What is a denture?
A removable prosthesis designed to cost effectively replace all missing teeth in a single arch. Three different types of full dentures commonly fabricated today are the conventional tissue supported dentures, overdentures, and dental implant supported dentures.
Tissue Supported Dentures:
Tissue supported dentures are supported mainly by alveolar bone and the mucosal tissue covering it. The retention and stability of the denture and ultimately the fit is determined by the amount of bone present, the architecture of bone and the intraoral anatomy. This is the least expensive way to replace all teeth and requires he least amount of treatment time. Since there are no teeth present, the periodontal ligament that supports the teeth in bone is also missing. The periodontal ligament provides sensory functions, which include tactile, pressure and pain sensations. This means that feeling the consistency of the food can be very difficult. Imagine getting a grain of sand stuck between your teeth. When you close on that single grain, you will be able to determine that something hard and gritty is present between your teeth. You will not be able to do that with dentures because there are no teeth present.
Tooth and Tissue Supported Overdentures:
Overdentures are complete dentures that are supported by tissue and by remaining teeth. Overdentures are mostly fabricated in the lower jaw to improve retention, stability, and fit of the denture. Teeth with favorable prognosis are prepared for overdenture placement. Usually the lower canines are ideal because of long roots and good positioning in the lower arch. The teeth are root canal treated and restored with overdenture abutments. The denture rests partially on the teeth and partially on the tissue. Some of the benefits of an overdenture are good force distribution, and alveolar bone preservation through retention of the teeth in the jaw. The purpose of alveolar bone is to retain teeth. When the teeth are extracted, the alveolar bone goes through resorption. Retention of teeth leads to better fitting denture over a longer period of time.
Some sensations transmitted through the periodontal ligament are retained. Ability to feel the consistency of food (grain of sand example above) is partially maintained. One of the main disadvantages of overdentures is that the teeth are still prone to cavities and gum disease. This means that regular brushing and periodic professional cleanings are essential. Conventional overdentures do not snap into place like implant supported dentures. The remaining teeth are there to simply absorb some of the chewing force. However, natural teeth can be fitted with special attachments which will allow the denture to be snapped into place. Overdentures are more costly than conventional dentures and require more treatment time, due to extra dental treatment required on retained teeth.
Dental Implant Supported Dentures:
Dental implant supported dentures are actively supported by dental implants and passively by the tissue. These can be fabricated for the upper or lower jaws. Four dental implants are usually placed in the upper jaw and only two are required in the lower. Healing time will vary from three to six months. After the implants have fused with bone special abutments are used to attach the denture to implants.
Dental implant supported dentures have the longest treatment time, mainly because of the implant healing period that is required. They are also the most expensive out of the three denture options. Dental implants lack a periodontal ligament and are fused directly to bone. This usually allows for only pressure sensation.
General Advantages and Disadvantages of Dentures:
- Able to fill in all the missing teeth with one prosthesis
- Cost stays constant and is not dependent on number of teeth replaced
- Esthetic result is obtained
- Usually can fabricate in a relatively short amount of time
- provides a chewing area to improve dietary intake
- implant supported dentures can provide more stability
- avoid that sunken-in appearance caused by missing teeth usually present in the older population
- stabilizes that area of the dental arch to give you a more youthful appearance
- it is a removable prosthesis (needs to be taken out at night except in special occasions)
- it can provide a patient with a perfect smile which is usually noticeable in individuals that had bad teeth all their life and suddenly have “perfect teeth”
- provides no “feel” for food as natural teeth do
- inability to taste food due to the palate being covered by the prosthesis(this can be eliminated with implant supported dentures)
- they can be broad and bulky and it takes time to get used to them
- stability can be compromised depending upon how much bone is present for support
- denture can be loose and unstable during eating
Recommended products for denture maintenance:
Effervescent cleansers alone cannot remove all food particles and stains. Dentures require daily brushing for maintenance of healthy tissues, freshness, and effective stain removal. A toothbrush can scratch the surface of the denture and allow odor causing bacteria to flourish. Denture brushes are specifically designed to care for dentures
There are various products on the market that help keep your denture clean. These products make it easy to remove plaque and tartar (which can cause bad breath) as well as coffee and tea stains. Everyday use keeps dentures feeling clean, smooth and odor free.
Other Resources For Denture Patients