Why do people lose their teeth?
Patients can lose their teeth for various reasons – trauma from a fall in early childhood; tooth decay or fracture in adulthood; to periodontal (gum disease) in their older years. In the last Adult Oral Health Survey carried out in Singapore in 2003, although there was an increase in the proportion of adults retaining their full complement of teeth compared to 10 yrs ago, almost 20% of the participants were found to wear dentures.
What should people about their missing teeth
Patients who experience tooth loss will usually need some form of prosthesis to replace their missing teeth. The prosthesis serves to replace and even in some cases improve chewing efficiency, speech / pronunciation as well as facial profile and aesthetics. Wearing a denture to replace missing teeth provides support for the lips and cheeks and corrects the collapsed appearance that occurs after tooth loss, therefore providing a natural facial appearance. All these factors are very important for a person’s self-esteem and can greatly affect his/her quality of life. Dental prosthesis can also prevent drifting and over-loading of the remaining teeth and serve to prevent further tooth loss. Your Dentist would be the best person to assess what form of dental prosthesis would be most appropriate for your remaining dentition and which best suits the individual’s lifestyle, ability to maintain as well as budget.
Are there different types of dentures?
Dentures are removal replacements for missing teeth and they are designed to look and function like your own natural teeth and the surrounding gum tissues. Modern day dentures can look very realistic and natural and feel comfortable as well.
Dentures can be divided into 2 main categories:
Removable partial dentures
Removable partial dentures are for patients who are missing some of their teeth in either the upper or lower jaw.
Fixed partial dentures, better known as “crown and bridge”, are made from crowns that are fitted on the remaining teeth to act as abutments (on the anchoring teeth) and pontics (which replace the missing teeth) made from materials to resemble the missing teeth. Modern day porcelain and advancement in casting and milling techniques can produce artificial teeth that are barely discernible from the real thing. Fixed bridges are more expensive than removable appliances but are more stable.
Conversely, complete dentures or full dentures are worn by patients who are missing all of the teeth in either a single jaw or from both jaws
There are various types of complete dentures. A conventional full denture is made and placed in the patient’s mouth after the remaining teeth are removed and tissues have healed which may take several months. An immediate complete denture is inserted as soon as the remaining teeth are removed. The dentist will take all the necessary measurements and makes models of the patient’s jaws during a preliminary visit. With immediate dentures, the denture wearer does not have to be without teeth during the healing period.
How do you take care of dentures?
Even if you wear full dentures, you still must take good care of your mouth. Brush your gums, tongue and palate every morning with a soft-bristled brush before you insert your dentures to stimulate circulation in your tissues and help remove plaque.
It is important to keep your dentures clean at all times. You should remove your dentures at night to give your gums “a rest” and the chance to be exposed to your natural saliva which contains protective antibodies and enzymes which will keep them healthy. It is highly recommended that you brush your dentures (toothpaste is optional) and soak them in a glass of water (room temperature is fine as hot water may deform the denture) whilst you are not wearing them. After brushing, you can use special cleaning tablets which you can buy from the pharmacy or supermarket to add to the water when you soak your dentures. These dentures cleansing tablets can be used on a weekly basis and they are excellent for removing stale smells from the denture eg from garlic and durian. Always brush your dentures before putting them back into your mouth and never soak them in bleach.
If your dentures begin to collect debris or stains that you cannot remove by normal brushing, your dentist or hygienist will be able to professionally clean your dentures for you. Accumulation of dental plaque under the full dentures can sometimes lead to mucositis or inflammation of the supporting gums.
It is therefore important to visit your dentist regularly to ensure that your dentures are in good condition and continue to fit your gums as the shape of your gums and underlying bone can change with time. Loose fitting dentures can cause irritation and inflammation of your gums and problems with eating and speech.
What are the common problems with dentures?
Patients who have never worn dentures before will complain of drooling or excessive saliva during the first 2 weeks. This is because the patients are not used to having something in their mouth that is not food. The brain senses this appliance as “food” and sends messages to the salivary glands to produce more saliva and to secrete it at a higher rate. This will subside in a couple of weeks.
New dentures will also be the inevitable cause of sore spots as they rub and press on the mucosa (denture bearing soft tissue). A few denture adjustments for the weeks following insertion of the dentures can take care of this issue.
Gagging is another problem encountered by some patients. At times, this may be due to a denture that is too loose fitting, too thick or extended too far posteriorly onto the soft palate. At times, gagging may also be attributed to psychological denial of the denture. (Psychological gagging is the most difficult to treat since it is out of the dentist’s control. In such cases, an implant supported denture without extending onto the palate may have to be constructed or a hypnotist may need to be consulted).
As can be expected with any removable appliance placed in the mouth, there will be some problems with dentures no matter how well they are made. This is because the best the Dentist can do is fabricate the upper denture to work in harmony with the lower denture when the patient is at rest and set the teeth in certain ways to help prevent dislodgement during opening, closing and swallowing. Once food enters into the picture, though, this fine balance and the stability of the denture bases can be easily disrupted.
Intimate contact between the denture bases with the ridge and the margins of the denture base is therefore imperative to create a perfect suction seal and ideals are rarely if ever met in this imperfect world, and thus some movement is to be expected.
How long do dentures last?
This depends on many factors including how you take care of them and also how much you use them in terms of general wear and tear. Over time dentures can become loose as your gums resorb or shrink and your bite changes. When this happens you may need a new set of dentures or in some cases a simple modification of your existing dentures may solve the problem. As a general guide, you should visit your dentist once a year to service your dentures.