What to do when your dentures become loose?

Loose Dentures

If it’s not bad enough having to wear false teeth or dentures, it gets even worse when the false teeth or dentures that you do have, are loose and you are struggling to use them. Scientific research shows that loose dentures have a significant effect on a person’s general well-being and a happy State of Mind. You don’t even need to wear dentures to understand this fact.

Wearing dentures is difficult at the best of times however if you speak and your dentures are continually moving around in your mouth, you can understand how this can make you feel. Some patients even avoid having to go out and interact with people simply because they are wearing dentures which they do not feel comfortable with. There are many more patients who stop going out to eat in cafes or restaurants with their friends or family because their dentures are inhibiting them.

All dentures will become loose over a period of time even if they were absolutely fantastic to start off with. However, a significant proportion of dentures will be loose from day one. When this happens, the first port of call is to go back to your dentist and in some cases, the problem can be rectified easily. However, when the problem cannot be rectified easily even after numerous visits back to the dentist, the patient is unfortunately resigned to a life of denture misery.

A few patients will ask the dentist to remake their dentures or seek alternative consultations with another dentist or dental technicians. As an example, last week we saw a patient who was complaining that her dentures were loose and she had been having a problem ever since she got her first pair of dentures 2 years ago. She literally came in with a pump bag with at least 6 pairs of dentures and they were all no good. Ironically, the best that she was managing with was an upper set from a full set made at 1 practice and a lower set made from a different full set at another practice.

When loose denture problems continue, patients will almost certainly start to use denture adhesive or seek solutions from the internet. Patients can easily spend more money on these quick fix gimmicks then the amount they paid for the original dentures and there is no guarantee that any of them will work for them.

When dentures prevent you from eating properly, you start to eat more soft processed foods which isn’t good for you.

In my experience of more than 25 years, I have never had to send away a patient because I could not help them in some way. This is not to say that all the dentures that I have made have been absolutely perfect, but at the very least they are a significant improvement on their original condition.

The solution to loose dentures can be summarised in three basic stages

1. The denture construction itself must be as perfect as possible to give the maximum chances for a patient to adapt to them satisfactorily.

2. The use of denture adhesives as an adjunct to good denture design.

Alternatives to dentures

The use of denture adhesives has been discussed in a separate article and you can find the link here:

Denture adhesives

Alternative to dentures have also been discussed and you can find the links here:

Dental Implants

Bridges To Replace Missing Teeth

For this article, we will mainly concentrate on how you can remedy the problem of loose dentures. Unfortunately, there are many false tales and incorrect assumptions about loose dentures on the internet so we will look at what has been scientifically proven in a consistent manner.

When you go and see your dentist complaining of loose dentures, he will often use the term retention and stability

In simple terms, a denture becomes loose if it does not have enough retention and stability.

Denture retention can be defined as the resistance of a denture to vertical movement away from the underlying supporting tissues. In other words, a denture becomes loose because there is not enough resistance for the denture to stay seated on the gums. Denture stability can be defined as resistance to forces of dislodgement. A denture becomes unstable when forces that can dislodge a denture are not balanced.

A denture can be loose simply when it is seated in the mouth or it can be stable in the rest position that only becomes loose during functions such as talking, swallowing and eating. In practice usually you find that the two go hand in hand.

There are various factors which influence the resistance of a denture. Some of these factors are not controllable, such as the shape of a particular patients mouth which may be a disadvantage. We hear so many times that a patient with loose dentures tells us that their Uncle Goober has been wearing dentures for 50 years and he has never had any problems and he can even crack walnuts open with his false nashers. Needless to say that these stories are pretty much exaggerated and in any case, I still have never seen two patients with exactly the same mouth and conditions. Another factor that is not controllable is the patient’s ability to adapt. All dentures require adaptability in order to become accustomed to wearing them and some patients will adapt better than others.

Factors which can be controlled however are related to the construction of the denture.

Denture impressions

When you had your dentures made, you will have heard that the dentist will instruct his nurse to get the impression material ready or to start mixing.

The first stage of denture construction starts of with denture impressions. A denture impression is an imprint that is Taken off your mouth in order to produce a model outside the mouth which is then used to construct the denture.

An accurate impression is critical because the ultimate goal is to have as small a space possible between the denture and the gum tissues that it will be seated on.

If the gap is too big, this will reduce retention and conversely, you do not want the dentures to be rubbing excessively causing denture soreness.

This small space under a denture will fill up with saliva and this will aid retention naturally by capillary action.

Another important function of the denture implant or denture impression is to create a border seal. The border seal defines the outward extensions of the denture including during rest and function. The idea here is to avoid having a denture which is under extended i.e. too short or overextended i.e too long.

Denture impression materials

A denture imprint or a mould or impression utilises an impression material in order to capture the details of your mouth. This detail includes your gums, any teeth you still have remaining and surrounding tissues.

There are many different types of denture impression materials such as hydrocolloids, Zinc Oxide and eugenol and elastomeric impression materials.

The most common material used for denture impressions is called alginate which is a hydrocolloid based on seaweed. Alginate is widely used because it is cost-effective, it is easy to mix, it sets quickly in the mouth but it needs to be stored carefully until it can be cast in the laboratory.

