Dentures Care
Proper denture care is important for both the health of your dentures and mouth. Here are some tips:
Handle dentures with great care. To avoid accidentally dropping them, stand over a folded towel or a full sink of water when handling dentures.
Brush and rinse your dentures daily. Like natural teeth, dentures must be brushed daily to remove food and plaque. Brushing also helps prevent the development of permanent stains on the dentures. Use a brush with soft bristles that is specifically designed for cleaning dentures. Avoid using a hard-bristled brush as it can damage or wear down dentures.
Gently brush all surfaces of the denture and be careful not to damage the plastic or bend attachments. In between brushings, rinse your dentures after every meal.
Clean with a denture cleaner. Hand soap or mild dishwashing liquid can be used for cleaning dentures. Household cleansers and many toothpastes may be too abrasive for your dentures and should not be used. Also, avoid using bleach, as this may whiten the pink portion of the denture. Ultrasonic cleaners can be used to care for dentures. These cleaners are small bathtub-like devices that contain a cleaning solution. The denture is immersed in the tub and then sound waves create a wave motion that dislodges the undesirable deposits. Use of an ultrasonic cleaner, however, does not replace a thorough daily brushing. Products with the American Dental Association (ADA) Seal of Acceptance are recommended since they have been evaluated for safety and effectiveness.
Denture care when not being worn. Dentures need to be kept moist when not being worn so they do not dry out or lose their shape. When not worn, dentures should be placed in a denture cleanser soaking solution or in water. However, if your denture has metal attachments, the attachments could tarnish if placed in a soaking solution. Your dentist can recommend the best methods for caring for your particular denture. Dentures should never be placed in hot water, as it can cause them to warp.
More about dentures:
Dentures are prosthetic devices constructed to replace missing teeth, and which are supported by surrounding soft and hard tissues of the oral cavity. Conventional dentures are removable, however there are many different denture designs, some which rely on bonding or clasping onto teeth or dental implants. There are two main categories of dentures, depending on whether they are used to replace missing teeth on the mandibular arch or the maxillary arch.
Patients can become entirely edentulous (without teeth) due to many reasons, the most prevalent being removal because of dental disease typically relating to oral flora control, i.e. periodontal disease and tooth decay. Other reasons include tooth developmental defects caused by severe malnutrition, genetic defects such as Dentinogenesis imperfecta, trauma, or drug use.
Advantages
Dentures can help patients in a number of ways:
1. Mastication – chewing ability is improved by replacing edentulous areas with denture teeth.
2. Aesthetics – the presence of teeth provide a natural facial appearance, and wearing a denture to replace missing teeth provides support for the lips and cheeks and corrects the collapsed appearance that occurs after losing teeth.
3. Phonetics – by replacing missing teeth, especially the anteriors, patients are better able to speak by improving pronunciation of those words containing sibilants or fricatives.
4. Self-Esteem – Patients feel better about themselves.
Types of dentures
Removable partial dentures
Removable partial dentures are for patients who are missing some of their teeth on a particular arch. Fixed partial dentures, also known as “crown and bridge”, are made from crowns that are fitted on the remaining teeth to act as abutments and pontics made from materials to resemble the missing teeth. Fixed bridges are more expensive than removable appliances but are more stable.
Complete dentures
Conversely, complete dentures or full dentures are worn by patients who are missing all of the teeth in a single arch (i.e. the maxillary (upper) or mandibular (lower) arch).
Prosthodontic principles of dentures
Support
Support is the principle that describes how well the underlying mucosa (oral tissues, including gums and the vestibules) keeps the denture from moving vertically towards the arch in question, and thus being excessively depressed and moving deeper into the arch. For the mandibular arch, this function is provided by the gingiva (gums) and the buccal shelf (region extending laterally (beside) from the posterior (back) ridges), whereas in the maxillary arch, the palate joins in to help support the denture. The larger the denture flanges (part of the denture that extends into the vestibule), the better the support. This last sentence requires comment and correction, it reveals some misunderstanding by the author as flanges usually provide stability and not support. Indeed, long flanges beyond the functional depth of the sulcus are a common error in denture construction, often (but not always) leading to movement in function.
