Denture care is the maintenance of removable artificial teeth. Full or complete dentures replace all teeth in the upper jaw (maxilla), lower jaw (mandible), or both jaws. Partial dentures replace some teeth.
Purpose
Dentures replace natural teeth lost because of a health condition or injury. The artificial teeth fit in the mouth, allowing a person to eat normally. Daily denture care by the patient helps prevent conditions such as plaque. Periodic dental appointments assure that dentures fit properly and that the patient's mouth is healthy.
Precautions
Dentures are fragile and can break if dropped. The American Dental Association (ADA) advises people to hold dentures over a towel or basin of water. The patient should not try to repair dentures.
Dentures should fit, so dental adhesive should be used only in an emergency. Extended adhesive use can conceal infections.
Sores
Dentures and partial dentures can cause sores in areas such as the jaw, below the tongue, and on the roof of the mouth (palate). Sores can swell slightly and are generally red. Poor oral hygiene and wearing dentures too long can lead to denture stomatitis (denture sore mouth). Symptoms often include an inflamed palate. The dentist may prescribe antibiotics or an antiseptic rinse.
Other causes of sores include poorly fitted dentures, an uneven bite, illness, and infections. Moreover, smoking, alcoholism, or oral cancer may cause sores. Furthermore, neglected sores could stimulate the growth of excess soft tissue. Tissue should be removed and a biopsy performed to detect malignant cells.
Description
People have worn dentures for thousands of years. Early material for artificial teeth included whale ivory. Today, most restorative teeth are made of plastic material such as acrylic resin.
Types of dentures
There are two types of complete dentures. Immediate dentures are placed in a patient's mouth after teeth are removed. These temporary dentures allow patients to have
Dental prostheses
Appliance type
Maintenance required for oral health
SOURCE: Alvarez, K.H. Williams & Wilkins' Dental Hygiene Handbook. Baltimore: Williams & Wilkins, 1998.
Orthodontic: fixed, removable, space maintainers Specific plaque control instructions Orthodontic brushes
Interdental aids: rubber tip, toothpick/holders, flossthreaders, proximal brushes, single tuft brushes Fluoride application: dentrifrice, brush-on gel, gel trays Oral irrigation Store in water when not in use
Toothbrushing instructions Oral irrigation Floss or yarn with threader Nonabrasive dentrifrice with fluoride (do not use acidulated fluoride with composite and porcelain restorations)
Removable partial dentures, complete dentures, and overdentures
Power-assisted brush should not be used Use a separate toothbrush for dentures and natural teeth Immerse dentures in liquid cleanser after brushing Store in water when not in use
teeth while gums heal. Healing can take up to eight weeks. Conventional dentures are worn after gums heal.
Complete dentures rest on the dental ridge, the arch in the mouth that supports teeth roots.
For a partial denture, artificial teeth are attached to a base that fits on the gums. Clasps and attachments link the framework to the patient's other teeth.
An overdenture fits on the roots of natural teeth. Those teeth provide stability and support.
Costs for care
At-home denture care involves traditional oral hygiene and denture cleaning. In the spring of 2001, at-home denture products such as cleansers and toothpaste cost $7 or less.
Denture care also includes dental appointments. In the United States in 2000, the average complete denture cost about $874 for the upper arch and $900 for lower arch, according to information compiled by <http://www.bracesinfo.com>. That information was based on statistics from sources including the ADA and the U.S. Bureau of Labor Statistics.
An acrylic partial denture cost averaged $632, while a metal partial costs $983.
Denture repairs averaged $51 for an adjustment, $91 for a broken denture with no teeth involved, $90 for tooth replacement, and $139 to reline dentures.
Dental plans may cover some costs. For example, the 2000 Delta Dental Plan of California assessed a patient co-pay of $395 for the upper or lower complete denture, and $495 for an immediate denture for one jaw. The copay for one partial was $300 or $395, with the higher cost for a metal framework.
Repair co-pays included $20 for adjustments, $50 for repairing the denture base, and $25 for a tooth replacement. The plan allows one relining per denture in a year. The chairside reline cost was $50 per denture and $150 for laboratory relining.
Preparation
The process for making dentures generally starts with the dentist taking a wax impression of the patient's mouth. A material similar to plaster is poured into the impression to make a model of the teeth. The plaster model is sent to a lab, where a wax denture is made. The dentist fits this denture on the patient and then sends it to the lab where the permanent denture is created.
Aftercare
The dental team educates new denture wearers about how to adjust to restorative teeth and clean them.
Dentures should be rinsed to remove food particles. Then the patient brushes natural teeth and dentures to removes plaque and food. The ADA recommends using a toothbrush recommended for dentures or a soft bristle brush. Dentures can be cleaned with denture cleansers bearing the ADA Seal of Acceptance, mild liquid dish soap, or hand soap.
