What Is A Denture?

Partial Denture

What is a denture?

To replace a missing tooth, there could be few options. There are two major options to replace the missing area: 1) fixed replacement 2) non-fixed replacement. If you want something that is fixed in the mouth, you have an option of either bridge or implant. Otherwise, for non-fixed option, a partial denture could be your option. In this post, we will be discussing denture.
There are mainly four types of dentures: 1) partial denture 2) complete denture 3) immediate partial denture 4) immediate complete denture.


1) Partial Denture & Immediate Partial Denture


In order to replace the missing tooth, a partial denture may be an option for you, if you are okay with wearing a denture. In order for denture to work, all the remaining teeth must be in good condition in terms of both caries and periodontal issues. Typically, if you are missing a significant number of teeth, the partial denture would be a better option for you compare to getting implant or bridge in terms of finance. In order for the partial denture to work, it needs to be bilaterally supported, meaning there have to be teeth supporting the denture on both sides. Without the support from both side of the mouth, the denture becomes very wobbly over time and the supporting teeth tend to be loosened up and you end up losing the supporting teeth because of that. For any partial denture, there are two different types of denture material that can be used. One is tissue-based denture, where there is no metal clasp that showing up. It may be good if you are more concerned with the aesthetic, but the denture can be little loose and most stable enough. Another option would be with teeth supported denture which has cast metal clasp attached. The cast-metal based partial denture may not be so much esthetic because of the metal clasp showing up but it is a better option for most cases because the denture can be more stable. The lab fee for this denture is somewhat significantly higher and your dentist may charge extra for this option.
In order for the partial denture to work, you need to have all the remaining teeth in good shape. If you need any filling, extraction, root canal, crown work that need to be done, all this work need to be done prior to even starting the denture. Once you get your denture and any changes on the remaining teeth can affect your denture. For example, if you end up losing a tooth that is supported by the denture, your denture may not stay in and you may end up needing to get a new one. Therefore, it is very important to have all the remaining teeth in good condition in terms of caries and periodontal related issues.
If you end up getting extractions prior to getting a partial denture, it is very important to wait at least 6 weeks prior to starting the partial denture. Your bone changes once you lose your tooth because the bone change needs to be stabilized prior to even starting the denture. If you start your denture too early, by the time your denture is ready your bone may have changed significantly, and your denture may not be fitting too well. It is worth it to wait a minimum of 6 weeks.
However, there are situations where teeth need to be taken out and you don’t want to walk around with no teeth. In this case, an immediate partial denture may be indicated. Instead of waiting 6 weeks after the extraction, you are making the denture prior to the extraction with assumption how your bone is going to be after the extraction. So your dentist starts making the denture prior to the extraction and at the time of extraction, you will be wearing your denture. However, since your bone is changing after the extraction, your denture may cause pain and not fitting too well. Some denture reline may be needed, if not a new permanent denture may be needed.
Unless you are really opposing the waiting period of 6 weeks, it is the best practice to wait until the bone stabilizes prior to starting the denture. This way, your denture is better fitting and may cause less pain, not to mention, you can save more money doing this way.

Complete Denture


2) Complete Denture & Immediate Complete Denture


If you are missing all teeth, a complete denture may be the option for you. In order for the complete denture to stay in your mouth, you need to have some bone remaining called residual ridge. Bone resorption occurs in after extraction. To simply state, your bone follows teeth. If you are missing teeth, the bone around the tooth resorbs and disappears. If you have lost your teeth for a long time, you may have not much residual ridge bone remaining, and you may want to need to get implant overdenture. On the upper arch, typically the bone resorption is minimal enough so you don’t need implant but on the bottom arch, typical bone resorption occurs are significant enough so you may need implants to support the denture. When you go to your dentist, your dentist will tell you if you can get denture or if you need implants along with the denture.
There are situations where you need some teeth taken out. Once you get an extraction, your bone changes. The bone change needs to be stabilized prior to even starting the denture. If you start your denture too early, by the time your denture is ready your bone may have changed significantly, and your denture may not be fitting too well. It is worth it to wait a minimum of 6 weeks.
However, there are situations where teeth need to be taken out and you don’t want to walk around with no teeth. In this case, an immediate complete denture may be indicated. Instead of waiting 6 weeks after the extraction, you are making the denture prior to the extraction with assumption how your bone is going to be after the extraction. So your dentist starts making the denture prior to the extraction and at the time of extraction, you will be wearing your denture. However, since your bone is changing after the extraction, your denture may cause pain and not fitting too well. Some denture reline may be needed, if not a new permanent denture may be needed.
Unless you are really opposing the waiting period of 6 weeks, it is the best practice to wait until the bone stabilizes prior to starting the denture. This way, your denture is better fitting and may cause less pain, not to mention, you can save more money doing this way.

General Procedure


Denture takes almost 1.5 months to finish the process. It is a long process. You will be going to your dentist periodically multiple times for each step. Depending on your dentist, you may divide the payment throughout the process.
The first step would be taking an impression for the arch and the opposing arch. The second step would be trying the base or framework to make sure there is no pain spot or to make sure the denture is fitting good. For the complete denture, the vertical height of your face needs to be measured. The third step would be teeth setup so you can see how they would look prior to making the final fabrication. During any previous step, it is important to let your dentist if there is anything that you don’t like or if there is anything that you want to change. During the teeth setup trying in, you can actually see how they would look and this is the final chance for you to let your dentist know if you want any changes.
Any time you get a new denture, it takes some time to get used to it. Also, it is normal to cause some pain. It may require a few adjustments to make it fit good. In sometimes, denture reline may be required.


Flipper


A flipper is temporary denture, typically just for esthetic. If you end up pulling front teeth and you want something to be filled right after, flipper can replace one or two missing areas temporarily. Flipper is like immediate partial denture but more affordable way to replace temporarily for just esthetic purpose.

References:
https://www.mouthhealthy.org/en/az-topics/d/dentures
https://en.wikipedia.org/wiki/Dentures

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