Sometimes dental conditions like tooth decay, gum disease, dental trauma, etc. can cause tooth loss. This could lead to the use of dentures, which are removable substitutes for missing teeth.

Dentures are custom made in the dental laboratory. Your dentist will determine which denture is best for your case in particular.

There are two types of dentures available:

FULL DENTURES

Full dentures offer full tooth replacement when all the teeth from the lower or upper jaw are missing, with a natural-looking prosthesis. There are 3 types of full dentures:

• Immediate denture: This prosthesis is used immediately after remaining teeth are removed. While immediate dentures have the benefit of never having to be without your teeth, they must be relined several weeks after being inserted, because the supporting tissues are remodeled, causing the denture to become loose.

• Conventional denture: It is made after your teeth have been extracted and after the gum tissue has started healing. These are ready to be worn about 8-12 weeks after your teeth are removed.

• Implant-supported denture: When there is a lack of supporting bone, dentures are not comfortably retained. But, can be held in place by attaching to dental implants that are surgically placed in the jaw bone. This treatment provides greater stability.

PARTIAL DENTURES

A partial denture is very useful if the patient has several healthy teeth remaining in the upper or lower jaw, partial dentures are an economical solution to replace missing teeth, fill in the spaces, improve your function and restore your confidence.

Most partial dentures contain a thin metal framework that is designed to rest close to your gums and allow for a smooth, non-bulky feel. This metal structure is supported by your natural remaining teeth to provide a reliable, secure prosthesis that is easy to use.

ADVANTAGES of DENTURES

1. Restores chewing function, this means that you will be able to eat normally
2. Improves muscle tonicity
3. Reduces problems at the joint level (temporomandibular joint)
4. Improves gastric health
5. Improved phonetics, the pronunciation of words will be much clearer and better understood.
6. Improved aesthetics because it returns lost teeth
7. Recovers vertical dimension (height from the tip of the nose to the chin) which had been lost due to the absence of teeth, this manifests itself in the form of wrinkles around the lips and depressions on the lips, giving the impression of premature old age. By recovering it, we not only recover vertical dimension, but also the tonicity of the peri-labial and labial muscles.
8. Recommended stability and retention are achieved, allowing you to perform your normal functions.
9. Improved health.
10. Improved self-esteem, patients will feel more secure and having a denture will improve their social life interactions.
11. Prices may vary, removable dentures are relatively an economical option compared to implant-supported dentures.

Procedure of Dentures Treatment

First phase: Diagnosis and treatment plan

During the first dental visit to assess the need for dentures, the dental professional will examine your gums, remaining teeth and supporting bone structure to identify the appropriate treatment plan.

Once your dentist decides that dentures are right for you, he or she will make an impression of the oral cavity to identify each ridge and socket to ensure the best possible fit.

If an implant-supported denture is the treatment of choice, the dentist will send dental X-rays and 3D images to see the condition (quality and quantity) of the jawbone.

Full and partial removable dentures:

Second phase: Surgery (if necessary)

In some cases, oral surgery must be performed to correct bony ridges that can interfere with the prosthesis’s stability.

In other cases, it may be necessary to extract the remaining teeth before placing the denture. When this is the case, an immediate denture is usually placed to allow the extraction area to properly heal and also serve as an aesthetic replacement for natural teeth. This transitional prosthesis will be placed during the healing process until the final denture is ready. To construct the immediate dental prosthesis, dentists use a chart of molds and choose the replacement teeth that most closely resembles the patient’s natural teeth, minimizing changes in appearance.

Third phase: Final denture

The final prostheses are fabricated when the gums are healthy and enough time has passed for them to heal. The gums will shrink which is a physiological process during the healing phase after the loss of a tooth, which typically takes 6 to 12 months.

The dental professional will take a dental impression of the implants. The impression will be sent to the dental laboratory and the denture is then fabricated.

During this period, the immediate prosthesis may require adjustments to accommodate changes in the gums and underlying bone structure.

Implant-supported denture

Second phase: Surgery

The second phase consists of the placement of the dental implants, which are the ones that will provide the necessary support to the denture, the dentist will decide the appropriate number of implants needed, they can vary from 2 to 8 implants depending on each specific case.

Implant placement can be performed in one or two surgical phases; this will depend on the patient’s condition. The dentist will use local anesthesia or IV sedation to make you comfortable.

If the surgical procedure is satisfactorily performed in one phase, the implants will be placed and at the same moment, the transitional prosthesis will be screwed to the implants.

If the surgical procedure is performed in two phases, the implants will be placed in the first phase, leaving it covered by gum tissue for 2 to 3 months. In the second phase, a small incision is made in the gum tissue covering the implant and the abutments will be screwed. The provisional prosthesis will be placed to comfortably overcome the rest of the healing period.

**A bone graft, soft-tissue graft, or other surgical procedures are necessary prior or after the implant placement.

Third phase: Final denture

Once the implants are osseointegrated to the bone, the dental professional will take a dental impression of the implants. The impression will be sent to the dental laboratory and the denture will be fabricated.