The next most common denture impression materials are termed elastomeric impression materials. These can be classified into three broad categories which are condensation silicone based, additional silicones and polysulphide materials. Elastomeric impression materials are deemed more accurate but they have disadvantages in terms of cost, they are technique sensitive to mixing and are not easily as tolerated as alginates in patients.

As well as the impression material, there are many different techniques of actually taking the impression such as a one-stage impression technique, a two-stage impression technique, mucostatic technique and functional impressions, Neutral Zone impressions with open-ended and closed-ended impression trays.

In my experience, dentists get too hung up with the exact technique and should be more worried that the impression that they do take is as accurate as possible regardless of the material used. Studies also show this to be true.

The impression material once it has been mixed, is loaded into something called an impression tray. The impression tray is the plastic contraption that a dentist uses to place in your mouth which contains the impression material.

When the impression material has been mixed, it is critical that it has been mixed to the right consistency and proportions as specified by the manufacturer. The impression material cannot be too thick or too runny and must not set to quickly.

It is also the dentist’s responsibility to manage the patient in having an impression taken. If you are one of those patients to feel sick or gag when having impressions taken, there are methods which help to reduce this feeling.

An ideal denture will be one that fits as close as possible to the underlying gums and will be extended to cover the maximum surface area without encroaching or being hindered by function.

Partial dentures are those dentures where you still have some of your remaining teeth present and you are just having a part denture to fill gaps where required. The advantage of still having your own teeth is that teeth can be used to help with the denture retention. This may be by way of clasps or attachments. Clasps or attachments are like clips that can be used which go over your natural teeth in order to make the denture more retentive and stable. Other ways in which teeth can be used to help with denture retention or teeth being modified including precision attachments. Unfortunately, dentures can also do considerable harm to any existing teeth you may have. This is why acrylic dentures are also known as gum strippers.

A denture has three surfaces known as the fit surface, the polished surface and the surface which incorporates the teeth.

The polished surface is important in that it must not encroach into an area which produces an unbalanced force which will dislodge the danger. The teeth themselves are extremely important as you do not want to be biting down which causes the denture to become and stable. This is known as the occlusion of the denture.

Many dentures are loose simply because of deficiencies in the original design. It is always better to remedy the design before moving onto using denture adhesives or thinking about other forms of treatment. If you do go back to your dentist to have your dentures adjusted, you also need to remember that you may need to keep on going back for several visits until the problem has been fully rectified and you can eat with your dentures again without problems.

New denture

As discussed above one of the options available for a loose denture is to start all over again and make a new denture from scratch again. It is important before this is done to investigate thoroughly as to why the previous denture did not function as intended. If this is not carried out then it is likely that the same mistakes will be repeated in making the new denture. This will involve further visits and of course further costs. Although patients are often reluctant to have a new denture made, it is often in the long run the most effective solution and it certainly is better than putting up with loose dentures and coming back for adjustments time and time again.

Denture reline

One option that is available but I feel it is used too often and that is to reline a denture in order to correct a loose denture. A denture reline in theory will get you a better and closer fit. In practice however, it is not as easy to achieve. There are two main ways in which a denture can be relined. The quickest way is to use an in surgery reline material so that the real reline is done there and then. The main problem with this technique is that the reline material will never be as good as one that is heat processed acrylic in the laboratory. Over time that reline material will simply come away or wear away easily. The technique is also very technique sensitive.

The other method is a two-stage technique involving taking an impression again and sending the denture to The Laboratory for 2 or 3 days. the obvious disadvantage of this is that you will be without a denture for two to three days and this method is therefore only viable if you are going to become a hermit for two to three days or you have a reasonable spare set that you can use in this period. The main advantage of this method is that the reline surface will be of the same material as the rest of the denture so it should last longer. However, once again in practice, although the idea seems good it is difficult to achieve effectively. Quite often, the result is even worse with a reline than what it was with the original denture. In order to save face, the dentist then embarks on multiple visits in trying to adjust and further adjust but alas without successful.

For the above reasons, a denture reline often does not give the expected results. In addition, a reline cannot correct other problems with the denture especially in regard to The Polished surface and to the teeth. If for example the denture is under extended or over extended, the rear reline will not correct this. If for instance the denture teeth are at the wrong height or in the wrong position or the occlusion is incorrect, reline material can never correct this. Quite often, when a denture is loose, it is not just the fit surface that is at fault but also of problems with the fit surface, the polished surface and the teeth. Finally, it is almost impossible to reline a partial denture in contrast to a full denture which is easier but still difficult.

Immediate dentures that are loose

If you have teeth out and immediately have dentures fitted, a physiological phenomenon called bone resorption occurs which will cause the dentures to rapidly become loose. Whenever teeth are taken out, the jaw bone underneath the gums that the teeth were sitting in, will wear away very quickly and within a matter of 1 to 3-months, the dentures will become loose. In any case, your dentist should warn you before making an immediate dentures that bone resorption will occur and a new denture will be necessary within a short period of time. It is important to also realise that to bone resorption occurs for the remainder of your life although the maximum bone resorption occurs within the first 6 months of having teeth extracted. This is why dentures that were fantastic at the beginning, become loose after sometime. It is generally recommended that dentures should be remade every 5 years.

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