In this article we explore the challenge of upper denture problems for both first-time denture wearers and those people replacing old dentures. While both new wearers and denture veterans share many of the same issues, a major difference is that veterans have experience on their side. We will address each of the most common issues to refresh and reset for the veterans and reassure and restore confidence for the new denture wearers.
Feelings of fullness
One of the most common challenges new denture wearers report is an overwhelming feeling of fullness in the mouth. This is especially the case when dentures are fitted immediately after extractions. Together with swollen tissues and the foreign body of a denture, they report having a mouth so full that they can barely manage, sometimes even experiencing gagging. Eventually the swelling subsides, natural receding of the gums and bone takes place, and facial muscles learn to accommodate the interloper in your mouth. A veteran denture wearer may also experience a feeling of foreignness with a new denture as space created by shrinkage of gums over time is now occupied with the new better-fitting denture. However, having experienced adapting to a new denture before, most are reassured knowing the feeling is temporary.
Gagging
Gagging is a natural, involuntary reaction to having what feels like a large object in your mouth on which you feel you may choke. The gag reflex may be triggered when an object touches the back of your tongue or tonsil area. The gag reflex can also be activated by taste, smell, sight, sound, and even anxiety generated by fitting a foreign object in your mouth. Certain individuals are more sensitive to gagging than others, with some experiencing mild choking and others violent retching and vomiting.
How to resolve gagging
Various measures can be taken to avoid gagging. Oral health professionals may prescribe medications or attempt to distract the patient by talking to them during treatment or using the way they position the patient. Dental Prosthetists also employ various techniques to help patients overcome gagging during appointments. These may include placing a small amount of salt on the patient's tongue to stimulate other sensory receptors, or asking the patient to wriggle their toes as a distraction technique. These methods can help redirect the patient's focus and minimize the gag reflex. Anaesthetic sprays or acupuncture have proven effective for others. Desensitisation is a long-term solution involving brushing the back of your tongue each day for 15 seconds with a toothbrush, just before the point which makes you gag. Repeat the exercise each day until you no longer trigger the gag response, moving further back as the area becomes desensitised, until you have reached the base of your tongue without gagging.
Sometimes, the design of the denture itself can be to blame for constant gagging. If the posterior border of an upper denture extends too far back on the palate, it may trigger the gag reflex in sensitive individuals. In such cases, adjusting the denture design can help alleviate the problem.
Slippage
Slippage happens when dentures are loose or ill-fitting, making eating and talking difficult. Consequently, the patient loses confidence fearing the denture will dislodge or worse, fall out when they cough, sneeze or laugh. Slippage isn’t necessarily the result of a poorly-made or badly-fitted denture although this can happen. Your mouth is a dynamic environment. Gums recede and bone loss occurs overtime as part of the normal process of ageing, or as a part of healing after tooth extractions.
When a denture is fitted immediately after tooth extractions, slippage may occur as tissues heal, swelling decreases and the denture becomes loose. The ’immediate’ or temporary denture is then relined or replaced with a permanent one fitted to your mouth’s new topography.
While suction between the denture and your palate helps to keep the upper denture secure, new denture wearers may find it takes time for facial muscles and tongue to learn to accommodate the denture and hold it in place. Take heart, patience and persistence eventually pay off.
How to resolve slippage
Seek assistance from your dental prosthetist early rather than later to avoid complications like sore spots. An adjustment to your denture by your prosthetist may be all that’s required. Dentures can be relined with either a soft or hard material applied to the inside of your denture where it contacts your palate to restore fit. Soft relines provide cushioning for sensitive gums, while hard relines offer a more durable, long-term solution. In some cases, if the denture is old, a new denture might be due. In the meantime, denture glues or adhesives applied at home are a temporary measure to keep your denture in place. Eventually the materials from which dentures are made, deteriorate with age or rough handling, and a new denture is the only solution.
Denture sores
As a new denture wearer, you’re likely to suffer some soreness until your mouth and gums adjust to the presence of a denture pressing on your gums. However, should the discomfort persist, seek help from your prosthetist because loose dentures and slippage can lead to denture sores and even infection if not addressed. Constant rubbing as the denture moves across your gums while chewing can abrade sensitive oral tissue resulting in sore spots or ulcers.
Dealing with dental sore spots
Rinsing with saltwater several times a day can help heal minor sore spots. Develop and practise a good oral hygiene regime. Leave your dentures out overnight to give your gums a rest. Over the counter anaesthetic salves like oil of cloves or pain medications can help with temporary soreness but should pain persist, see your oral health provider.
