Dentures

There are two types of dentures: complete dentures which replace all the teeth in one arch, and removable partial dentures which replace some of the teeth in an arch.

Complete dentures

Complete dentures are commonly called full dentures by many dentists and in some parts of the country they are referred to as plates. Removable partial dentures are commonly referred to as just partial dentures by most dentists and as bridges by some patients. This later term can be confusing because many dentists use that term for fixed bridges or fixed partial dentures.

Removable partial dentures

Removable partial dentures may be made totally of plastic. I consider these to be provisional because they lack the necessary rigidity to prevent long-term damage to the supporting tissues. Definitive removable partial dentures will usually have a cast metal framework which resists bending under function. This is important for preserving supporting tissues. Removable partial dentures should obtain anchorage to natural teeth or to dental implants to minimize movement. Sometimes attachments are used to avoid the unsightly display of clasps.

In-house dental laboratory

We make all our dentures in our in-house dental laboratory. The doctor personally selects the teeth and sets them. All teeth are tried in the mouth mounted in wax. This gives the patient the opportunity to approve of the color, shape, size and placement of the teeth before the denture is converted to plastic. Our dentures are custom characterized so that the “pink” part is not smooth and uniform in appearance but has contour and color variation to mimic natural gum tissues and so the teeth appear age appropriate for wear and to avoid that “denture” look. Comfort and function are paramount and post-delivery adjustments are an important part of the process and are included in the fee to assure a proper fit.

Attachments are devices which have a component which is commonly cast as part of a crown or bridge or is screwed into a dental implant that mates with a component in the removable partial denture. Many have plastic parts that are intended to be the component that wears under use and will periodically need to be replaced.

Clasps are the part of the cast framework of a removable partial denture which grips the tooth. Properly it should be passive when the denture is in place and not impart force onto the tooth. Most clasps have an arm which is intended to spring out around the bulge shape of the tooth and come to rest below that point. Another arm should engage the tooth at the same time of contact but is intended to brace the tooth from movement when the spring arm is in flexure. A third part of the clasp is called the rest, and it’s function is to direct the bite force on the denture along the natural tooth to which it is clasped.

* An important note on removable partial denture design is that, properly, there should be no wrenching or torqueing forces applied to the natural teeth under function.

Complete dentures for the upper arch are much better tolerated than for the lower arch. For that reason, most dentists will resist removing all the lower teeth until there is no choice. Upper dentures should have a complete palatal coverage for best retention and support. Lower dentures should extend to the pad of firm tissue at the back of the ridge. The flanges of the denture should not extend into places that move and would tend to dislodge the denture during speech or eating. At the same time each denture should cover as much immobile tissue as possible for maximum distribution of functional forces.

* An important note regarding the lower jaw. Because the lower jaw has no equivalent to the palate of the upper jaw, the lower bone is 4 times more likely to dissolve away under pressure from a denture. It is important for lower dentures to rest on a pad of tissue quite far back on the ridge. This may be disconcerting to patients getting a new properly made denture.

Denture adhesives come in pastes, powders, and wafers. It is our goal to fabricate dentures that require no adhesives to stay in place. When adhesives are necessary we prefer only the thinnest layer of the powder type to be the first choice. Regardless of the adhesive used, the thicker the layer the more potential damage there will be to the supporting tissues as time goes by.

Denture cleansers are not really necessary. Cleaning the dentures is the goal. A brush and soap will do the job nicely and for all plastic dentures I frequently recommend a teaspoon of bleach to a cup of water as a good solution to soak dentures. Just be sure to rinse them thoroughly before inserting them in your mouth.

Leave dentures out for several hours a day. It is good to give the supporting tissues a rest. The most convenient time for most patients is while sleeping, though that is not totally necessary. Constant pressure on the tissues can damage them. When dentures are not in the mouth, they should be in a 100% humid environment. They are made under water and if the dry out completely the can warp and ruin the fit.