Dentures & Implants

Dentures

Millions of people have benefited from removable dental prostheses, including full and partial dentures. However, a variety of potential problems can accompany the use of dental prostheses. Many patients who wear full dentures believe that the fewer natural teeth there are, the less the need for dental checkups. However, over time tissue changes do occur and visits to the dentist are necessary to detect possible serious conditions.

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It is a common but incorrect belief that dentures may be worn at all times (twenty-four hours per day) and only need to be removed for rinsing and cleaning. Generally it is recommended that dentures be left out of the mouth at least four to six hours, but preferably eight hours, in every twenty-four hour period. Leaving dentures in place twenty-four hours per day makes the denture-bearing tissues more prone to atrophy. This is true for all dental prostheses.

Partial Dentures

Partial dentures use remaining natural teeth for support to replace areas of missing teeth and are usually made with metal attachments (clasps). The clasps engage strategic natural teeth to provide stability and retention for the partial denture. The presence of clasps increases the need for proper oral hygiene and periodic evaluation, because the clasps may increase the accumulation of plaque. This, in turn, increases the risk for caries and gingival problems. If tissue changes occur under a partial denture, the relationship between a clasp and the tooth upon which it rests may change. This can produce forces on the tooth in unfavorable directions causing it to fracture or become loose. To learn more about the use and care of dentures, please visit the American Dental Association website.

It is essential that a person wearing a partial denture be able to insert it and remove it with ease. If with aging or age-related diseases there are decreases in dexterity, vision, and cognition, it may become difficult to remove and insert a partial denture. In these situations the clasps may produce trauma to soft tissue, such as the tongue, lips, and cheeks, as the prosthesis is removed or inserted. Periodic evaluations allow for assessment of the teeth and soft tissues that support a prosthesis, the condition of the prosthesis itself, and the ability of the patient to use it properly.

Implants

Many elderly prefer dental implants as an alternative to dentures. Either single teeth or multiple teeth acting as an anchor for dentures may be replaced through osseo-integrated implants. Contraindications to dental implants include the inability to physically and mentally understand and tolerate a surgical procedure, the inability to participate in on-going meticulous oral hygiene, the lack of adequate bone in the implant site, and the high cost involved (usually not reimbursable by insurance). Age per se does not seem to be a limiting factor for the placement of dental implants however certain systemic diseases may be detrimental to a successful outcome (Blanchaert, 1998).

Oral care is also needed for the edentulous patient. Special sponge brushes or a simple 2x2 gauze can be utilized to remove food debris and plaque accumulation from the intraoral tissues. Ideally, removable dentures should be cleaned after each meal with a non abrasive detergent such as a dish washing liquid, or a specially formulated denture paste (conventional tooth paste, due to its abrasive nature, should be avoided). Liquid hand soap may result in a residue build up and should also be avoided.

Specially designed dentures brushes make it easy to properly clean both the inside and the outside of a denture. Removable dentures are to be removed from the mouth before bedtime. To prevent the denture material (acrylic) from damage and bacterial infestation while outside the mouth, the denture should be cleaned and kept moist. Water with or without an added antimicrobial solution (such as clorhexidine, Listerine or an effervescent tablet), make an ideal storing solution. To prevent overgrowth of oral candida, dentures with no metal parts may be soaked in a solution of nine parts water and one part household bleach. Take care to thoroughly rinse the denture before reinsertion and remember not to use bleach if the denture has metal parts (bleach will corrode metal).