.  The finished denture is sent to the office and then we place it in your mouth and then make adjustments to the bite.  You then get care instructions and then get to take home your new set of teeth.
  5. Post-op visits should be scheduled to make the adjustments that are necessary.  There will be sore spots in most cases and the bite may feel weaker on one side.  These problems can be improved with adjustments.  Most times, several adjustment visits will be necessary before the dentures reach their maximum comfort.

Partial dentures have the same steps but there is sometimes an extra step called the framework tryin which usually occurs after step 1.  If the framework in a partial denture setup fits well, then the same steps as the full denture fabrication will occur too.  Partial dentures also usually need a few teeth to be adjusted.  The adjustments are very minor and almost never require numbing or anesthesia.

If you want to discuss the pros and cons about dentures or if you have a set that doesn’t work well and want to know your options, then contact Dr. Tony Kim’s Honolulu denture office.  You can contact us through the website or call the office.  We offer free consultations to see if we can help you.