Geriatric Dentistry – Dentures

About the Procedure

What are Dentures?

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Dentures are removable appliances made of acrylic resin or a combination of acrylic resin and metal. They are used to replace missing teeth and surrounding tissues. Dentures are custom-made for each patient to match their natural teeth and gums, allowing them to regain their ability to chew and speak properly.

There are two types of dentures:

  1. Complete Dentures: These are used when all teeth are missing. They consist of a full set of artificial teeth that are supported by the gums and underlying bone structure. Complete dentures can be either conventional (placed after the gum tissue has healed) or immediate (placed immediately after the teeth are extracted, so the patient does not have to be without teeth during the healing process).
  2. Partial Dentures: These are used when some natural teeth remain. They are designed to fill in the gaps created by missing teeth, preventing neighbouring teeth from shifting position. Partial dentures usually have a metal framework that attaches to the remaining teeth, with artificial teeth attached to fill the empty spaces.

Dentures require regular care and maintenance, including daily cleaning and overnight soaking in a denture cleaning solution. They should be fitted and adjusted by a dentist or prosthodontist to ensure proper fit, comfort, and functionality. In some cases, dentures may need to be relined, rebased, or replaced over time as the shape of the jawbone and gum tissue changes.

Procedure to fabricate Dentures?

The process of making dentures typically involves several steps and requires the expertise of a dental professional. Here is an overview of the general process:

  1. Initial Assessment: The first step is a thorough examination of the patient’s mouth, including taking X-rays and impressions of the teeth and gums. The dentist or prosthodontist will evaluate the oral condition, determine the need for dentures, and discuss the patient’s specific requirements and expectations.
  2. Impressions and Measurements: An impression is taken of the patient’s jaws to create an accurate mold. This mold is used to create a plaster model, which serves as a base for designing the dentures. Measurements are taken to determine the appropriate shape, size, and alignment of the artificial teeth.
  3. Wax Rim and Bite Registration: Wax rims are placed in the patient’s mouth to establish proper jaw position and bite alignment. The patient is asked to bite down on the wax rims to record their natural bite and to ensure proper fit and aesthetics. This step helps in creating a denture that functions well and looks natural.
  4. Denture Try-In: Using the wax rim and bite registration, a trial denture is fabricated in a dental lab. This try-in allows the patient to preview the appearance, fit, and comfort of the dentures before the final fabrication. Any necessary adjustments can be made at this stage to ensure a proper fit.
  5. Final Denture Fabrication: If the trial dentures are approved, the final dentures are fabricated in a dental lab. The artificial teeth are set in a pink base material (typically acrylic resin) that resembles the colour of the patient’s gums. The dentures are then finished and polished to ensure a smooth and comfortable fit.
  6. Fitting and Adjustments: Once the final dentures are ready, the dentist or prosthodontist will fit them in the patient’s mouth to check the fit, bite alignment, and overall comfort. Adjustments may be necessary to ensure the dentures fit properly and are comfortable to wear.
  7. Follow-up and Maintenance: Dentures may require occasional adjustments, especially in the initial weeks after placement when the gums and jawbone may change shape. Regular dental check-ups are recommended to evaluate the fit, function, and condition of the dentures, as well as to address any issues or discomfort.

It’s important to note that the manufacturing process and materials used may vary depending on the type of dentures (complete or partial) and the specific needs of the patient.

The Journey of new Dentures:

Getting new dentures can be a significant change, and it is normal to have some adjustments and adaptations. Here are some things to expect when getting new dentures:

  1. Initial discomfort: Initially, it is common to experience some soreness, irritation, and discomfort as your mouth and gums adjust to the presence of the dentures. This discomfort usually subsides as your mouth gets accustomed to the new dentures.
  2. Speech changes: It may take some time to adjust to speaking with dentures. You may notice changes in your pronunciation or a slight lisp. Practicing speaking, reading aloud, and slowly articulating words can help improve your speech.
  3. Eating challenges: Eating with dentures may feel different at first, as the artificial teeth may not have the same biting and chewing ability as natural teeth. Start with soft foods, cut them into smaller pieces and chew slowly to gradually build up your ability to eat a wider variety of foods.
  4. Increased saliva production: Some people may experience an increase in saliva production during the initial adjustment period. This typically decreases as you become more accustomed to wearing dentures.
  5. Frequent adjustments: It is common to require multiple adjustments or modifications to ensure a comfortable fit. Your dentist or prosthodontist will make necessary adjustments for proper fit and function. It may take several appointments to achieve the desired fit and comfort.
  6. Regular maintenance: Dentures require regular care and maintenance. You will need to clean them daily, remove them at night for soaking, and visit your dentist for regular check-ups and cleanings. Proper care and maintenance will help prolong the lifespan of your dentures.
  7. Emotional adjustment: Adjusting to the appearance and feel of new dentures can have an emotional impact. It is normal to feel self-conscious or anxious initially. However, over time, most people adapt and gain confidence in their new smile.

It is important to communicate any concerns or difficulties you may experience with your dentist or prosthodontist. They can provide guidance, make necessary adjustments, and offer support throughout the denture wearing process.

Will Dentures make me look different?

