Dentures are commonly referred to as “false teeth”, “ plastic removable teeth” , “false nashers” or ” a plate.”
There are two types of dentures. They are called partial dentures and full dentures.
Partial dentures replace one or more teeth but the patient will still have a few of their own natural teeth still present. These are the most frequent types of dentures that a dentist makes. This is because it is rare for a patient to suddenly lose all their teeth in their mouth in one go.
For partial dentures, the most common scenario is when a patient needs to lose one or two teeth because of gum disease or broken teeth cannot be repaired anymore. In this instance, these teeth are taken out and replaced with a partial denture.
Another scenario, although less common, is where a patient has an accident and the patient has to lose one or more of the front teeth because of the trauma and the teeth cannot be saved. Once again, a partial denture has to be made to replace the teeth that have been lost due to accident or trauma. Sometimes, a partial denture is a prerequisite to a full denture which we will discuss below.
Types of Dentures
A partial denture is a lot easier to get accustomed to than a full denture. This is one reason why a dentist may make a partial denture first and then when the patient has got used to wearing that denture, the partial denture can be converted into a full denture. Similarly, once a partial denture has been made, it is common to find that further teeth may have to be lost in the near future and even if eventually all the teeth have to be lost.
Such a partial denture is also there for them as a transitional denture.
A full denture is used when all the patient’s own natural teeth are totally lost. Full dentures can replace all of the teeth in the upper jaw or all of the teeth in the lower jaw or both together at the same time.
A full upper denture is easier to get used to than a lower full denture. The main reason for this is that an upper denture stays in the mouth better due to the suction effect of the denture on the roof of your mouth. On the other hand, a lower denture has to fight with the patient’s tongue and the tongue will tend to dislodge the dentures. Also with a lower denture, you do not get the suction to hold the denture in place like you do with an upper denture.
Going back to the basics
As stated above, most patients will go to a transitional denture where they have a partial denture and then over a period of time, they will have a full denture.
The most common instance when a dentist makes a full denture is when an existing patient who already is wearing full dentures wants a brand new set again.
Probably the next most common instance when a dentist makes a full denture for a patient is when the patient is suffering from widespread gum disease or widespread decay or broken down teeth. In these instances, there is no alternative but to make a full denture.
Your dentist may sometimes also mention the term immediate dentures. An immediate denture is a temporary type of denture and here is the reason why. This is to do with the process that occurs in your mouth when a tooth is taken out.
When you lose a tooth in your mouth, there is obviously an immediate and obvious gap where the tooth was positioned. But, something else also happens over the next few weeks and months. It is a process called bone resorption. Bone resorption is commonly known as gum shrinkage after a tooth or teeth have been taken out. Due to this gum shrinkage, there will be a change of shape in the mouth. Most of the gum shrinkage or bone resorption occurs in the first 3 to 6-months after a tooth or teeth have been extracted.
This is why, in the past, dentists used to take teeth out and send the patient home for a few months without any replacement. Then after 3 to 6-months, once the gum has shrunk back to a more stable position, the dentist would then start making the definitive dentures.
It is sufficient to say that nowadays no one would be willing to go without any teeth for such a long period of time. In order to get around this problem, dentists therefore construct a temporary transitional or immediate denture as soon as a tooth or teeth are extracted.
The advantage of this is obviously so that the patient has got something to chew and is able to smile. The disadvantage is that, when the initial rapid gum shrinkage occurs, the denture will become looser and looser over the first few weeks and months. Eventually, once stabilisation is reached, a second more long term permanent denture will be needed.
In summary, when a patient loses a tooth or teeth, one has to wait at least a few weeks for the gum to stabilise but an immediate denture is one that is placed at the same time as when the tooth/teeth are taken out.
Patients always ask, how long my dentures will take to be ready. It is fairly easy to predict how long a denture takes to make because there are a set number of stages always involved. Roughly speaking, it takes 4 stages and therefore 4 visits to make a set of dentures. Also approximately, it is about one week in between stages. You always have to factor in a couple of extra visits in this procedure because a stage may have to be repeated and also it may be necessary for the patient to return for adjustments. The above is a general rule and some simple dentures can only take 2 visits to get ready.
The four stages of making a denture are:
- Taking a mould or an impression of the teeth and gums.
- Measuring the bite.
- A try in stage in wax to see how the final teeth will feel and look.
- The final stage is the fitting of the denture.
Dentures are used to replace teeth once lost and although they have come a long way in terms of obtaining a natural appearance, the fact remains that they do have a lot of disadvantages. I have made thousands and thousands of dentures for patients and one of the best pieces of advice I give to new training dentists is to listen to what the patient wants.
As a consequence, I have never had two patients the same. Never. Some patients just want to be able to chew with their dentures and don’t care at all about the appearance. Other patients want their dentures to be as white as possible even if they look completely unnatural.
Not all dentures work with all patients but luckily, as a worst case scenario, if a denture does not work, you can always start again without any long term damage or you can then consider other alternative form of treatment. It is important to realise, that it takes considerable time and persevering and effort by a patient to get used to wearing dentures.
In the end, there are a certain percentage of patients who can never get accustomed or used to wearing dentures so alternatives that can be considered instead of wearing conventional dentures are: