Tooth Replacement and Dental Implants
A removable partial denture is a restoration that holds a false tooth in the space of a missing tooth and is removable by the wearer. The removable partial denture is held in place by clasps that are designed to fit around some of your natural remaining teeth. Despite the use of clasps, all removable partial dentures move slightly during function. In general, the more missing teeth that are replaced by the partial denture, the more it will move. A removable partial denture is most frequently used to:
- replace missing teeth to restore a natural smile, restore an even bite for better chewing or to facilitate normal speech sounds
- replace missing teeth when an inadequate number of teeth remain to allow the use of a fixed bridge or when an inadequate amount of bone precludes or complicates the use of dental implant supported crowns
- prevent teeth on either side of a space from progressively tipping over or teeth in the opposite jaw from over erupting which can result in an unattractive smile, an uneven bite and damage or pain in the jaw joints or muscles
- maintain the natural shape of your face by providing support for your lips and cheeks
- prevent excessive wear on the remaining teeth when some teeth are missing
- Conventional Partial Denture: Some of your teeth will be selected to help support and hold the partial denture in place. These teeth usually require some minor reshaping in order for the partial denture to maintain the health of the tooth, to prevent unwanted tooth movement and to enable the design of a clasp that will be effective in stabilizing the partial denture. Sometimes teeth require fillings or other procedures to enable them to adequately support the partial denture. Sometimes crowns (caps) might also be needed to improve the fit of a partial denture or to allow a tooth to be capable of supporting the partial denture. Depending on which teeth are required to stabilize your partial denture and whether these teeth are visible during smiling, talking or laughing, the clasps may be visible.
- Attachment Partial Denture: Similarly to a conventional partial denture, some teeth will be selected to help support and hold the partial denture in place. These teeth will have crowns (caps) made for them with precision attachments (snaps) incorporated into the crown to more securely hold the partial denture in place and further reduce movement of the partial denture. Attachments need to be anchored to the teeth by the use of crowns. Often, two crowns are required for each attachment. Usually a partial denture will need two attachments, one on each side of the jaw that will have the attachment partial denture. Attachments, unlike conventional clasps are made so that they are hidden from view and are not visible. This can dramatically improve the overall appearance.
It is important to realize that partial dentures do not last forever. Changes are always taking place in the bone and gums under the partial dentures. Experience shows that most partial dentures need to be refitted to the soft tissues of the mouth, approximately every one to three years, to help maintain stability and a good fit. When changes within the mouth are more significant such as tooth movements or tooth loss or if the partial denture framework no longer adequately fits the teeth, the dentures will require replacement. Many people will state that they have worn their partial dentures successfully for far longer periods than 5 years.What these people do not realize or know, is that ill fitting partial dentures cause damage to the bone, gum tissue and teeth as well as promote mouth infection, despite occasionally being comfortable. Some people have heard that partial dentures are bad for your teeth because they wear the enamel and cause cavities. While it is true that partial dentures and teeth are lost because of tooth decay and gum disease, this is not very likely if you will follow our advice and instructions. It is important to clean your teeth and partial denture thoroughly every day and have all of your teeth and removable partial denture regularly examined and cleaned by your dentist.
Because food, plaque, bacteria and mineral deposits stick to dentures it is desirable to rinse your mouth and denture after each meal. It is critical to thoroughly scrub, clean and disinfect your denture every day.
Clean your denture over a sink full of water or a towel. If the denture is dropped, it will fall into the water or onto the towel and not chip or break. Scrub the outside and inside surfaces of the denture using a denture brush. Toothpaste is not good to clean dentures as it is abrasive and will eventually wear the denture. Use denture cream or regular liquid hand or dishwashing soap. The denture must, be scrubbed with a brush and soap at least once a day to remove food, plaque and reduce mineral buildup.
Your dentures must be disinfected every day to kill bacteria and yeast that are associated with mouth infections and odor. Disinfection, stain and calculus removal is best accomplished by soaking the dentures in ‘Prodent’ solution for 30 minutes daily, which can be obtained through our office. Alternatively, either 'Efferdent' or 'Polident' can be used, which are available from most drug or large food stores but are not as effective at stain and calculus removal. In either case, rinse the denture thoroughly afterward, before placing it back in the mouth or preferably let them soak in water overnight.
If the denture starts to accumulate a mineral buildup called calculus (a hard white material), the denture can be soaked overnight in white vinegar, full strength. The vinegar will soften the calculus and it can be brushed off.
Your gums should be cleaned every day by very gently rubbing them with a soft tooth brush and then rinsing with water. Your remaining natural teeth must of course be thoroughly cleaned once or twice a day, ideally before bedtime using a soft tooth brush with fluoride tooth paste. Dental floss or other aides need to be used to clean between the teeth.
It is true that at first, removable partial dentures will not feel very natural. They will certainly feel strange to the tongue, cheek and lips and food definitely tends to collect around them. Some foods that are particularly hard to chew or sticky are probably best avoided. However, most people get used to partial dentures and enjoy the benefits of better appearance, speech, chewing and health.
Mrs. B.O. presented to our office in 1998 at age 55, concerned that her existing partial lower denture was uncomfortable and her upper complete denture caused her to slur her speech. She wanted to keep her remaining lower teeth. A removable partial denture was the only treatment alternative in the lower jaw due to the lack of adequate bone support for dental implants. However, we determined that it would be possible to realign a tooth on the lower left followed by a fixed bridge to better stabilize the teeth and bite in this area. This then created an improved situation for a better designed new partial lower denture which was made with a new complete upper denture. Not only is her lower denture more comfortable than before with better speech, the esthetic alignment of her teeth is much improved.
Mrs. T.K. had already left her previous dentist disappointed that her teeth were deteriorating and felt that she had not received proper dental treatment or advice. She had consulted two other dentists, one of which recommended a thorough examination in our office. She came to us in 2000 at the age of 53. We recommended periodontal (gum and bone disease) treatment be provided in a periodontal specialist’s office. Numerous other treatments were provided by our office including new crowns on the lower front teeth that fit properly and had a much improved bite and appearance. New crowns were also required on many of the upper teeth. Mrs. T.K. decided to proceed with an attachment retained removable partial denture to avoid the display of a metal clasp and this was accommodated in conjunction with the new crowns. Mrs. T.K. now has her confidence restored in the dental profession and can look forward to enjoying her teeth for years.
Mr. S.N. was 66 years old when he was referred to our office in 1994 by his general dentist because of his complaint that his dentures didn’t fit properly and the lower partial denture was loose. His lower partial denture was so troublesome that he was not even wearing it. We made a new complete upper denture and a differently designed lower partial denture to improve the evenness of his bite and the stability of his dentures. The smile was also significantly modified with Mr. S.N.’s input to achieve a much more youthful appearance.
Ms. H.R. was referred to our office in 1996 when she was 44 years old. She felt her old partial upper denture, which was only one year old, was loose, her tongue felt irritated by the position of the denture teeth, she had difficulty speaking with the denture and the appearance of the gum on the partial denture looked unnatural to her. New removable partial upper and lower dentures were made for her that were more stable, had a much better appearance and allowed her to speak much more naturally without irritation.