Dentures can affect your appearance, but the goal is to create natural-looking dentures that enhance your smile and restore a more youthful appearance. Here are some ways dentures can impact your appearance:

  1. Teeth and Jaw Alignment: Dentures are designed to replace missing teeth and restore proper alignment to your jaw and facial structure. This can help improve the symmetry of your face and reduce the sagging or sunken appearance that can occur when teeth are missing.
  2. Facial Support: Dentures can provide support to your facial muscles, especially the cheeks and lips, which helps fill out your face and reduce the appearance of wrinkles and lines associated with tooth loss.
  3. Smile Enhancement: Dentures are custom-made to fit your mouth, taking into account factors such as the shape and size of your face. Dentists and prosthodontists work closely with patients to create dentures that look natural and suit their individual facial features, ensuring that the dentures complement your smile and overall appearance.
  4. Tooth Colour and Shape: Dentures are designed to match the appearance of natural teeth as closely as possible. The colour and shape of the artificial teeth can be customized to resemble your original teeth or to create a desired aesthetic. This allows for a natural-looking smile that is in harmony with your facial features.

It is important to communicate your preferences and expectations to your dentist or prosthodontist during the denture fabrication process. They will work closely with you to ensure that your dentures are crafted with your appearance and satisfaction in mind. Remember, with proper fit and adjustments, dentures should provide a natural-looking smile that can positively impact your overall appearance and self-confidence.

How to take care of Dentures:

Proper denture care and regular cleaning are essential for maintaining good oral hygiene and extending the lifespan of your dentures. Here are steps to clean your dentures effectively:

  1. Remove and rinse: Take out your dentures and carefully rinse them under running water to remove any loose food particles and debris.
  2. Brush the dentures: Use a denture brush or a soft-bristled toothbrush specifically designed for dentures to gently brush all surfaces of the dentures, including the teeth, gums, and any metal attachments. Avoid using regular toothpaste, as it may be too abrasive and can damage the denture material. Instead, use a mild denture cleaner or a non-abrasive, antibacterial soap.
  3. Soak overnight: After brushing, place your dentures in a denture cleaning solution or water. Soaking them overnight helps to keep them hydrated and maintains their shape. Follow the package instructions for the specific soaking solution you are using.
  4. Rinse thoroughly before wearing: Before reinserting your dentures in the morning, be sure to rinse them thoroughly under running water to remove any residue from the denture cleaning solution.
  5. Clean your mouth: While your dentures are out, it is important to clean your mouth and gums. Use a soft-bristled toothbrush or a gauze pad to gently clean your tongue, cheeks, and gums. This will help remove any plaque or bacteria and ensure a healthy mouth.
  6. Handle with care: When cleaning or handling your dentures, be cautious not to drop them as they can break easily. Fill the sink with water or place a towel on the countertop to provide a cushion in case you accidentally drop them.
  7. Regular dental check-ups: Regular dental check-ups are important, even if you wear dentures. Your dentist can examine your mouth, gums, and dentures to ensure they are in good condition and make any necessary adjustments or repairs.

Remember, maintaining good oral hygiene is important even if you wear dentures. It is recommended to clean your dentures at least once a day and to follow these steps consistently for optimal denture care and oral health.

When to wear Dentures:

Dentures are typically worn during the day to replace missing teeth and restore the function and appearance of your natural teeth. However, there may be some factors that determine when and how long you should wear your dentures. Here are a few guidelines:

  1. Initially: Your dentist or prosthodontist will provide guidance on when to start wearing your dentures after their placement. In some cases, they may recommend wearing your dentures immediately after tooth extraction or placement, allowing the gums to heal and adjust to the dentures.
  2. Daytime Wear: Most people wear their dentures during the day, especially when they are socializing, eating, or speaking. This allows for improved speech, chewing function, and a natural-looking smile.
  3. Removal at Night: It is usually recommended to remove your dentures at night to give your mouth a chance to rest. Removing your dentures allows your gums and jawbone to relax and promotes oral hygiene by allowing for proper cleaning of your mouth and dentures. However, if advised by your dentist, some individuals may be instructed to wear their dentures at night for specific reasons.
  4. Follow Professional Advice: Your dentist or prosthodontist will provide specific instructions on when and how long you should wear your dentures based on your individual needs and oral health condition. They may recommend gradually increasing the duration of wear over time to allow your mouth to adjust.

Remember, proper denture care is essential for maintaining oral health. Clean your dentures daily and ensure a clean mouth and gums before reinserting them. Regular dental check-ups are crucial to evaluate the fit, function, and condition of your dentures and address any concerns or necessary adjustments.

If you have any specific concerns or questions about when and how long to wear your dentures, it is best to consult with your dentist or prosthodontist for personalized advice.

Does Medical Aid cover the cost of dentures?

In South Africa, the coverage for dentures under medical aid plans can vary depending on the specific medical aid scheme and the type of plan you have. Some medical aid schemes may provide limited coverage for dentures, while others may offer more comprehensive coverage.

It is important to review your specific medical aid plan or contact your medical aid provider to determine the extent of coverage for dentures. Typically, medical aids in South Africa have a list of prescribed minimum benefit (PMB) conditions, which include dental treatments for certain conditions. If dentures are required due to a PMB condition, your medical aid may cover a portion or all the cost.

However, if dentures are needed for cosmetic reasons or are not considered medically necessary, coverage may be limited or even excluded.

To ensure you have accurate information about denture coverage under your medical aid plan, it is recommended to consult with your medical aid provider directly. They will be able to provide you with the most up-to-date information specific to your plan and coverage.

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