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DENTURES

Dentures

A denture is a removable replacement for missing teeth and surrounding tissues. Two types of dentures are available — complete and partial dentures. Complete dentures are used when all the teeth are missing, while partial dentures are used when some natural teeth remain.

Complete Dentures

Complete dentures can be either “conventional” or “immediate.” Made after the teeth have been removed and the gum tissue has begun to heal, a conventional denture is ready for placement in the mouth about eight to 12 weeks after the teeth have been removed.

Unlike conventional dentures, immediate dentures are made in advance and can be positioned as soon as the teeth are removed. As a result, the wearer does not have to be without teeth during the healing period. However, bones and gums shrink over time, especially during the healing period following tooth removal. Therefore a disadvantage of immediate dentures compared with conventional dentures is that they require more adjustments to fit properly during the healing process and generally should only be considered a temporary solution until conventional dentures can be made.

Partial Dentures

A removable partial denture or bridge usually consists of replacement teeth attached to a pink or gum-colored plastic base, which is sometimes connected by metal framework that holds the denture in place in the mouth. Partial dentures are used when one or more natural teeth remain in the upper or lower jaw. A fixed bridge replaces one or more teeth by placing crowns on the teeth on either side of the space and attaching artificial teeth to them. This “bridge” is then cemented into place. Not only does a partial denture fill in the spaces created by missing teeth, it prevents other teeth from changing position. A precision partial denture is removable and has internal attachments rather than clasps that attach to the adjacent crowns. This is a more natural-looking appliance.

Type of denture base

1.  Plastic/acrylic base: pink plastic base with or without wire.

Pros of plastic/acrylic denture

  • Simple and Economical.
  • If there is more tooth loss in the future, acrylic tooth can be added to the denture. It can be used as an interim denture in periodontal patient or in patient with poor prognosis teeth.
  • Used as an interim denture before permanent denture can be made

Cons of plastic/acrylic denture

  • Thick acrylic base which might cause discomfort when eating or disrupt speech
  •  Acrylic is brittle and has short life span


2.  Metal base: made from cobalt, chromium . Suitable for patient with healthy remaining teeth

Pros of removable partial denture:

  • Metal base is thin which is more comfortable to wear

        – Stronger than conventional acrylic base

Cons of removable partial denture:

  • Higher price than acrylic denture


3.  Removable partial denture with valplast base: made of nylon thermoplastic which has elastic property

Pros of removable partial denture with valplast base

  • Lightweight
  • More esthetic, gum-color wire

Cons of removable partial denture with valplast base

  • Alteration difficulty
  • More expensive than normal acrylic base
  • ot suitable for multiple missing teeth due to lack of rigidity

Dentures treatment process

The denture development process takes a few weeks and several appointments. Once your dentist or prosthodontist (a dentist who specializes in the restoration and replacement of teeth) determines what type of appliance is best for you, the general steps are to:

  1. Make a series of impressions of your jaw and take measurements of how your jaws relate to one another and how much space is between them.
  2. Create models, wax forms, and/or plastic patterns in the exact shape and position of the denture to be made. You will “try in” this model several times and the denture will be assessed for color, shape, and fit before the final denture is cast.
  3. Cast a final denture
  4. Adjustments will be made as necessary

Treatment time:

Partial denture : 3-4 visits (5 – 14 days up to number of teeth replacement required)

Complete denture : 4-5 visits (3-4 weeks)

Are There Alternatives to Dentures?

Yes, dental implants can be used to support cemented bridges, eliminating the need for a denture. The cost is usually greater, but the implants and bridges more closely resemble the feel of real teeth. Dental implants are becoming the alternative to dentures but not everyone is a candidate for implants.Dental implants may also be used to support dentures, offering more stability. Consult your dentist for advice about implants.

