Complete, Partial, and Implant-Supported Dentures
When a person has lost a number of teeth, leading to problems chewing food or a desire for cosmetic improvement, the subject of dentures is bound to come up. Dentures, also known as false teeth, have an undeservedly bad reputation, considering how natural they look these days.
There are many different types of dentures to choose between, from partial to full or complete, and from porcelain to acrylic. And did you know that implant-supported dentures exist, as well as mini-dental implants, which are lower-cost options for attaching this type of false teeth? Learn all the types of dentures to help you be informed about your choices—and then consult a dentist to determine which is the best kind for you.
Plastic dentures have come a long way. Though it's generally better to keep as many of your natural teeth as possible, sometimes dentures are the best option for your health. Modern dentures are more comfortable than they once were, as well as more natural looking.
Complete Dentures (Full Dentures)
"Full" or "complete" dentures are individually fitted fixtures that take the place of teeth by sitting over the gums. Over the course of several visits to the dentist, complete dentures are custom fitted to the mouth so they rest directly on the gums, covering the upper jaw or lower jaw completely.
If all the natural teeth are missing, standard full dentures are used. If some teeth are still present in the mouth when a patient decides to get dentures, there are a couple of options:
- The patient might choose to have the teeth removed so that conventional dentures will fit directly onto the gum. During the healing period (which may be a couple of months) permanent standard dentures cannot be fitted, so "immediate dentures" are used as a temporary replacement for the missing teeth. An immediate denture may need adjustment as the gums shrink during the healing process. And in some patients, these temporary dentures serve as the final dentures.
- The patient might opt to be fitted for full dentures called "overdentures." This type of denture fits over the teeth or denture implants after the teeth have been shaped and root canals on them have been performed.
In some cases, complete dentures are fixed to the bone onto dental implants, and implant-supported dentures instead of conventional full dentures are used.
Complete dentures come in a variety of colors and designs from which the wearer can choose to get the best match for his or her teeth. The size of the denture teeth is also important, as it must be personalized to your jaw, mouth and bite.
There is a period of adjustment to the full dentures, during which time patients get used to eating and speaking with complete dentures instead of natural teeth.
Men and women with full dentures must take special care to brush their gums, tongue and roof of their mouth before inserting the dentures. This is not only to keep the area clean of plaque, but also to stimulate circulation within the tissues of the mouth.
Overdentures are a type of full denture. They are replacements for teeth that rest over any remaining natural teeth or implants, thus helping to save some of the bone in one's jaw. Their design has improved over the years, sometimes including CuSil, denture material made of silicone rubber, to help stabilize the overdenture.
False teeth in the form of overdentures can be fitted over any remaining natural teeth that have not decayed "too far" and need pulling. The teeth that are saved - usually canines and premolars - will have been filed and shaped, had root canals (the nerve root removed) and possibly covered with metal copings to protect them before the overdentures are fitted. If no metal is used on the tooth, fluoride drops may be needed to help stave off tooth decay.
The remaining healthy tooth stubs not only protect the connected facial bone from resorption (a type of decay) but also distribute pressure more evenly along the jaw and provide stability for the overdenture, particularly on the lower jaw. The "mouth feel" is said to be more natural than if all the teeth in the mouth are missing.
If fitting over implants, which are fake teeth that have been permanently inserted into the old tooth recesses in the gums to serve as structural roots for dentures or bridges, the overdentures either fasten onto the implant itself or onto small metal bars between them. These types of overdentures are called implant supported dentures. (See the section on dental implants for more detail.)
Denture Implants, Implant-Retained Dentures and Mini Implants
Implant-supported or implant-retained dentures are a kind of complete overdenture used in people who have no teeth—as long as the underlying bone is healthy. Implant-retained dentures provide extra stability, make speaking easier, make eating easier and are removable.
These dentures have a pink gum-colored acrylic base to which are attached acrylic or porcelain "teeth." The implants (usually at least two) are inserted into the bone at the front of the jaw and have attachments that affix to those of the overdenture. The dentist who performs the surgery is likely to be a prosthodontist.
Due of the additional stability they offer, implant retained dentures are more commonly used in the lower rather than upper jaw. This is because the denture that fits over the upper jaw suffers less from instability than does the lower jaw. Nevertheless, upper denture implants are sometimes used and can feel more natural than standard dentures.
When placed in the lower jaw for dentures, implants take at least 5 months to complete, and in the upper jaw, at least 7 months. Until the overdenture is ready to be fitted, a temporary denture (immediate denture) is used in the mouth.
The basic types of dentures supported by implants include:
- those that attach to a metal retention bar, which is attached to implants that have been fixed into the jawbone - called bar-retained dentures. Replace the attachments once or twice a year as they wear. People who grind their teeth or clench their jaw frequently may need repairs or adjustments made to bar-retained dentures because of the way they are fixed in the mouth.
- those that attach to round studs on the implants - called ball-retained dentures.
Care for implant retained dentures by cleaning them twice daily and keeping excellent oral hygiene around the denture implants as well.
Note that the patient pays a price for the increased stability of denture implants. The cost of implants is not cheap. The implants alone can cost thousands of dollars each.
Slim mini-dental implants, fashioned of titanium, are "less-fuss" fixtures for the lower jaw that are cheaper, quicker, require fewer overall dental procedures, and not as prone to causing discomfort in the insertion process. They are a promising option for patients who have lost too much bone to be fitted with standard sized implants. The lower cost of mini implants can make implant-supported dentures possible for those who cannot afford the more expensive option.
Removable Partial Dentures - Different Types
Partial dentures are false teeth and gums kept together on a metal framework. Removable partial dentures in particular are partial dentures that can be removed easily from the mouth to facilitate oral hygiene. Removable partial dentures can make eating an easier proposition than before and are typically less expensive than full dentures.
Removable partial dentures are used when the patient keeps some or most of his or her natural teeth - generally, at least two teeth on each side of the top or bottom must be present.
If only a few teeth are missing - or even just one is missing - partial dentures can affix directly to the teeth "next door" to replace those that have been lost by means of discreet and invisible precision attachments. The neighboring natural teeth are usually fitted with crowns to facilitate this type of attachment.
A cheaper attachment option for removable partial dentures are basic
metal clasps, which clasp onto nearby teeth that may need to be shaped
for proper fitting.
Removable partial dentures have plastic teeth. The relatively cheap "flipper" denture uses acrylic, and was not designed as a permanent solution for tooth replacement, though some people use them for years.
The cast metal partial denture is another type of denture - it does not put pressure on the gums, which means greater comfort for the patient, particularly those suffering pain from temporomandibular joint syndrome (TMJ).
A third type of partial is the flexible framework removable partial denture (one example is the ValPlast partial denture; another is the Flexite denture). This type uses ValPlast, a sturdy synthetic polymer that blends in realistically with the gums but can be prone to creating sore spots, or Flexite, which is more adjustable than the ValPlast denture and thus may be ultimately more comfortable.
The discomfort problem with the ValPlast denture can be overcome by another type of flexible framework denture, a combination denture that uses ValPlast clasps for aesthetic superiorty and a cast metal framework that does not rest on the gums.
Non-removable partial dentures - called fixed partial dentures - are known as permanent bridges. Bridges, which are made of porcelain and/or gold, cost more than removable partial dentures. Along with not being as "cheap", they generally have more aesthetic appeal. They do require the support of healthy teeth adjoining them.
After getting the final partial dentures and wearing them around the clock for a time, the dentures will be adjusted if necessary for comfort, and then can usually be taken out at bedtime.
You may be interested to read another article I wrote on this topic: The Pros and Cons of Dentures.