The new denture wearer is usually advised to wear the full denture most or all of the time. After an adjustment period, the dentist generally tells the patient to take the dentures out before bedtime. This gives the gums a chance to rest and promotes oral health, according to the ADA. When removed, dentures are soaked in water or a cleanser solution.
Complications
Bones and gums may shrink, especially during the first six months after teeth are removed. When shrinkage occurs, the dentist may need to rebase or reline the immediate dentures.
The new denture wearer may experience soreness. This is caused by the pressure of hard dentures on soft tissue and is usually temporary. However, soreness is frequently a sign that dentures need adjusting.
The patient may also experience a temporary increase in saliva flow. If any symptoms persist, patients should contact their dentists.
Results
After a patient adjusts to new dentures, the person should have no trouble eating or speaking. Subsequently, modifications to dentures may be required because the shape of the mouth changes over time as gums recede or sink.
Dental adjustments include:
Relining, adding material to reshape the denture.
Rebasing, building a new base and placing the artificial teeth on it.
Replacement of teeth.
A set of dentures may need to be replaced within five to 10 years.
Health care team roles
The dental team monitors the patient's mouth health during periodic check-ups.
In addition, the dental staff educates the new denture wearer about oral hygiene and how to adjust to wearing artificial teeth. Advice to new denture wearers includes:
Eat soft foods and cut them into small pieces. After adapting to dentures, add other foods to the diet.
Read aloud to adjust to speaking with dentures.
Smiling, laughing, or coughing could cause dentures to slip. Gently biting down and swallowing will reposition the dentures.
KEY TERMS
Plaque—A transparent material in the mouth that contains bacteria and causes tooth decay.
Prosthodontics—The area of dentistry concerned with the replacement of missing teeth.
BOOKS
Guerini, Vicenzo. A History of Dentistry From the Most Ancient Times Until the End of the Eighteenth Century. Boston, MA: Longwood Press, 1977.
McGivney, Glen P., et al. McCracken's Removable Partial Prosthodontics. St. Louis, MO: Mosby-Yearbook, Harcourt Health Sciences, 1999.
Taintor, Jerry, and Mary Jane Taintor. The Complete Guide to Better Dental Care. New York: Facts on File, Inc., 1997.
Teabord, Mark, et al, eds. Development, Function and Evolution of Teeth. New York, Cambridge UK: Cambridge University Press, 2000.
Zarb, George A., et al, eds. Boucher's Prosthodontic Treatment for Edentulous Patients. St. Louis, MO: Mosby-Yearbook, Harcourt Health Sciences, 1997.
ORGANIZATIONS
Academy of General Dentistry. 211 E. Chicago Ave., Chicago, IL 60611. (312) 440-4300. <http://www.agd.org>.
American College of Prosthodontists. 211 E. Chicago Ave., Suite 1000, Chicago, IL 60611. (312) 573-1260. <http://www.prosthodontics.org>.
American Dental Association. 211 E. Chicago Ave., Chicago, IL 60611. (312) 440-2500. <http://www.ada.org>. Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Prevention. Division of Oral Health, MS F-10. 4770 Buford Highway, NE, Atlanta, GA 30341. (888) CDC-2306. <http://www.cdc.gov>.
National Institute of Dental & Craniofacial Research. National Institutes of Health. Building 45, Room 4AS-18, 45 Center Drive MSC 6400, Bethesda, MD 20892-6400. <http://www.nidcr.nih.gov/>.
SOURCE: Alvarez, K.H. Williams & Wilkins' Dental Hygiene Handbook. Baltimore: Williams & Wilkins, 1998.
Dental hygiene
Throughly clean dentures twice each day by immersing dentures in chemical solution and brushing for plaque removal; rinse throughly. It is preferable to leave the dentures out while sleeping, or for 6–8 hours during the day. Brush and massage the gums to clean away plaque and debris and stimulate circulation.
Denture storage
After cleaning, store the dentures in water in a covered container when they are not being worn. Keep the container in a safe place inaccessible to children or house pets.
Eating
New denture wearers should cut food into small pieces, avoid foods that need incising, and avoid raw vegetables, fibrous meats, and sticky foods until experience has been gained. Practiced denture wearers may select a variety of foods, but should not expect the same efficiency as with the natural teeth. Use the canine and premolar area to bite food, and push back as the food is incised; do not pull or tear the food in a forward direction. Take small portions and try to chew with some food on each side at the same time to stablize the denture.
Over-the-counter products
Consult the dentist for advice about all denture problems, and before buying self-reline materials, adhesives, or other additives. Never attempt to alter the denture for relief of discomfort.
Speaking
Speak slowly and quietly. Practice by reading aloud at home, preferably in front of a mirror, and repeat and practice words that seem the most difficult.
