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Dentures replace several missing teeth, or all of them, with a removable appliance. They are the right answer when the remaining teeth cannot be kept, when implants are not possible or not wanted, or when the budget decides. A denture that works depends on the planning, the fit, and realistic expectations from the start. At Vizcaya Dental Arts Dr. Kottar makes complete and partial dentures over several visits, with a try-in of the teeth in wax before anything is finished, and adds implants under a loose lower denture when the bone allows.
Complete or partial
A complete denture replaces all the teeth in an arch, when none remain or the remaining ones cannot be saved. A partial denture replaces some teeth and is held by the ones that remain, which need to be solid enough to have a long-term future. Which you need follows from the condition of your teeth, which we assess carefully, because a partial built around teeth that are about to be lost is a partial that will soon need remaking.
Partial denture designs
For a partial meant to last, our choice is a cast metal framework with acrylic teeth and gum-colored acrylic where needed. The framework rests on the teeth, not just the gums, which gives much better stability. The clasps that hold it can be metal, for durability, or a clear flexible material that is less visible but somewhat less durable over the years.
Two other designs have a place:
- A flexible nylon partial, such as Valplast, is comfortable and nearly invisible, but it is gum-supported rather than tooth-supported, it is harder to adjust and repair, and we have found it less kind to the remaining teeth over time. We use it as a transitional appliance for patients who will be losing their remaining teeth, not as a long-term solution.
- A precision-attachment partial, which clips onto specially made crowns and hides the clasps, is a technique we still offer but use less often, because implants usually solve the same problem better.
Immediate dentures
When teeth have to be extracted and you cannot be without teeth in the meantime, an immediate denture is made in advance and fitted at the extraction visit. It involves some guesswork, since it is made before the teeth are out, and it is relined as the gums heal. Immediate dentures are a good temporary. They do not fit as well as a denture made on healed gums, and they should be thought of as the step toward a final set rather than the final set.
The visits
- Step 1 of 5 Assessment
Examination, X-rays, and a conversation about what you want the denture to do and what is realistic for your gums and bone.
- Step 2 of 5 Initial impressions
A first impression of each arch, from which custom trays are made for the next step.
- Step 3 of 5 Final impressions and bite
Precise impressions with the custom trays, and a record of how your jaws meet, which sets the height and position of the new teeth.
- Step 4 of 5 Try-in
The teeth are set in wax on a trial base. You see the shape, shade and position in your own mouth and ask for changes before anything is finished.
- Step 5 of 5 Delivery and adjustments
The finished denture is fitted and checked. Sore spots are normal in the first weeks; adjustment visits deal with them.
Appearance
A denture decides a great deal about how a face looks: the fullness of the lips and cheeks, the height of the lower face, how much tooth shows when you speak and smile. All of that is designed at the try-in, where the teeth are set in wax so that the shape, shade, size and arrangement can be judged on your face and changed before anything is processed. Some patients want a denture that looks like the teeth they had, down to a slight irregularity; others want something brighter and more even. Either is possible.
Partial dentures and the teeth that hold them
A partial denture depends on the teeth it clasps, and those teeth take on extra work. Plaque collects around clasps, so the remaining teeth need more care, not less:
- Brush along the gum line where the clasp sits.
- Clean between the teeth daily.
- Keep your check-ups, because decay at a clasp or gum disease around a supporting tooth is what ends a partial early.
- Take the partial out at night to let the gums and the teeth rest.
- Insert and remove it with your fingers rather than biting it into place, which bends clasps.
When a supporting tooth is eventually lost, a tooth can often be added to the partial rather than making a new one, which is one of the advantages of a well-designed cast framework.
Relines
Gums and bone change shape over time, and a denture that fit well two years ago can start to rock or trap food. A reline adds new material to the fitting surface so it matches the gums again. It is a routine part of denture ownership, usually done every few years and sooner after extractions, and it is far less expensive than a new denture. A denture that is loose should be relined, not patched with ever more adhesive.
Adapting
A denture is not natural teeth, and the patients who do best know that going in.
- A conventional denture has much less chewing power, so you will eat softer foods, cut things smaller and chew longer, particularly at first.
- Speech changes a little while your tongue learns the new tooth positions; reading aloud for a few minutes a day speeds that up.
- There is a learning curve, and we help with adjustments as you go, but your own practice is a large part of success.
- If a spot keeps rubbing, come in. A sore spot is a fitting problem, and an adjustment fixes it.
Bone, and why some dentures fit better than others
How well a denture can fit depends on the ridge of bone it rests on. Someone who has just lost their teeth usually has a good ridge, and a denture made on it can be comfortable and reasonably secure. Lower dentures suffer most. Two implants under a lower denture, or four under an upper, hold it in place in a way the gums cannot. Implants can almost always be added, and our implant-supported dentures page explains how.
Daily care and replacement
- Dentures and partials come out at night, every night, and sit in water or a cleaning solution; sleeping in them inflames the gum underneath.
- Brush them daily with a denture brush, and brush your gums and any remaining teeth as carefully as ever.
- As the gums change over the years, a reline refits the denture to them.
- Acrylic teeth wear, slowly against another denture and faster against natural teeth, so an upper denture opposing your own lower teeth may need replacing within ten years, while a full upper and lower set can last much longer.
- We check the fit and wear at your yearly visit, which is still needed with no natural teeth left: implants, gums and an oral cancer screening all need looking at.
Frequently asked questions
How long does it take to get dentures?
Several visits over a few weeks: initial impressions, final impressions, a bite record, a try-in of the teeth in wax so you can see the appearance, delivery, and then adjustment visits. Each laboratory step takes about a week to ten days. A good set of dentures cannot be rushed.
Will I be able to eat normally?
You will eat, but not as you did with natural teeth. A conventional denture has far less chewing power, so softer foods, smaller pieces and more chewing are part of the adjustment. An implant-supported denture changes that substantially.
Will they look natural?
A carefully made denture can look very natural. The try-in visit exists so you can see the tooth shape, shade and position in wax and ask for changes before anything is finished.
How long do dentures last?
It depends on what they bite against. Dentures top and bottom wear slowly, because acrylic chewing against acrylic is gentle. An upper denture against natural lower teeth wears faster and may need replacing within ten years. Relines along the way keep the fit as the gums change.
Do I sleep with them in?
No. Dentures come out at night and go into water or a cleaning solution. Sleeping in them keeps the gum covered around the clock and leads to inflammation and infection. Your dentist may give different instructions for the first night after extractions.
Partial denture or bridge?
A bridge is fixed and relies on healthy teeth either side of the gap; a partial comes out and can replace several teeth across an arch. When the supporting teeth and bone allow, most people prefer something fixed, whether a bridge or an implant. A partial is the sensible choice when several teeth are missing or finances are the deciding factor.
