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Denture-Related Dental Procedures Including Implants, Bridges, and Partial Dentures

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Denture-Related Dental Procedures Including Implants, Bridges, and Partial Dentures

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Implants, Bridges, and Partial Dentures

Living with dentures might lead to the need for other dental procedures, such as partial dentures or dental bridges. The American College of Prosthodontists answers some common questions below. Read more about denture adhesives here.

I have upper and lower partials. I cannot get used to them, and they are sitting in the bathroom doing nothing. They feel so heavy and hard, and they make my mouth very tired. How can I get used to these things?

Answer: Dentures must replace the teeth and the gums, and the dentures must cover the roof of the mouth and all of the ridge to improve the fit of the dentures. So, there is more material in your mouth, which seems heavy and probably very big in your mouth. It may take a long time for new dentures to be fully comfortable, especially if there were teeth extracted at the time the denture was placed in your mouth. It takes at least eight to ten weeks for healing to really progress at the bone level, even if the gum tissue has closed over where the teeth were removed after only two weeks. Changes in the bone may occur up to six months after the teeth have been removed. So, it simply may be a matter of time. The more often you wear the dentures, the quicker your mouth will become adjusted to the feel of them. You may consider starting with a few hours a day and gradually work up to wearing them full time. Or, if they remain uncomfortable or painful, return to the dentist or prosthodontist who made the dentures to see if they can be adjusted to fit better. Read more about denture adhesive creams here.

Response provided by the American College of Prosthodontists.

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I am about to have fixed/permanent/implant retained dentures put in (upper and lower). I have no teeth: Everything will be supported by implants, and my dentist is telling me that he needs to do some sort of filling on the back of my teeth (a mix of white gold and other metal) to make my chewing and biting Is this typical?

Answer: It’s difficult to interpret your question. If the “filling” is being applied to your current teeth that will be extracted, then I don’t understand. If the “filling” is to be fabricated to the denture teeth of the implant-supported denture, I will give the following response. The type of denture (implant supported) is extremely challenging due to the increased forces that will potentially damage your new denture. Excessive wear of denture teeth is common for this type of denture and the denture periodically may have to be replaced. Perhaps what is being suggested is that a more wear-resistant material should be added to the denture teeth to help prevent excessive wear. I’m not sure if that is what is being suggested, but if it is, it does have some merit and may help to extend the wear on the denture teeth. You may want to seek the care of a prosthodontist. A prosthodontist is a dental specialist with three years of additional training in the restoration and replacement of teeth, including dentures. To find a prosthodontist near you, visit www.gotoapro.org.

Response provided by the American College of Prosthodontists.

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I was unable to afford reconstruction when I lost a molar and when I broke a tooth. I am in better shape financially now, but I realize that I really need to get dentures. Is bone reconstruction always necessary for people who have lost previous teeth?

Answer: It sounds as if you still have enough remaining teeth that may be used to reconstruct your mouth. Exhaust all the possibilities for keeping your own teeth first, even if they need to be crowned, before considering dentures. Regarding bone reconstruction, when a tooth is removed, the bone often shrinks. The amount it shrinks depends on many factors such as the skill of the surgeon removing the tooth, the amount of infection present at the time of extraction, the number of roots on the tooth, etc. Often, when teeth are removed, prosthodontists recommend “site preservation," which involves placing bone-graft material into the extraction site in order to minimize the amount of bone lost after extraction. Ask your dentist or prosthodontist about these procedures. A prosthodontist often will work with other dental specialists, including periodontists, who are bone surgery specialists, to provide patients the best care for their needs.

Response provided by the American College of Prosthodontists.

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I have Ehlers-Danlos syndrome. I was told by the local dentist that if I get dentures (as my teeth are rotting out of my mouth), my jawbone would break down, and it would be better to get partials and try to veneer the ones that might be savable. This, he said, would help the jaw from breaking down, and I could get dentures later when these teeth failed. Is this true? Or would that just be wasting money since I’ll most likely need full dentures eventually anyway?

Answer: The dentist should have determined if the teeth are in good enough condition to repair. If so, it is always better to keep your natural teeth as long as possible. Once the teeth are removed, the bone does continue to dissolve over the years, making it very difficult to wear dentures. You would then need to use denture adhesive to secure the dentures to help keep them from moving. You would also need to look into dental implants. If you keep your teeth, you will be prone to gum disease due to Ehlers-Danlos and will need to be sure to have regular dental cleanings and to follow your dentist’s advice on daily flossing and brushing. If you are not certain about your dentist’s advice, you should seek a second opinion with a prosthodontist, a dentist with three years of additional training in the restoration and replacement of teeth. To locate a prosthodontist near you, visit www.gotoapro.org.

Response provided by the American College of Prosthodontists.

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I have been wearing a lower partial denture for about 20 years. I have a bridge in the front that has four teeth and two teeth attached to the bridge. Now the bridge is very loose and will have to be removed along with the two teeth holding the bridge. I will then have no teeth on the bottom. I will have to wear a full denture. Will I have a hard time adjusting going from partial denture to full denture? And is it advisable to pay for overdentures and have my bone built up to receive two implants to hold the denture?

Answer: It’s always unfortunate to lose the remaining lower natural teeth since the lower complete denture has many challenges. It’s strongly suggested that when your lower teeth are removed, that they are replaced with an immediate denture. Studies have shown that the immediate insertion of a denture after extractions greatly enhances the ability of the patient to adapt to the denture. Secondly, having at least two dental implants in the lower jaw would unquestionably improve the retention and stability of the lower denture. Normally it does not require the bone to be built up, but that would have to be determined by your dentist. You may want to seek the care of a prosthodontist, a dental specialist with three years of additional training in the restoration and replacement of teeth, including dentures. To find a prosthodontist near you, visit www.gotoapro.org.

Response provided by the American College of Prosthodontists.

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I have had upper dentures for more than four years. I have gum disease and after pulling all my top teeth, the dentist says I may not be able to dentures them because my gums are receding. I cannot keep them in even with Polident®, Fixodent® or anything else. If I eat, they come loose, and I have to take them out. Is there anything that will hold them in?

Answer: Gum recession is a result of periodontal disease or possible treatment to remove diseased tissue. Prosthodontists work with periodontists to help patients with periodontal disease live comfortably. A prosthodontist is a dental specialist with three years of additional training in the restoration and replacement of teeth, including dentures. While it may not be possible to replace gums that reveal long teeth and roots, a prosthodontist can help to preserve your remaining teeth and gums when working side by side with the periodontist. To find a prosthodontist near you, visit www.gotoapro.org.

Response provided by the American College of Prosthodontists.

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