Assuming there is such a thing as an ‘ideal denture’, what would it entail? In this article we will examine what makes an ideal denture. We will explain the importance of patient expectations, and prosthetist expectations, and how they must intersect for there to be a good outcome for all.
Embedded in this notion of aligning expectations, is the idea of collaboration between the oral health provider and the patient, for they both have important roles to play.
It is the dental prosthetist’s job to make you the best possible denture for your individual needs using his or her extensive clinical knowledge and expertise. However, without you as the patient relaying to your prosthetist what your needs and expectations are, he or she won’t be fully equipped to produce the best job.
Firstly, with your prosthetists’ help, you will choose the right kind of denture for you, whether it be a partial denture or full denture. Your prosthetist will advise on the most suitable materials to craft your denture according to your clinical needs and your budget. He or she will also help you choose aesthetic aspects like colour of teeth. After which, the process of making your denture will begin, according to those preferences and clinical requirements.
Next, your denture will be tried in your mouth to determine how well it fits. It’s at this stage that you and your dental prosthetist will need to work together in an honest and collaborative manner to ensure you get your ‘ideal denture’.
It seems to be human nature that most people want to please. And this certainly includes your oral health provider. But he or she is not a mind reader, so this is not the time for you to say something is ‘working’ or ‘comfortable’ or even ‘okay’ unless it really is. Now is the time for you and your oral health provider to work together to iron out all the niggly issues on the path to that ideal denture. You will not offend your prosthetist. He or she expects there will be adjustments to be made. This is the nature and beauty of handcrafted dentures. They are custom made for your unique situation. Equally, you must also be aware that it may take two or three visits to get the best fit.
How do you know what to expect if you haven’t had dentures before?
But if this is your first set of dentures, how do you know what is ‘normal’ when adjusting to wearing dentures and what is not. Following are the things your denture should not do.
Dentures should not:
- Cause any pain.
- Cause you to regularly bite your cheek or your tongue.
- Strain your facial muscles.
- Give you headaches.
- Cause you to lisp and/or cause your teeth to click when talking.
- Boost your confidence (you should be happy with how they look)
- Allow you to eat a well-balanced and diverse diet.
- Be stable and snug.
- Allow you to speak clearly - an exception is full lower immediate dentures.
- Have longevity.
To clarify, let’s look closely at each aspect, beginning with what dentures should not do:
1. Dentures should not cause any pain
Some discomfort must be expected after having teeth extracted and replaced immediately with a denture. This differs with each patient. The extraction wound is generally responsible for any pain, not usually the denture. Equally, some discomfort will incur when an old denture is replaced with a new one until one’s mouth becomes adjusted. This may feel like pressure for some patients or could be caused by rubbing and sore spots in others. Adjustments by your prosthetist will correct these issues.
2. Dentures should not cause you to bite soft mouth tissues like cheeks and tongue
Cheek and tongue biting can occur with natural teeth as well as dentures and usually for the same mechanical reasons, like overcrowding of soft tissues in the space between the opposing teeth causing the tissues to be pinched [ref]. Patients can learn to overcome this in time by consciously avoiding behaviours that damage soft tissues. If the problem persists your oral health provider can adjust your denture to resolve the problem.
3. Dentures should not strain your facial muscles
Dentures are not the same as natural teeth which are secured by roots into the jaw. A denture wearer uses facial muscles and suction to keep a denture in place when eating and speaking. When you have a new denture fitted, even if you are used to wearing a denture, it will take your facial muscles some time to learn how to keep your dentures stable [ref]. Your denture success depends on your willingness to adapt and allow the process of muscle learning to become a habit. When your denture is well designed and appropriate to your clinical needs, persisting excessive strain of facial muscles may mean the denture needs adjustment. Consult your prosthetist for advice.
4. Dentures should not give you headaches
Ill-fitting dentures can sometimes result in an improper bite (where upper and lower teeth do not correctly align) for which jaw muscles try to compensate. As a result, muscles become overtired, or excessive pressure is placed on your temporomandibular joints (where your jaw hinges), both of which can lead to headaches, jaw and neck pain. Your prosthetist can resolve any misalignment issues.
5. Dentures should not cause you to lisp or ‘click’ your teeth when talking
Getting used to dentures takes time and patience and differs with each patient. The way your lips and tongue work to produce speech is altered by dentures because they take a different form in your mouth, not the same as natural teeth. As your oral muscles become accustomed to your dentures, speech will improve, including impediments like lisps. The more you practise the quicker you will adjust, and the lisp will become a thing of the past.
Resolving the issue of clicking dentures may also be a matter of adjustment. As you learn how much force is required to close, the clicking should resolve. However, in some cases clicking dentures can be a sign the dentures are loose and need adjusting, in which case consult your prosthetist.
On the positive side of getting dentures the following is what you can expect:
1. Dentures should boost your confidence.
While dentures are not the same as natural teeth they can look as good and often even better than the ones you were born with. If that isn’t a confidence booster, I don’t know what is. The thing to remember is once made, the aesthetics of dentures cannot be changed without extra expense. Therefore, it pays to choose wisely during the early stages and ask for guidance from your prosthetist. Taking a friend along to help you make decisions is also a good idea.
2. Dentures should allow you to eat a diverse and well-balanced diet
Once you are adjusted to them, well-made, well-fitting dentures allow you to enjoy most of the foods you like. Some exceptions are excessively sticky foods like toffee or small hard foods like some nuts.
3. Dentures should be stable and snug
New dentures should be stable and fit well. If you have had teeth extracted, and an immediate denture fitted, normal post-extraction gum and bone shrinkage will occur, causing dentures to become loose. Your prosthetist will arrange denture relines which restore fit over this period of natural shrinkage. Regular denture maintenance checks will ensure a continued snug fit.
4. Dentures should allow you to speak clearly - an exception is full lower immediate dentures.
While clear speech may be challenging initially, as your oral muscles adjust to your new denture, speaking clearly will become natural. An exception to this is a full lower immediate denture. Because of the need to leave room for the tongue, a full lower denture can’t use suction to retain it in your mouth and must rely on the wearer learning to hold it in place with the tip and sides of the tongue. Some people are challenged initially, but with practise this can be overcome.
5. You should get longevity from your dentures
With regular check-ups you can expect to get the best from your dentures in terms of longevity, fit, comfort and functionality. Like most things, if you look after them, they will serve you well, saving you time and money. Regular annual checks will alert you to denture or oral health issues before they become problems.
An ‘ideal denture’ for your unique situation is attainable. To get the best denture for you requires working as a team with your prosthetist toward the same goal. Essential to this end is making sure your expectations align with those of your prosthetist, taking time to be informed, and being prepared to put in the effort needed to achieve the best possible outcome. Patience and persistence are key.
Disclaimer – Always consult your oral health professional for expert advice about your unique personal situation. The information given here is of a general nature and for the purpose of education only. It is not meant to replace the advice of your oral health specialist
Northern Rivers Denture Clinic is located in the heart of Tweed Heads, southern Gold Coast. Finally have the smile you deserve with handcrafted, quality dentures.