Stability
Stability is the principle that describes how well the denture base is prevented from moving in the horizontal plane, and thus from sliding side to side or front and back. The more the denture base (pink material) runs in smooth and continuous contact with the edentulous ridge (the hill upon which the teeth used to reside, but now consists of only residual alveolar bone with overlying mucosa), the better the stability. Of course, the higher and broader the ridge, the better the stability will be, but this is usually just a result of patient anatomy, barring surgical intervention (bone grafts, etc.).
Retention
Retention is the principle that describes how well the denture is prevented from moving vertically in the opposite direction of insertion. The better the topographical mimicry of the intaglio (interior) surface of the denture base to the surface of the underlying mucosa, the better the retention will be (in removable partial dentures, the clasps are a major provider of retention), as surface tension, suction and just plain old friction will aid in keeping the denture base from breaking intimate contact with the mucosal surface. It is important to note that the most critical element in the retentive design of a full maxillary denture is a complete and total border seal (complete peripheral seal) in order to achieve ‘suction’. The border seal is composed of the edges of the anterior and lateral aspects AND the posterior palatal seal. The posterior palatal seal design is accomplished by covering the entire hard palate and extending not beyond the soft palate and ending 1–2 mm from the vibrating line.
As mentioned above, implant technology can vastly improve the patient’s denture-wearing experience by increasing stability and saving his or her bone from wearing away. Implant can also help with the retention factor. Instead of merely placing the implants to serve as blocking mechanism against the denture pushing on the alveolar bone, small retentive appliances can be attached to the implants that can then snap into a modified denture base to allow for tremendously increased retention. Options available include a metal hader bar or precision balls attachments, among other things.
Complications and recommendations
The fabrication of a set of complete dentures is a challenge for any dentist, including those who are experienced. There are many axioms in the production of dentures that must be understood; ignorance of one axiom can lead to failure of the denture case. In the vast majority of cases, complete dentures should be comfortable soon after insertion, although almost always at least two adjustment visits will be necessary to remove sore spots. One of the most critical aspects of dentures is that the impression of the denture must be perfectly made and used with perfect technique to make a model of the patient’s edentulous (toothless) gums. The dentist must use a process called border molding to ensure that the denture flanges are properly extended. An array of problems may occur if the final impression of the denture is not made properly. It takes considerable patience and experience for a dentist to know how to make a denture, and for this reason it may be in the patient’s best interest to seek a specialist, either a prosthodontist or perhaps even a denturist, to make the denture. A general dentist may do a good job, but only if he or she is meticulous and usually he or she must be experienced.
The maxillary denture (the top denture) is usually relatively straightforward to manufacture so that it is stable without slippage.
A lower full denture should or must be supported by 2-4 implants placed in the lower jaw for support. A lower denture supported by 2-4 implants is a far superior product than a lower denture without implants, because
1) It is much more difficult to get adequate suction on the lower jaw.
2) The functioning of the tongue tends to break that suction, and
3) Without teeth the ridge tends to resorb and provides the denture less and less stability over time. It is routine to be able to bite into an apple or corn-on-the-cob with a lower denture anchored by implants. Without implants, it is quite difficult or even impossible to do so.
Some patients who believe they have “bad teeth” may think it is in their best interests to have all their teeth extracted and full dentures placed. However, statistics show that the majority of patients who actually receive this treatment wind up regretting they did so. This is because full dentures have only 10% of the chewing power of natural teeth, and it is difficult to get them fitted satisfactorily, particularly in the mandibular arch. Even if a patient retains one tooth, that will contribute to the denture’s stability. However, retention of just one or two teeth in the upper jaw does not contribute much to the overall stability of a denture, since a full upper denture tends to be very stable, in contrast to a full lower denture. It is thus advised that patients keep their natural teeth as long as possible, especially their lower teeth.
References
- The inventions that changed the world, Reader’s Digest (1982) [Portuguese edition of 1983]
- Moriyama N, Hasegawa M. The history of the characteristic Japanese wooden denture. , Bull Hist Dent. 1987 Apr;35(1):9-16.
- John Woodforde, The Strange Story of False Teeth, London: Routledge & Kegan Paul, 1968
- S. E. Eden, W. J. S. Kerr and J. Brown, “A clinical trial of light cure acrylic resin for orthodontic use,” Journal of Orthodontics, Vol. 29, No. 1, 51-55, March 2002
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