FAQ

    A: For healthy patient without systemic disease and no pathology of the edentulous site, in some cases implant could be placed immediately and in some cases implant could be place after 6-8 weeks of extraction to allow soft tissue healing For those with pathology in the bone which cause bone defect or in case of infection in the area of future placement, usually the waiting time is longer, around 3-4 months after extraction. Please note that timing and treatment planning will be discussed with patient on a case by case basis.
    A: It is possible to have implants placed but it might need bone graft to reconstruct the bone for implant placement. Also alternative treatments such as bridges or other types of prostheses can be an option.
    A:
  1. Uncontrolled diabetes which affect wound healing
  2. Uncontrolled high blood pressure
  3. Ostoporosis patients who receive Bisphosphonate intravenous more than 3 years
  4. Cancer in craniofacial area which currently has radiotherapy
  5. Heavy smokers especially more than 20 cigarette/day. Smoking cessation should be done before the treatment.
  6. Pregnant patient should delay the treatment
  7. Patients who take anticoagulant or patient who has history of stroke within 6 months- 1 year should consult physician before treatment
  8. Patients who take immune suppressant should consult physician
  9. Patients with liver disease which leads to unstop bleeding should consult physician
  10. Q: Should I have other treatment before placing an implant?
    Any infection in the oral cavity should be removed before implant treatment to avoid the risk of infection at the implant site and to failure of the implant
  1. Periodontitis should be treated before placing and implant since patient with history of periodontitis has higher risk of implant failure
  2. Caries : defected tooth structure should be removed to reduce oral cavity germ
  3. Endodontics : root canal treatment should be done since apical infection especially adjacent to the site in the bone can infect the implant site
    A:New dentures may feel a little odd or loose for a few weeks until the muscles of the cheeks and tongue learn to keep them in place and you get comfortable inserting and removing them. Also, it is not unusual for minor irritation or soreness to occur and for saliva flow to increase when you first start wearing dentures, but these problems will diminish as the mouth adjusts.
    A:Dentures are made to closely resemble your natural teeth so there should be only a small noticeable change in appearance. In fact, dentures may even improve your smile and fill out your facial appearance.
    A:Eating with new dentures will take a little practice and may be uncomfortable for some wearers for a few weeks. To get used to the new denture, start with soft foods cut into small pieces. Chew slowly using both sides of your mouth. As you get used to new dentures, add other foods until you return to a normal diet. Be cautious with hot or hard foods and sharp-edged bones or shells. And, avoid foods that are extremely sticky or hard. You should also avoid chewing gum while you wear the denture. Also, don’t use toothpicks while wearing dentures.
    A:After getting dentures, you may have difficulty pronouncing certain words. If so, practice by saying the difficult words out loud. With practice and with time you will become accustomed to speaking properly with dentures. If dentures “click” while you’re talking, contact your dentist. Dentures may occasionally slip when you laugh, cough, or smile. Reposition the dentures by gently biting down and swallowing. If any speaking problem persists, consult your dentist or prosthodontist.
    A:Your dentist or prosthodontist will instruct you as to how long to wear dentures and when to remove them. During the first several days after receiving your denture, you may be asked to wear it all the time, including while you sleep. Although this may be temporarily uncomfortable, it is the quickest way to identify the areas on the denture that may need adjustment. Once adjustments are made, you should remove dentures before going to bed. This allows gum tissues to rest and allows normal stimulation and cleansing by the tongue and saliva. The denture can be put back in the mouth in the morning.
    A:A denture adhesive may be considered under the following circumstances:
  1. To enhance satisfaction with a properly constructed denture. Adhesives enhance retention, stability, bite force, and an individual’s sense of security.
  2. To assist individuals with dry mouth conditions that lessen denture adherence, such as individuals taking cold medications, those with neurologic disabilities including strokes, and the elderly.
  3. To provide added stability and security for those who place unusual demands on facial muscles, such as public speakers or musicians.
    A:There are situations when denture adhesives should not be used. Those cases include:
  1. When it is used as a “fix” for ill-fitting or poorly constructed dentures. If dentures begin to feel loose, cause discomfort or cause sores to develop, contact your dentist as soon as possible.
  2. When a dentist has not evaluated dentures for a long time. Dentures rest on gum tissue and the jawbone, which shrink and deteriorate, respectively, over time. Therefore, the real problem might be a need for a denture adjustment or new dentures.
  3. When oral hygiene practices cannot be sustained.
  4. When adhesives have been used for a long time, especially when visits to the dentist are infrequent, and when the frequency and volume of the adhesive use increases. These developments may indicate the need for a denture adjustment or new dentures.
  5. When any known allergy exists to the adhesive’s ingredients.
  • Use the minimum amount necessary to provide the maximum benefit. Apply less than you think you need, and then gradually increase the amount until you feel comfortable.
  • Distribute the adhesive evenly on the tissue bearing surface of the denture.
  • Apply or reapply when necessary to provide the desired effect.
  • Always apply the adhesive to a thoroughly clean denture.
  • Remember adhesives work best with a well-fitting denture.
    A:
  • 21.Paste application. Apply this denture adhesive to a dry or preferably wet denture. Avoid placing adhesive close to the denture borders. If the adhesive oozes, use less of the product. For dentures on the upper jaw, apply three short strips of adhesive — or a series of small dots — along the ridge area and one down the center. For dentures on the lower jaw, apply three short strips of adhesive — or a series of small dots — in the center of the ridge area.
  • 2.Powder application. Sprinkle a thin, uniform layer throughout the tissue-bearing surface of the denture. Shake off excess powder and press the denture into place. Powders may be preferred over pastes because they are easier to clean off the denture and tissue. In addition, they don’t have the same tendency as pastes do to “shim” (keep the denture away from the tissue).
    A:Dental adhesives are safe as long as they are used as directed. If the denture is well-fitting and the adhesive is only used to give added stability, there should be no ill effects. If adhesives are used excessively to fill voids for an ill-fitting denture, they can be harmful to the underlying soft and hard tissues. Occasionally, in these cases, inflammation of the soft tissues can result. In addition, because of its movement on the soft tissue and underlying bone, an ill-fitting denture can cause bone loss.

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