Why Have Regular Comprehensive Denture Check-Ups?
Regular and comprehensive examinations by a dentist are critical to ensure not only the proper function of a denture, but also the maintenance of total oral health.
Two significant things happen to a denture over time:
- It loosens -- Jaw ridges (alveolar ridges) will shrink in size and become smaller due to gradual and continuing bone loss (bone resorption) that occurs in everyone to varying degrees. This results in dentures becoming increasingly loose because they were fabricated originally to fit larger alveolar ridges.
-
- It wears -- Denture teeth will wear from use. In addition, uneven and irregular tooth wear develops as a denture becomes loose and starts shifting.
Denture loosening combined with uneven tooth wear results in a reciprocal and cyclical reinforcing synergism between the two destructive processes.
As a denture increasingly shifts on its soft tissue and jawbone foundation, it rubs and chafes the alveolar ridge. This causes irritation, soreness, and various types of pathology, including accelerated bone loss. In turn, this will cause more uneven tooth wear, which will cause more accelerated bone loss, and so on, back and forth. This is a gradual and unrelenting process that worsens over time, frequently at the expense of excessive jawbone loss, the thinning of overlying gum tissue, and the need to prematurely replace a denture -- unless detected and corrected in a timely manner.
If these problems are detected early, as during a regular check-up, they often may be remediated by adding plastic (acrylic resin) to the inside of a denture in order to allow it to fit closely against the alveolar ridge again (called relining or rebasing). In addition, irregularly worn teeth may be adjusted, or sometimes replaced or built up. Eventually, a denture will need to be replaced, but generally this will not need to be done too soon if a person visits their licensed dentist for periodic examinations.
Some Other Check-Up Considerations
- The need to adjust a denture, as determined by regular check-ups, helps keep a proper relationship between the jaws and thus maintains esthetics. Keeping jaws in a proper functional relationship, and sometimes building out certain denture surfaces, will support the face and help prevent a premature aging appearance.
- The temporomandibular joints or TMJs (the jaw joints located in front of each ear) undergo constant change in shape throughout life by a process called bone remodeling. This process is a functional response. If improper jaw function occurs, as a result of unadjusted dentures and improper bite, it is possible for the TMJs to remodel into a pathologic relationship. This could result in numerous pathological conditions, including impaired jaw function, headache, and other head and neck pains.
- Sometimes, more importantly than finding denture problems, is the opportunity to detect serious oral pathology, such as cancer, that may be discovered in early stages rather than later when radical and sometimes devastating therapy is necessary. The maintenance of healthy oral tissues is essential for optimum comfort in long-term denture wearers.
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.
Dry Mouth And The Denture Patient - Xerostomia
Xerostomia (Dry Mouth) and Wearing Dentures
To a great extent, dentures stay in place comfortably and in a stabilized manner by development of an intimate interface between denture surfaces and the soft tissues they rest upon. Presence of adequate amounts of saliva within this denture/tissue interface is essential. Without enough saliva, a denture will inadequately adhere to tissues, partly through loss of suction. In addition, tissues contacting a denture will become chafed and irritated without the lubricating effects of saliva.
Some Common Causes of Dry Mouth
- Medications: There are approximately 500 commonly prescribed medications that have xerostomia as a possible side effect, and this is a frequent cause of dryness.
- Aging: The amount of saliva produced by salivary glands lessens as a person ages.
li>Illnesses: Xerostomia is sometimes associated with certain illnesses or conditions such as chronic diarrhea, liver dysfunction, or Sjogren's syndrome.
- Radiation therapy: Radiotherapy that is used to treat some cancers may have reduced salivary gland function as a side effect.
- Habits: Chronic mouth breathing and inadequate fluid consumption often will cause dry mouth.
Approaches to Managing Dry Mouth
Before managing a persistent dry mouth, it is essential to first become aware of the problem, and then attempt to determine causation for the xerostomia. Sometimes the cause is easily eliminated, but in many instances, that is not possible, and the condition is persistent and often progressive. There are several approaches to managing dry mouth.
- Modify medications: If a certain medication is suspected of causing xerostomia, consultation with a person's physician may make it possible to use a different, but equally effective, drug that no longer causes dry mouth or causes it to a lesser degree. However, there often are not suitable alternatives for a particular person's individual problem. Under no circumstances should someone discontinue or attempt to change a medication without the explicit knowledge and approval of their physician -- to do otherwise may result in serious illness or death.
- Sialagogues: These are substances that stimulate the production of saliva. There are two important types of sialagogues. 1) Gustatory sialagogues such as sugar-free hard candies frequently will cause some increase in salivation, and citrus flavors such as lemon are sometimes more effective than others. While sugar-free, low-sticking gum has been suggested, the process of chewing gum could more easily irritate already poorly lubricated tissues by increasing denture movement. 2) Pharmaceutical sialagogues (called parasympathomimetic agents) sometimes improve salivation and must be prescribed by a person's physician if their health status allows such a consideration.
- Salivary substitutes: Salivary substitutes are commercially available solutions that help keep the mouth moist and more lubricated. These compounds usually must be applied frequently and they generally necessitate having a container of the substance nearby.
li>Water: Water is a salivary substitute and often is used in place of commercial salivary substitutes. Regularly moistening the mouth, and drinking increased amounts of water may both hydrate tissues and facilitate some increase in production of saliva in certain individuals. While increased intake of water is generally healthful, persons with certain medical conditions such as, but not limited to, congestive heart failure should first check with their physicians before significantly increasing their routine consumption of fluids.
Alternative Denture Therapy for Patients Suffering From Dry Mouth
Those patients who are not able to comfortably wear conventional dentures due to severe xerostomia might consider implant-supported dentures. If this course of treatment is pursued, intense oral hygiene practices are necessary to maintain healthy implants and avoid periodontal disease in the presence of reduced salivary production. A person should always consult with their dentist to determine which treatment is best for them.
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.