Trouble eating and speaking – developing muscles for new wearers
Removeable dentures are a brilliant replacement for natural teeth – but they are not the same. Unlike natural teeth, dentures do not have the same stability that natural roots anchored in the jaw provide. This means the denture wearer must rely on a good fit, suction, and facial muscular control to enable all manner of normal mouth function like chewing and speaking.
Helping to adjust
Measures like singing or reading aloud help to shift focus from your self-consciousness and allow you to master holding your denture in place.
Excessive saliva
Saliva is crucial for survival. It can be thought of as the gatekeeper of your mouth, maintaining homeostasis between you and the outside world of pathogens. In addition to maintaining oral hygiene, saliva helps to lubricate your mouth, assisting in the chewing and swallowing of food.
New denture wearers may experience excessive saliva until they adjust to the foreignness of a denture in their mouths. Saliva is also necessary for the retention of your denture creating cohesion, surface tension and adhesion. However, too little or too much saliva can be a problem. Usually, excessive saliva flows adjust as you become accustomed to the new denture. Several factors can cause insufficient saliva production, including ageing and smoking tobacco. Some medications like analgesics, angiotensin- converting-enzyme inhibitors and antihypertensives among others, may negatively affect the flow of saliva and therefore the denture retention.
Resolving irregular saliva flow
Excessive saliva in new denture wearers most often resolves itself as you become accustomed to denture wearing. Take small sips of fluids throughout the day. Practise a good oral hygiene regime.
Dry mouth or insufficient saliva can be caused by medications, vaping or tobacco smoking, resulting in sore spots and discomfort for the denture wearer. Chewing sugar free gum can stimulate saliva production. Be sure to stay well hydrated avoiding coffee and alcohol which contribute to dry mouth. Try to avoid mouth-breathing especially prevalent when sleeping on your back, by developing the habit of sleeping on your side. Specially formulated mouth-washes containing Xylitol can also help to keep your mouth moist.
Food getting caught beneath the denture
The secret to getting used to wearing upper dentures is patience and perseverance. A part of this is easing your way back into normal eating again. Choosing foods which are not difficult to chew, or swallow is important in the early stages. As you progress to foods that require more chewing, try to avoid dry foods like chips, popcorn, nuts or crackers which fragment and can lodge between your palate and the denture causing irritation or even sore spots.
Hints to avoid food getting caught
Regular rinsing of your mouth and denture will remove pesky food particles before they become an irritant. Choose your food carefully until you have mastered the art of chewing without food lodging beneath your upper denture. Avoid dry foods which fragment and get stuck. Avoid sticky foods which can dislodge your denture and allow food to collect beneath it.
Try to chew evenly on both sides of your mouth to avoid dislodging the denture and allowing particles to get underneath. This will also prevent uneven wear and tear and protect the denture’s integrity and longevity.
Exercise patience and perseverance until your facial muscles and tongue learn to hold the denture in place.
Regular consultation with your prosthetist who will adjust your denture when needed, will maintain a close fit.
Cleaning issues
Learning to care for your upper denture will ensure its longevity and your oral health. See here for advice on how to develop a cleaning and maintenance regime.
A final word: overcoming upper denture problems
Whether you are wearing an upper denture for the first time or replacing an old one, the fact that you are seeking advice will help you successfully negotiate your way through temporary adjustment issues to enjoying the benefits a denture can bring.
References
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https://www.healthline.com/health/how-to-get-rid-of-gag-reflex
https://www.healthline.com/health/how-to-get-rid-of-gag-reflex
https://www.healthline.com/health/how-to-get-rid-of-gag-reflex#desensitizing
Britannica, T. Editors of Encyclopaedia (2024, July 29). homeostasis. Encyclopedia Britannica. https://www.britannica.com/science/homeostasis
Vila T, Rizk AM, Sultan AS, Jabra-Rizk MA. The power of saliva: Antimicrobial and beyond. PLoS Pathog. 2019 Nov 14;15(11):e1008058. doi: 10.1371/journal.ppat.1008058. PMID: 31725797; PMCID: PMC6855406.
Sonthalia A, Chandrasekaran AP, Mhaske SP, Lau M, Joshy VR, Attokaran G. Comparative evaluation of effect of complete denture wears on the flow rate of saliva in both medicated and apparently healthy patients. J Int Soc Prev Community Dent. 2016 May-Jun;6(3):219-23. doi: 10.4103/2231-0762.183103. Epub 2016 May 30. PMID: 27382537; PMCID: PMC4916795.
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