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The Difficult Truth About Dentures

Posted Jul 01 2009 6:39pm

Most dentists who have been in practice any length of time have probably made quite a few complete sets of dentures. These occur often in cases when patients go in with old sets that need to be replaced. There are also cases in which the patients go in to see a dentist with their teeth in such bad condition that there is literally no other affordable option. However, sometimes young people may go into a dentist’s office with numerous teeth that have what they believe are non-repairable cavities, or they may not like the appearance of their teeth because they are crooked. They assume that dentures will be a simple way to correct all their problems.

Many of these people have avoided going to the dentist because they are afraid of what the dentist will think, or afraid of what will happen to them once they get there. Let me try, in this article, to clear up a few important points.

Your Fear of the Dentist
Any fear you have of going to the dentist, and the pain you may experience while being worked on is completely out of proportion to the actual discomfort you will feel while you are there.
Modern dentistry is designed to care for you in such a way that you will feel very little pain at all during your visits. In fact, your dentist can even give the very anxious patient medicine to take just before their appointment time, to help them relax, so that even their fears are lessoned.

Full Dentures Should be Your Last Resort

You cannot even imagine how disappointed you may be with full dentures. You do not naturally lose your teeth when you get old. With a little care, anyone can keep their teeth all their life! Having full dentures is not at all like having real teeth. People with them can barely chew their food. Most people can put just an average of 15% of the pressure on their false teeth as they normally used to chew their food with, before they lose the suction that keeps the top denture in their mouth. The lower ones have no suction at all and they just sit there by virtue of their own weight, and the ability of the tongue to help them stay in place. Many people find lower dentures so cumbersome that even if the top ones are reasonably successful, they do not wear the lowers except when they go out in public.

Nearly the instant the natural teeth are removed, the face begins to age rapidly. When your new dentures are inserted for the first time, your facial appearance remains the same, for the time being, however within a very short amount of time, the bone that held your original natural teeth begins the process of resorption, literally disappearing, which begins the process of collapsing your facial structure.

Wearing dentures rapidly accelerates the aging progression of your face because the distance between your nose and your chin begins to diminish as soon as the natural teeth are removed. The bone that used to hold your top natural teeth begins to draw back up toward your nose, and the bone that held the lower natural teeth “goes south”, allowing both the top and bottom false teeth to ride with them in the same directions. Within just the first few months, your face has aged several years. As a result, the denture teeth ultimately begin to disappear under your lips while the lips themselves begin to flatten out. This process continues for the rest of your life, as you will always appear much older than you actually are. The rapid aging usually has a profound effect on the emotional well-being of the patient, and can unfortunately affect their ability to gain employment and be socially active.

Dentures Must be Refitted Every Two Years
Approximately every two years you must go back to your dentist to have your dentures relined. What this means is that new plastic must be added to the inside of your existing denture in order to fill in the spaces between the denture and your gums left have been left vacant by the receding bone. Relines do not actually restore vertical dimension, but they do help keep the denture fitting tight and stable. If you fail to reline the denture regularly the consequences will not be good.

As the bone continues to recede and more and more space becomes vacant inside the denture, most people will begin wearing some type of stiff denture adhesive to maintain the denture stability in their mouths. They tend not to notice that the teeth move around more and more while they are chewing their food. When a denture retains suction, but begins to move around over the bony ridge that supports it, dentists say that the denture has good retention, however it lacks stability. When the hard denture base is in close approximation to the bone that supports it, the denture has maximum stability, but as the distance increases, no matter what type of substance you put under it, the teeth become less and less secure and are much more easily dislodged when chewing food.

People just try to live with this worsening condition and they plan to get new dentures, someday, when the difficulty becomes so serious that they can not eat properly at all. However, if they have waited over two years to refit their denture, something very unfortunate begins to happen to the tissue that supports the denture. Nature begins to actually create more gums between the bone and the denture to take up the slack. At first this sounds good, but the gum tissue that nature builds after the real teeth are gone is soft and flabby. You can compare it to a layer of play dough. Of course, play dough will adhere to a wall, and it has some retention values, however it won’t support any weight and it certainly has no stability. That is just like the loose new gum tissue that forms under an ill fitting denture, it will not support a new stable denture.

If your dentist attempts to fit a new denture over a growth of this flabby tissue, it will have the same stability problems that the old one did unless you first go to an oral surgeon to have the tissue removed before your denture is made.

If you get to the point when you are needing to use more than just a touch of denture adhesive to retain your denture, then you are due for a reline. Do not try to fit something under your denture to make up for the gap as a makeshift “denture liner”. Using anything other than actual denture adhesive is a bad idea because the denture breath gets pretty sour very quickly.

The Gag Reflex
If you have a strong gag reflex, and avoid going to the dentist because of this, be assured that your dentures will cause you to gag too. Perhaps the saddest group of patients that dentists must try to treat are those who hate their dentists because they tend to gag when anyone, especially the dentists, put something in their mouths. These patients have the idea firmly in their minds that they will just wait until their teeth get so bad that a dentist will just have to put them to sleep, remove all their teeth and they will wake up with dentures and live happily ever after.

Certainly, you can wait that long to see a dentist. And, although it is very costly, you can have all of your teeth extracted at once, while under general anesthesia and have an immediate denture placed. However, I am not too certain about the “happily ever after” part. Gaggers tend to go without their dentures quite a bit, because the very presence of the denture in their mouths makes them feel like throwing up all the time. They begin to avoid accepting invitations to eat out, and will wear their dentures only when it is absolutely necessary. The only real hope these patients have is if they can someday afford full mouth implants.

Are There Affordable Alternatives to having all the Teeth Removed?
The missing teeth and teeth that are beyond repair can be replaced without extracting the remaining good teeth. They can be replaced using removable partial dentures. Partial dentures are much more comfortable and secure than full dentures. They do not have to cover the entire roof of your mouth for stability because they are kept secure by the remaining natural teeth. Even the existence of a few natural teeth remaining on either side of the dental arch can make it feasible to wear a partial denture as an alternative to full dentures. The presence of any number of real teeth can greatly reduce, although not completely eliminate, the hastened aging process related to having full dentures.

Having said all of this, there certainly always will be some patients who truly do need to have all their teeth removed. For them, we will be posting an article describing the different types of dentures, and the steps involved in making them.

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