Are Lower Dentures Always A Problem?
While dentures are marginally adequate substitutes for missing natural teeth, the lower denture can be troublesome for many individuals.
Inherent Lower Denture Problems
- A lower denture interfaces with more movable mouth surfaces than an upper denture.
- The lower denture has less stabilizing surface to rest upon. For example, there is no broad palatal surface (roof of the mouth) as in an upper denture.
- Loss of jawbone over time brings a lower denture into closer contact with tissue extensions called frenum attachments, which create dislodging forces.
While these problems are inherent to lower dentures, every person is different and not affected in the same way. There are ways to approach these problems.
Some Considerations for Improving Lower Denture Stability
A thin band-like tissue extension (called a frenum) may attach between a jaw ridge (called an alveolar ridge) and the inside of the cheek. This strip of tissue may become active while eating or speaking and can lift a denture from its alveolar ridge. This frenum attachment may be surgically moved (this is called a frenectomy).
Alveolar ridge bone profile lessens or literally comes closer to the floor of the mouth as jawbone is lost over time. The bone loss is called resorption. This reduces the vestibule or space between the lip and alveolar ridge. Surgical extension of this vestibule (called vestibuloplasty) provides more alveolar ridge exposure for a denture to rest upon and reduces muscle pull due to a high frenum attachment.
As an alveolar ridge loses bone, it often may be built-up by surgically placing various substances beneath the gum tissue to increase both bulk and height of the ridge. This is called alveolar ridge augmentation.
As a person eats and speaks, the lips and cheeks exert forces towards the inside of the mouth while the tongue exerts an outward counter force. There is a space between the tongue and lips and cheeks, called the neutral zone, where there are balanced forces during function. These opposing forces can help maintain a denture in place, with surprising power, if the denture is fabricated so that its bulk and teeth rest within this space.
Inserting metal implants into the jawbone and fabricating a lower denture to receive and connect with these implants in various ways will help stabilize a lower denture, while still allowing for comfortable and easy removal of the prosthesis for cleaning.
Ensuring that upper and lower teeth contact optimally during function (called balanced occlusion) is a basic means of stabilizing a lower denture. If one tooth strikes on one side only, the denture will rock. Even contact or biting is a necessity. Fabrication of a denture that completely avoids contact with all potentially dislodging structures and has a metal base for strength and some weight often will facilitate stability.
What's the Best Approach?
Frequently, several approaches are combined, and not all may be suitable for a particular patient. After a thorough examination, a licensed dentist can best advise an individual as to the best means of helping stabilize a lower denture in their unique situation.
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 Prosthodontics
Dentures are replacement teeth that can be removed. Many people who are missing one tooth, several teeth or all their teeth benefit greatly from false teeth.
Prosthodontics improve your chewing and speech, and support your facial muscles. They make a big difference in your appearance and your smile, and can boost your self-confidence.
Made from acrylic resin, most dentures are very natural-looking and can be matched in color and appearance to your other teeth. Several visits to a denturist are usually required over the course of a month to take the impressions and make sure your false teeth fit right. These multiple appointments with a prosthodontist are necessary for receiving all the benefits you'll gain from them -- your increased ability to chew, a great-looking smile, and confidence when speaking.
Complete Dentures
A complete denture is for people who have no teeth in their lower jaw or upper jaw, or both jaws. In addition to the other suggestions for denture care listed below, complete dentures should be removed and cleaned two or three times daily to keep your gums healthy and to allow your tissues to relax.
Partial Dentures
Partial dentures are for people who have some natural teeth remaining, or who only need to replace a few teeth. The benefits are the same as for full denture wearers: your facial muscles will be supported, your smile improved and your ability to chew and speak will be enhanced.
Immediate Dentures
If a tooth is damaged and cannot be restored, you and your dentist may decide to create temporary dentures. That way, the dentist can pull your tooth and you can wear the temporary denture until a permanent solution is designed for you.
This temporary solution allows you to continue with your professional and social commitments without showing a gap in your smile. Sometimes an immediate denture is used to replace a number of hopeless teeth at one time. Generally, the prosthodontics will require relining, rebasing, or being completely remade three to six months later.
Getting Used to Your False Teeth
Even dentures that fit beautifully require an adjustment time. At first, you may experience minor speech changes and some eating difficulties. You may also notice an increased flow of saliva during this period.
While you're getting used to your replacement teeth, you may want to keep high-profile events to a minimum and give yourself time to adjust. You may also want to start with soft food that is easy to chew, while your comfort level increases.
Some prosthodontics wearers notice a slight change in their facial appearance. Knowing what to expect helps to anticipate normal adjustments for denture wearers and to effectively manage them.
While the dentist may advise you to wear your false teeth initially at night, normally you will remove your dentures while you sleep. Taking a break for eight hours gives your tongue and saliva a chance to do its natural job of cleaning and stimulating your gums.
Caring for Your Dentures
- Handle with care.
- Remove and brush daily.
- Use a brush and cleansers designed for dentures.
- Don't use abrasive cleaners or abrasive toothpastes, which will leave scratches.
- Don't sterilize them in boiling water or in the dishwasher -- the hot water will warp them.
- If you wear a partial denture, remove it before you brush your natural teeth and clean it carefully with a brush and cleanser.
- When the false teeth are not in your mouth, soak them in a glass of water or cleanser. Dry dentures can become brittle and crack or break.
- Keep your dentures in the same place and away from children and pets -- keep them safe and reduce the chances of losing or misplacing them.
- Have your mouth and the dentures checked at least once yearly by your denturist.
by Brian J. Gray, D.D.S., M.A.G.D., F.I.C.O.
+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.