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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.

Is It Time for New Dentures?

Dentures that fit well can improve your looks and enhance eating and speaking. Talk to your prosthodontist about your current situation and whether you need new dentures. In general, the life expectancy of false teeth is about five to seven years.

Factors that affect the satisfaction and life span of your prosthodontics include:

• General health status
• Significant weight increase or decrease
• Time since loss of teeth
• Denture care and cleaning
• Tobacco and caffeine use
• Shape of your mouth
• Changes in facial and oral muscles
• Variation in skin tone or color

The color match of false teeth to a natural tooth color can seem to change, especially if the natural teeth are darker due to stains or lighter because of past dental treatment. Also, dentures can wear, stain, chip, or fracture over time. Today's denturists are able to modify the look of smiles and gum tissues in order to compliment existing teeth, skin color, or tone.

Dentures, like all manufactured goods, require regular maintenance and eventual replacement. To maintain proper fit, appearance, function, and to avoid any damage to oral structure, a prosthodontist should regularly evaluate your false teeth. The gum and bone tissues that support dentures undergo changes over time and with age. Often, these changes include a good amount of bone shrinkage. Bone shrinkage causes a denture to become loose, less functional, and slip during eating and speaking. Age-related changes in facial muscles, complexion, and lips also will affect the function and appearance of your prosthodontics. Oral hygiene habits, use of tobacco, and drinking coffee or tea will also affect the appearance of a denture, as well as any odors associated with them.

Since dentures are in use every day, for many years, it is reasonable to periodically replace those that no longer fit properly. If you have not visited a denturist recently, if your false teeth slip, have lost their good looks, cause discomfort, or if they are more than five years old, you may need to replace them.

by Denise J. Fedele, D.M.D., M.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.