Dentures

"Still the best, most-cost effective way to replace multiple teeth"

Tags: dentist, london dentist, nhs, whitening, inman aligner, cosmetic dentist, checkup, dental, anish, anish dentist, london hygienist, dental hygiene, root canal., crown, cap, onlay, veneer, wisdom tooth, extraction.

by Mr Anish Patel
denture
A typical cobalt chromium partial denture.

Overview

A denture is a removable replacement for missing teeth and the surrounding tissues. Two types of dentures are readily available and vary in construction material. Complete (replaces all teeth) dentures are mostly made from acrylic, while partial dentures (replaces few teeth) can be acrylic or colbalt chromium. The later being stronger and actively engaging the remaining teeth for a firmer more secure fit.

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The Procedure

Complete dentures
1.  
We start by taking an impression of your top and bottomm teeth with standard trays. This is mostly done with a material called alginate which is soft when mixed and hardened over a miunute. This is sent to laboratory where special custom-made trays to fit your mouth are constructed.

2.  The special trays are used to get a better impression of the soft tissues and teeth. This again is done in alginate. The better the impression, the better fitting the final denture will be.

3.  Registration. The wax rim blocks received from the lab are carved and used to work out how the denture will bite down together, aswell how much lip and cheek support the denture will give. We will record how much tooth you want on show at this point and set up the natural curves/inclines that natural teeth folow. The colour and shape will also be decided at this stage.

4.  Try-in.The lab send back a mock-up of the denture in wax to try-in so we can assess the colour, shape, and how the teeth fit together. We will make any minor adjustments here before we send off the denture to be made in acrylic. Note- At this stage the denture may be a little loose as they are in wax, this is completely normal.

5.  Fit of denture. We will give you your final denture at this stage. We will assess the denture again for fit and aesthetics. We will often make small adjustments to the denture to prevent rubbing of the gums and un-even bite.

Partial cobalt chromium dentures
1.  
We start by taking an impression of your top and bottomm teeth with standard trays. This is mostly done with a material called alginate which is soft when mixed and hardened over a miunute. This is sent to laboratory where special custom-made trays to fit your mouth are constructed.

2.  The wax rims blocks are used to record your bite, and allow the lab to mimic how your jaw moves. This way they will be able to design a metal denture bespoke to you.

3.  We will make some minor adjustments to the teeth where the metal frame work will rest on.. This does not require anaesthetic as it is very minimal.
The special trays are then used to get a better impression of the soft tissues snd teeth. This again is done in alginate or silicon (more accurate). The better the impression, the better fitting the final denture will be.The laboratory will send back a metal frame work to try in.

4.  We will try in the metal frame with no artificial teeth. This is to check we have a tight fit and that you are biting down correctly. At this stage we will select the colour, shape, and how much of your teeth you want to show when you smile.

5.  Try-in of waxed denture.The lab then will send a mock-up of the denture in wax to try. We will assess the colour, shape, and how the teeth fit together. We will make any minor adjustments here, before we send off the denture to be made in metal and acrylic.

6.  Fit of denture. We will check the denture for the look, and comfort at this stage, followed by home-care instructions.


Risks

The major risk is of not replacing lost teeth is the over-growing of un-opposed teeth which can lead to problems associated with an un-even bite. If back teeth are not replaced you may get excessive wear of your front teeth. Your jaw will naturally shift forward to find a stable rest position and with back teeth missing this is your unfortunately your front teeth which have not been designed to take sure a load.

Alternatives to extraction

If you have always had loose full dentures (due to bone loss), you can have implant retained dentures. This involves having a few implants placed in the jaw, follwed by a special denture that clips actively in place with them. It does not rely on the the amount of "suction" your gums have.

implant_retained_denture
A typical upper implant retained denture on 4 implants.

What To Think About

Dentures are not for everyone. They take a determined pateint who will persevere with them and want them to work. Successful outcomes are as much psychological as they are good technique and construction. They are also not the best replacement for people with a strong gag reflex.

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