2. Maintenance

Regular dental check-ups should be carried out every six months to observe the state of the teeth and soft tissue, detect wear on the prosthesis and make appropriate adaptations to correct any unfavorable situation that may occur, and especially to guarantee the long-term health and longevity of the treatment.

Whenever ulcerations, pain or instability of the prosthesis appear, you should visit the dentist immediately.

POSTOPERATIVE INSTRUCTIONS

• Handle your dentures carefully
• Brush your dentures daily
• Clean your mouth after removing dentures
• Remove and rinse dentures after eating, and also before putting them back in your mouth.
• Place dentures in water or mild denture-soaking solution overnight.
• Schedule regular dental checkups

POST-TREATMENT CARE

1. Brush the dental prosthesis with a brush with soft filaments.
2. It is not recommended to use very hot water for cleaning, as the prosthesis can become distorted.
3. Wash your remaining teeth or oral mucosa after every meal, as plaque remains usually accumulate in them.
4. Have proper oral hygiene and remember to clean the back of your tongue.
5. Remove the removable dentures overnight
6. Visit your dentist for the periodic check-ups he or she indicates.

FAQS (3-4 QUESTIONS AND ANSWERS)

What consequences can tooth loss cause in the oral cavity?

1. Alterations in chewing: When there are missing teeth, it is difficult to cut food properly, which produces long-term nutritional problems.
2. Aesthetic alterations: Missing teeth may cause gaps between teeth, making the patient insecure and uncomfortable when smiling.
3. Facial change: Sunken cheeks, unsupported lips, and prominent chin.
4. Alterations in spaces and teeth: When losing a neighboring tooth, the adjacent teeth are prone to move, causing spaces or crowding. This is a very difficult problem to solve and indicates an even more complex treatment

Are there disadvantages of using dentures?

The main disadvantage is that it has an adaptation process: discomfort and difficulty speaking. On the other hand, it can also cause irritations and ulcers when chewing, eating, or by a small particle that gets trapped between the prosthesis and the gum. There may also be some difficulty chewing hard, crunchy or sticky foods.

In addition, when dentures only have support on the mucosa (gum) or on teeth, removable prostheses, over the years, can suffer imbalances and a progressive loss of stability and retention, something that does not occur with fixed prostheses when cemented or implant-supported, which will have perfect aesthetic properties and optimal retention over the years.

You need a rigorous hygiene routine, because the accumulation of food debris between the prosthesis and the oral mucosa is common, facilitating the material’s deterioration, and lesions in the mucosa, for this reason, you must take into account that treatment success will depend on proper cleaning and maintenance so that your prosthesis is preserved and lasts longer.

Why is it necessary to carry out a correct cleaning of the dental prosthesis?

If we do not clean our prosthesis correctly, bacteria and food debris can accumulate, causing problems in the oral mucosa, damage to healthy teeth, gum inflammation, or partial loss of the prosthesis’s functionality.

What is the type of denture indicated for me?

The choice of one type or another dental prosthesis depends directly on your dental condition and other personal factors. Some aspects to assess are:

1. The number of missing teeth. There are dental prostheses that replace the entire arch and others that only replace an area.
2. Volume and quality of the bone. Depending on the condition of the jawbone, the dentist will assess the available options. Sometimes it is not possible to place a dental implant in the patient’s mouth, in which case implant-supported dentures are ruled out.
3. Depending on the price you are willing to pay, you can choose one or the other treatments.

DO’S AND DONT’S

DO’s

• Maintain a good oral hygiene
• Clean your denture every day after each meal
• Avoid eating hard, crunchy or sticky foods
• Remove the denture every day at night.

DON’Ts

• Don’t clean your dentures with toothpaste
• Don’t use bleaching products
• Don’t use hot water

MYTHS ABOUT TREATMENT

Myth #1: Dentures will affect my everyday life

Truth: Dentures are custom-made to be flattering, well-fitting and comfortable to wear to maintain your life quality. Any dental appliance will initially feel quite different, especially if this is your first denture, but this will diminish as the mouth adjusts.

When you first begin eating foods with your denture it can be useful to start with softer, easier to chew foods, and gradually introduce harder food as you become accustomed to wearing your dentures.

Myth #2: I won’t be able to talk or eat with dentures

Truth: In the days after the procedure, you may not feel completely comfortable when eating or speaking. However, it is a common process, since, after the placement of a dental prosthesis, an adaptation period is necessary.

Once these first days have passed and you have managed to re-educate you mouth, you will be able to eat and speak without any discomfort.

Myth #3: Dentures are only for elderly persons.

Truth: There is a belief that dentures are for older people. Although it is true that, with the passage of time, teeth are more likely to deteriorate, we must not forget that we may need to replace a tooth at any time of our lives due to an accident, trauma, decay, etc.

Anyone in whom bone development has finished, can undergo the placement of a dental prosthesis.

Myth #4: Dentures won’t last a long time

Truth: Dentures last a long time, the materials that are used to fabricate the prostheses are of good quality and prepared to last. Also, it is critical that the patients follow the dentist’s advice to ensure the durability and longevity of their prosthesis.

It is recommended to change the dentures every 5-7 years.