COMPLETE DENTURES
There
are two types of appliances: conventional and immediate.
A
conventional appliance is made and placed in the patient’s
mouth after the remaining teeth are removed and tissues have healed.
It is a process that can take several months. An immediate
appliance, on the other hand, is inserted as soon as the remaining
teeth are removed. With an immediate appliance, the patient does not
have to be without teeth during the healing period. An immediate
appliance may require basing or relining to fit properly during the
healing period (6-8 weeks) due to bone and gum shrinkage. After the
healing period, a conventional appliance is then made.
Fabricating a Complete Denture
There are many factors involved when designing this type of appliance
and if one factor is overlooked, it can lead to failure of the case.
In many instances, the appliance should fit comfortably soon after
being inserted. One of the most critical aspects of the process is
that the impression must be perfect and with a flawless technique,
used to make a model of the patient's gums. The dentist must use a
process called border molding to insure that the denture edges do not
hit aggressively into the edges of the mouth. An endless array of
never-ending problems with this appliance may occur if the final
impression is not properly made. Designing it takes a considerable
amount of patience.
The
full upper appliance is usually easier to design so that it is stable
without slippage. The lower appliance tends to be more difficult
because there is no "suction" holding it in place. For this reason,
most dentists have come to strongly recommend that a lower denture be
supported by 2-4 implants placed in the lower jaw for support. This is
a far superior product than a lower appliance without implants that is
held in place with weak lower mouth muscles. The ability to bite into
an apple or corn-on-the-cob with a lower appliance anchored by
implants is possible. The ability to bite into this same apple or corn
on the cob with a lower appliance that is not supported with implants,
is a difficult, if not impossible task to achieve.
Some patients, believing full denture appliances are in their best
interest, extract all of their teeth and have the appliance inserted.
Yet, statistics show that the majority of patients who received the
appliance in this manner come to regret their decision. They come to
find that there is a decrease in their chewing ability (full dentures
have only 10% of the chewing power of natural teeth) and they
experience difficulty with the appliance sitting properly. They do not
realize that while a full upper tends to be very stable, the lower
appliance needs as much help from the natural teeth as possible for
stability to be successful. If one tooth is retained on the lower area
of the mouth, that tooth can contribute to the appliance's stability.
It is advised that patients keep their natural teeth as long as
possible, especially the lower teeth.
Newly Inserted Dentures
Your new appliance may feel awkward for a few weeks after they are
inserted. They may feel loose while the muscles of the cheek and
tongue learn to keep them in place. It is also not unusual to
experience minor irritation or soreness. You may find that your saliva
flow also increases. As the mouth becomes accustomed to the appliance,
these problems should diminish. One or more follow-up appointments
with the dentist are generally needed after an insertion.
Eating takes practice with a newly inserted appliance. It is advised
that patients begin with soft foods cut into small pieces, chewing
slowly using both sides of your mouth at the same time to prevent the
appliance from tipping. As you become accustomed to chewing, you can
add other foods until you return to your normal diet, being very
cautious with hot or hard foods and sharp edged bones or shells.
Continue to chew food using both sides of the mouth at the same time.
Pronouncing certain words may
require practice. Reading out loud and repeating troublesome words
will help. If your appliance "clicks" while you talk, try to speak
more slowly. It may occasionally slip when you laugh, cough or smile.
Reposition the by gently biting down and swallowing. If any of these
problems persist, consult your dentist for further help.
We will provide instructions about how long the appliances should be
kept in place. During the first few days, you may be advised to wear
them most of the time, including while you sleep. After the initial
adjustment period, you may be instructed to remove them before going
to bed. This allows gum tissues to rest and promotes oral health.
Generally, the gum tissues should not be constantly covered by the
appliance.
Problems with Complete Dentures
Some of the problems associated with removable appliances include an
overproduction of saliva, sore spots, gagging, gingivitis and
movement.
Saliva
The
brain senses this appliance as "food" and sends messages to the
salivary glands to produce more saliva and to secrete it at a higher
rate. Patients must become accustomed to having an appliance inside
their mouth that is not food.
Sore
Spots
Newly
installed appliances may cause sore spots in many individuals as they
tend to rub and press on the mucus membranes of the mouth. Subsequent
adjustments for the weeks following their insertion should take care
of this problem.
Gagging
Gagging is another issue encountered by some patients. The cause of
this may be due to a loose fitting or to a appliance that is too thick
or not extended far enough back on the palate. Some suggest that at
times, the gagging may be attributed to some sort of psychological
denial of the appliance. And since the psychosis is difficult to treat
by the dentist, as it is beyond the scope of their expertise, both a
psychologist referral or an implant supported palate less may be
offered as alternative to helping a patient.
Gingivitis
Gingivitis can develop underneath the appliance, a result of
accumulating dental plaque. Gingivitis can involve gum inflammation
and mouth sores. The condition is generally reversible. Denture
wearers are advised to clean the thoroughly. The removal of plaque and
calculus is usually not painful, and the inflammation of the gums
should be gone between one and two weeks. A dentist or dental
hygienist can also perform a thorough cleaning of the teeth and gums
areas of the mouth. Following a professional service, patients must be
persistent with their oral hygiene care. Oral hygiene including proper
brushing and flossing is required to prevent the recurrence of
gingivitis. Anti-bacterial rinses or mouthwash may reduce the swelling
and local mouth gels which are usually antiseptic and anesthetic can
also help with the problems associated with gingivitis.
