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What To Expect From Immediate Dentures

Immediate dentures are placed in the mouth directly after the remaining teeth are extracted. This approach is utilized when a person does not want to be without any teeth for several months while extraction tooth sockets heal and a denture is fabricated.

Immediate Dentures Involve a Two-Step Denture Process

Optimally, immediate dentures are the first denture of a two-denture process and should be considered as a temporary interim prosthesis until a second refined and esthetically enhanced denture may be constructed after healing.

First Stage

• Usually, most or all of the back teeth are removed and extraction sites are allowed to heal for a minimum of six weeks or more, depending upon an individual's healing rate.
• After adequate healing, the immediate dentures unit is fabricated.
• The remaining teeth are extracted and the immediate dentures are placed in the mouth. Wearing immediate dentures right away over extractions normally is no more uncomfortable than the extractions alone.
• Discomfort is managed with proper anesthesia and pain medication. Immediate dentures act like a Band Aid bandage, holding tissues together and protecting them during healing.
• Generally, the dentist does not remove immediate dentures until the day after surgery. Surgery is checked and denture adjustments are made as necessary.
• Immediate dentures will gradually become loose because of bone shrinkage as the jaw continues to heal. Provisional liners are placed in the loosening denture to help hold it in place during healing.
• Adhesives also maintain the denture in place as it becomes looser. If immediate dentures become too loose during this healing period of several months, it may be necessary to reline multiple times.

Second Stage

• After adequate healing has occurred, a second refined denture is fabricated. This denture allows the dentist to artistically position teeth in an optimal and enhanced esthetic relationship, which was not possible with immediate dentures. It also is now possible to establish better functional relationships of the jaws.
• Approximately six months after the second denture is delivered, it will most likely need to be relined to compensate for continuing jaw shrinkage. After this reline, a patient usually needs annual relines to accommodate a continually shrinking jaw.
• The frequency of relines is an individual matter unique to each patient and is best determined by a licensed dentist after a thorough periodic examination that should occur at six-month intervals.

Modified Approaches to Immediate Dentures

• It is possible to extract all the back and front teeth at one time and insert immediate dentures. However, such an approach is problematic and generally is discouraged unless the patient has no other alternatives.
• All teeth may be extracted with no interim denture while the jaws heal and a denture is fabricated. This is generally a more economical approach, but an individual would be without teeth for several months.

Advantages of Immediate Dentures

• A person is not without teeth for any extended period of time.
• Immediate dentures act as a bandage while bony tooth sockets are healing after tooth extractions.

Disadvantages of Immediate Dentures

• A second refined and esthetically enhanced denture is necessary soon after the immediate dentures.
• While the cost of immediate dentures is generally about the same as a conventional denture, the second denture needs to be fabricated soon after the immediate denture. Therefore, a person would be experiencing the additional cost of the second denture sooner.

by Joseph J. Massad, D.D.S.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

Learn About Conventional Over-Denture

A conventional over-denture rests over some healthy natural tooth roots. This approach was first reported in 1861. To understand this method, it is necessary to review some facts.

An Overview of Alveolar Ridge Dynamics

• Maintaining a denture on the jawbone ridge (called alveolar ridge) is essential to prevent it from becoming loose during eating, speaking, and other activities.
• Preserving the alveolar ridge facilitates denture stability.
• The body tends to conserve energy and nutrients by maintaining only structures with apparent immediate value. A typical example is the bulk reduction of a broken leg held immobile by a full-leg cast for a month or more.
• The body recognizes that the only one purpose for alveolar bone is to hold tooth roots.
• Alveolar bone no longer supporting a tooth root is removed, or literally dissolved away, by the body. This is called resorption, or simply shrinkage.
• Resorption progresses at varying rates in the same person at different times, and at different rates between different people. Resorption progresses rapidly within the first year of losing a tooth, after which time, the rate progresses at a slower pace.

From this overview, if the maximum amount of alveolar ridge is to be maintained, then preserving the maximum number of periodontally healthy tooth roots should achieve that end.

Preserving the Sensation of Having Teeth

Studies demonstrate that even though only roots are preserved, and a denture covers them, a patient still has sensory input sensations similar to that experienced with teeth, as opposed to individuals with conventional dentures and no preserved roots. Over-denture patients also appear to have a more natural perceived directional sense in their chewing activities. In other words, many patients relate that they still feel like they have teeth -- a positive comment.

Underlying Philosophy of the Conventional Over-Denture

If a patient's treatment plan to have a denture, and the roots of some remaining teeth are supported in healthy alveolar bone, then a conventional over-denture is a viable consideration.

However, only a licensed dentist can determine if a conventional over-denture is a suitable consideration for a certain person, after a comprehensive examination.

Some Characteristics of a Conventional Over-Denture

• Most of a tooth crown (that part of the tooth above the gums) is removed. This often necessitates root canal therapy if not already done.
• The remaining tooth, projecting above the gum, is rounded and usually covered with a similarly shaped artificial crown-like covering.
• Various configurations and extensions may be built onto some retained roots. In those cases, that portion of the denture overlying these configurations is modified to contain attachments that clip onto a framework or receive the individual extensions. In addition to preserving alveolar bone and sensory input, the denture is held securely in place, but may be comfortably and easily removed for cleaning.

Advantages of a Conventional Over-Denture

• Feels more like having teeth
• More retentive in many cases
• Helps reduce shrinkage of surrounding bone
• Reduces pressure to portions of the alveolar ridge
• Positive psychological advantage of still having teeth

Disadvantages of a Conventional Over-Denture

• Scrupulous oral hygiene is essential in order to prevent decay and gum disease
• The over-denture may feel bulkier than a conventional denture
• Frequent maintenance examinations are necessary
• Generally, this is a more expensive approach than a conventional denture

by Joseph J. Massad, D.D.S.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.