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Archive for the ‘Dentures’ Category
Removable Partial Denture Questions and Answers.
Some of the questions and answers about removable partial dentures.
How do you wear a removable partial denture?
Removable partial dentures usually consist of replacement teeth attached to pink or gum-colored plastic bases, which are connected by metal framework. Removable partial dentures attach to your natural teeth with metal clasps or devices called precision attachments. Dentures with precision attachments generally cost more than those with metal clasps, and bridges are permanently fixed to your teeth. Precision attachments are generally more esthetic than metal clasps, and they are nearly invisible. Crowns on your natural teeth may improve the fit of a removable partial denture, and they are usually required with attachments. Consult your dentist to find out which type is right for you. Implants can also be used to fill the gaps instead. These are a good solution if you have enough bone or can have bone added because they won’t take out the other teeth if they fail.
Nothing in dentistry lasts forever, but in terms of bridges, the longer they are, the more of a chance they have to fail. The key to maintaining bridges and partial dentures is care. They can last 10 years, and some people retain them for upwards of 30 years. One disadvantage is that it is difficult to clean under the bridge, and if one of the teeth supporting the bridge gets wrecked, either from decay, breaks, or it comes unstuck from the bridge, it may result in bad outcomes for the other teeth. Also, food can get stuck under them, and if not cleaned properly, you get decay where your denture sits as plaque festers. They often need to be replaced or relined every so often..
How long will it take to get used to wearing a denture?
Ask your dentist for specific details about wearing dentures. Find out how long he or she prefers you to wait after your tooth is removed before the denture is placed. Some dentists believe that very little waiting time is necessary, while others prefer you wait until the gums are fully healed before getting a final fitting. Don’t worry about being without teeth for awhile — it will not cause any serious harm.
For the first few weeks, your new partial denture may feel awkward or bulky. You may feel like your mouth is very full and you’ll have the impulse to take them out. However, your mouth will eventually become accustomed to wearing it. Inserting and removing the denture will require some practice. Follow all instructions given by your dentist.
Your denture should fit into place with relative ease. Don’t worry — you will get used to the feel of having them in your mouth. Never force the partial denture into position by biting down. This could bend or break the clasps. When the dentist first inserts the dentures it will feel very awkward. Once at home, try to do other things to take your mind off of the dentures.
Eating with these new teeth may be a frustrating experience at first. Continue to try to eat soft foods while you get used to them. Take very small bites and relearn the chewing process to fit your new teeth. You’ll find that your tongue will be busier than ever, helping you move the food around in your mouth. Eat as much as you can with the teeth in. If you get very frustrated, excuse yourself and go remove the teeth and then return and finished the meal. Try to keep them in longer at the next meal, and you’ll soon find you’ve made it through the entire dinner.
Use a denture glue to help you hold them in if you have to. Some denture wearers never have to use anything to secure the teeth, while others have to use the glue daily. Loose dentures are even harder to get used to, so you want them to feel tight and secure. Experiment with several kinds of denture adhesive until you find the one you like. Just use a tiny bit at first to see how much works for you.
Ask your dentist what he/she recommends as a time out or resting period for your mouth. Some dentists advise their patients to remove the dentures nightly to let the mouth rest. Others say it is okay to wear them all of the time. If you take yours out to sleep, get used to the routine of brushing them and putting them back in the first thing every morning. Always keep them in a covered container filled with water when you are not wearing them.
Can I make minor adjustments or repairs to my denture?
You can do serious harm to your denture and to your health by trying to adjust or repair your denture by yourself. A denture that is not made to fit precisely by a dentist can cause irritation and sores. A person who lacks the proper training will not be able to reconstruct the denture. This can cause greater damage to the denture and may cause problems in your mouth. Using a do-it-yourself kit can damage the appliance beyond repair. Glues sold over-the-counter often contain harmful chemicals and should not be used on a denture.
If your denture no longer fits properly, if it breaks, cracks or chips, or if one of the teeth becomes loose, see your dentist immediately. In many cases, dentists can make necessary adjustments or repairs, often on the same day. Complicated repairs may require that the denture be sent to a special dental laboratory.
Everything about denture pain. How to relieve dentures pain?
Denture Pain.
Anyone that has worn dentures is probably aware of the pain that they can cause. Most commonly, pain occurs in the first stages of denture wear, with the gum tissue of the mouth still sensitive from tooth removal, although discomfort and pain throughout denture use is common. Whatever pain dentures may bring the wearer, however, there are many available options to relieve the pain, aid in the healing of the mouth, and help prevent future pain. Even in later stages of denture-wearing, there are treatment options available to help relieve the pain and provide normal mouth function. Understanding how dentures work in the mouth and how personal behavior influences comfort or pain can greatly aid in understanding how best to treat denture pain.
The part of the mouth that often causes denture-wearers the greatest discomfort is the mucosa. The mucosa is the membrane lining the mouth and gums that help protect the mouth from irritants and helps the mouth absorb materials introduced orally. It is this membrane that is most easily irritated by dentures, and oral procedures such as tooth extraction are hard on the membranes of the mouth. It is this mucosa that really takes on the immediate stress of the dentures.
It is to this surface that the dentures adhere in the mouth. The mucosa covers the gums, with the dentures requiring so much suction to make a good hold. In the process, a mouth new to dentures can be unprepared for the surface contact, and the mucosa can take damage, be worn away, or be irritated, allowing pain to develop. The mucosa is the most prominent area of the mouth to take damage from dentures. Damage can be subtle, sometimes not even apparent, although injured tissue can lead to swelling, sensitivity, and sores, which can make denture wear excruciating.
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.
Source: www.wikipedia.com
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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