Dentures are false teeth, made mostly of plastic, that replace missing or lost teeth. Dentures are a solution of last resort. Many people assume that they will need dentures as they age, but losing teeth is not a normal part of the aging process. If you care for your teeth well and guard against periodontal (gum) disease, you should be able to keep your teeth for a lifetime.
Saving even a few natural teeth is often better than losing them all. Natural teeth or even parts of natural teeth can help you retain bone in your jaw. They also can act as stable supports for bridges, over dentures or removable partial dentures. Your dentist will try to save as many of your natural teeth as possible.
Dentures can be either complete or partial. Complete dentures are made for people who have lost all of their teeth. They can be given more support by placing implants in the bone under the denture. Partial dentures are used to replace only a few teeth. They are attached to the nearby teeth.
The good news is that dentures aren’t what they used to be. Newer materials and technology have allowed great improvements. Now dentists can fashion dentures that fit comfortably, appear natural and help you stay healthier.
Denture problems still can occur, of course. But problems such as clicking, slipping, frequent gum irritation and odor may be signs that your dentures do not fit well. They may need to be adjusted, relined or remade. Although dentures may look like your natural teeth, they cannot work like them. Simple actions such as speaking and eating may feel different. You will have to learn how to use and adjust to your dentures. For some people, this can take up to several months.
Removable partial dentures consist of a metal framework with plastic teeth and gum areas. The framework includes metal clasps or other attachments that hold the denture in place. However, partial dentures can be removed easily for cleaning.
Fixed partial dentures, which most people call bridges, are cemented in place. They look more like natural teeth. Bridges are more expensive than removable partial dentures. They also have to be supported by nearby healthy teeth. Bridges are made in several ways. Some are made entirely of porcelain, whereas others are made with porcelain covering a gold framework. Two types of attachments are used in partial dentures — metal clasps and precision attachments.
Metal clasps are C-shaped, I-shaped and Y-shaped parts of the denture framework. They fit around the neighboring natural teeth. These teeth may require shaping to help hold the clasps and keep the denture securely in place. A precision attachment is like a key fitting into a keyhole. A crown that is placed over the tooth contains the “keyhole.” The denture contains the “key.” When you put in your denture, the “key” fits into the “keyhole” in the crown. This type of denture looks better because no clasps are visible. It also fits tighter. However, it does take more skill to place in the mouth because the “key” must fit.
Complete dentures cover your entire jaw, either upper or lower. Some people call them “plates.” Complete dentures rest directly on the gum that covers the bone and are custom made for you. The process involves multiple appointments, usually about five. The dentist first takes impressions of your mouth. At later visits, you and the dentist select the size, shape and color of the artificial teeth.
Learning to chew food with complete dentures takes patience and practice. You might have to cut your food into smaller pieces than you did in the past when you had your natural teeth. On a certain occasion, natural teeth are kept when a denture is made. These teeth usually have root canal treatment and are shortened to fit under the denture. This type of denture is known as an over denture.
Dentists like to maintain a few natural teeth and replace the missing teeth with an over denture if possible. This has several advantages:
- Your natural teeth help preserve the bone.
- Your natural teeth bear some of the chewing pressure. This reduces pressure on other areas of the jaw.
- Your remaining teeth make the denture more stable and less likely to shift in your mouth.
- You feel a better sense of where your jaw is and you feel the pressure you are placing on the denture if you have not lost all of your teeth.
- You may find it easier to accept wearing dentures if you have kept some natural teeth.
Lower dentures tend to be more difficult to keep in your mouth than upper dentures. Therefore, an over denture can be particularly helpful for the lower jaw. However, it is an option for almost anyone who has a few teeth remaining. Teeth that will be preserved with an over denture must meet certain standards of health. Canines and premolars are the most common teeth selected because of their root length and position in the jaw. The teeth will have to be shaped to fit the denture. Shaping may expose the tooth’s living pulp. For this reason, the teeth usually need root canal treatment. This removes the pulp (the nerve of the tooth) and replaces it with filling material.
The teeth that will remain are covered with thin metal castings called copings. They fit into openings in the denture. Attachments can also be placed on the copings to help retain the denture in the mouth. On a certain occasion, a natural tooth can be kept in the mouth without a metal coping. If this is done, the dentist will prescribe fluoride drops. These should be used in the over denture to prevent the decay of the tooth. Over dentures also can fit over implants instead of natural teeth. In fact, implants originally were developed to give people “artificial roots” for bridges or dentures in the lower jaw. The denture can fit onto the implants directly or onto a metal bar between implants.