Dentures and Partial Dentures
A denture is a removable replacement for missing teeth and nearby gum tissue. Usually made of acrylic, dentures can replace all of a patient’s teeth (complete dentures) or only some missing teeth (partial dentures).
Denture design and technology has improved, and it is now possible to have aesthetic, functional and well-fitting dentures.
Consequence of missing teeth
There are many reasons why you might be missing teeth; it is a common complaint at the dental office.
Complete dentures have greatly increased the vertical facial height of this patient, as seen in the before and after photos.
Why should you get the missing tooth or teeth replaced though? The most popular reason is appearance. A smile that shows off missing teeth often sends an uncomplimentary message to others. If a considerable number of teeth are missing, your mouth might be over-closing, resulting in a face that appears short. From a dentist’s standpoint though, there are greater concerns than just appearance.
When teeth are missing, the above teeth might begin erupting (coming out of their socket) into the empty space. A missing tooth can also result in nearby teeth drifting, or tipping, into the open space. Problems in occlusion (bite) can arise, making it difficult to close the mouth or chew. Speech sounds can also be altered if prominent teeth are missing.
Available Options For Replacing Teeth/Tooth
Dentists have several options for replacing missing teeth – not all options apply to every patient though. The following are viable options for replacing one or more teeth:
• Partial or Full Dentures
• Bridges (Fixed, Resin-bonded, or Cantilever)
There are various factors that dentists consider in choosing the best option. Some include:
Number of teeth missing: When only 1 or 2 teeth are missing, implants are the best option. Alternatively, bridges can be placed. Partial dentures are good for cases when more than 3-4 teeth are missing, and complete dentures are for when all teeth are missing.
Time: Bridges are usually completed by two appointments in the course of a week. Dentures are made as quickly, but need adjustments over the course of months. Implants involve surgery, and require several months for healing.
Oral health: The biggest dental concern is the condition within the mouth. Few dentists will place implants in patients who are avid smokers, as they are prone to failure. Similarly, bridges need to be supported by nearby teeth, so those teeth need to be of sound health. Dentures have the highest success rate in those with poor oral hygiene.
Comfort: Dental implants are the gold standard for replacing missing teeth, and many patients can hardly tell them apart from real teeth. Bridges are also highly aesthetic and fixed in the mouth, but keeping them clean can be difficult. Dentures can appear natural, but can slip out while eating certain foods, so most patients need to learn to adapt.
Complete dentures (above) and partial dentures (below).
Two types of dentures are available – complete and partial. Complete dentures are used when all teeth are missing in an arch (upper or lower) and partial dentures are for when some natural teeth remain. If your few remaining natural teeth are mobile, heavily decayed or worn down, your dentist may suggest extracting them and opting for complete dentures – always consider the consequence of tooth extractions though.
Complete dentures are either of the “conventional” or “immediate” type, depending on when they are made. Immediate complete dentures are made in advance so that they can be placed right after your teeth have been extracted. This saves you the embarrassment of being seen without teeth as your gums heal from the extractions. During the healing process though, your bones and gums shrink, so your immediate dentures will require regular adjustments to ensure proper fit – therefore, immediate dentures are a temporary solution. Conventional dentures are made 2 to 3 months after your teeth have been removed and healing is complete. They are better fitting and only need occasional adjustments.
The second type of denture is a partial denture. A removable partial denture consists of replacement teeth attached to a pink or gum-colored plastic base, which is connected by metal framework that holds the denture in place in the mouth. Partial dentures are used when one or more natural teeth remain in the upper or lower jaw.
Complete dentures are designed to adapt perfectly to the mouth contour. Adaptation to the bone and gums, as well as the patient’s unconscious neuromuscular control, helps retain complete dentures in the mouth. Because of the tongue, lower complete dentures are more difficult to keep in the mouth than their upper counterpart.
Partial dentures are removable but have internal attachments, such as clasps, that attach to adjacent teeth, helping to keep them in the mouth. Partial dentures are therefore considerably more retentive than complete dentures.
Example of lower implant-supported dentures.
A relatively recent development has been the use of implants alongside traditional complete dentures. Complete dentures are aesthetic, cheap, but do not retain well in the mouth (especially lower dentures). Implants are permanently fixed in the mouth, but are too costly to replace all the teeth in a dental arch. Clinicians have combined the best features of both by developing implant-supported dentures.
To begin, three to four implants are placed in the jawbone. Then, instead of placing artificial porcelain teeth, small “male” abutments are attached on top. The complete denture is separate and has “female” parts underneath that bind and “lock” onto the implant abutments. Dentures made in this manner are held firmly in place and can only be removed in one direction.
Advantages & disadvantages
With proper care, dentures can last long – up to a decade. Compared to other treatments, dentures are non-invasive and cheap. Dentures can replace missing teeth and gum tissue (bridges and implants only replace the tooth, not the tissue) and appear natural to most. They are functional and allow for chewing and speech.
There are some clear disadvantages with dentures though. They take time getting adjusted to, and chewing function will never be as it was with natural teeth. Mouth irritation and sores develop over the years, but are quickly resolved with denture adjustments made during regular checkups. Many patients have trouble keeping lower dentures in place, and since upper dentures cover the palate, taste sensation is somewhat reduced.
Want a better option than dentures? Consider dental implants.