In this interview with Dr Uche Onyeso of Smilewell Dental Clinic, she shares her knowledge of artificial or false removable teeth medically known as dentures. Dr Uche is an experienced dental surgeon with 13 years of practice. Her answers to various questions thrown at her can help disambiguate what most of us do not know about false teeth. She also emphasized on the importance of immediate care and restoration especially in cases of tooth decay and trauma from accidents as dentures are necessary in restoring a person’s smile, good oral functions and confidence.
Q: What are removable dentures?
A: They are custom-made removable replacement teeth also known as false teeth, fabricated for people with missing tooth or teeth due to trauma, accidents or tooth decay. They help in restoring proper oral functions and esthetics, and are usually made of acrylic, nylon, or metal.
Q: What are the different types of removable dentures?
A:There are two major types of removable dentures. Full or complete dentures are used when all of a person’s teeth are missing. They are usually made of pinkish plastic base that mimic the gum tissue, supporting a full set of porcelain or plastic teeth. Full or complete dentures can also be referred to as conventional or immediate dentures depending on when they are made and inserted into the mouth. Unlike conventional dentures, immediate dentures are considered temporary.
Partial dentures are used when one or more of a person’s teeth are missing. They can be made of plastic base or a metal frame work. They support the teeth by clasping on the surrounding natural teeth. Plastic partial dentures are usually recommended as an emergency or temporary replacement of missing teeth, allowing the gum and bone to heal before a more permanent restoration is done.
Q: How are dentures made?
A: The process begins with a patient visiting a dentist for an evaluation and possible teeth replacement. The dentist will then take series of impressions and a wax bite are made of the patient’s oral tissues that will support the denture. This is to determine the vertical dimensions and proper jaw position.
A dental laboratory technician will then use the impressions to create wax forms or plastic models of the patient’s mouth. The dentist and the laboratory technician will then build the dentures on the model, taking care to ensure the shape, color, position and fit of the denture resembles that of the patient.
Q: Can children wear dentures?
A: Yes, but the child’s age determines the type of dentures the child can wear. A child that is still erupting or has mixed dentitions of milk and permanent teeth will only wear a replaceable or removable dentures. This is because a permanent denture will affect the eruption process and also the spacing of the child’s teeth. But a child that has all permanent teeth can wear a fixed denture.
Q: Are there tests required before a patient can undergo this procedure?
A: Before having any dental procedure, the dentist or dental surgeon will usually have a patient’s medical history. Apart from that, no test is usually required except for known diabetics. The sugar level of the patient is usually checked before an extraction process. If it is high, it is usually not advisable to proceed until the patient’s sugar level is certified alright. This is because the healing time after the extraction will be longer.
Q: Can you give us a short summary of the extraction process and the replacement with dentures?
A: On the day of the extraction, the patient is given anesthetics which numbs the surrounding area of the tooth or teeth. This wears off after an hour or less depending on the dosage. The extraction is carried out and the bleeding is controlled by the use of a gauze pad placed on the extraction site. The patient keeps biting down on the gauze pad while swallowing constantly as this helps to stop the bleeding and encourage blood clot over time. Some antibiotics and analgesics are given to the patient which helps in the healing of the socket and reduction of pain.
The patient is expected to rinse his/her mouth with saline water (salt in warm water) 24hrs after the extraction. This could be done before and after meals or 6-10 times a day until for at least 7 days or till the dentist asks the patient to stop. The healing process is usually complete in6-8 weeks, but in some cases it can be up to 6 months. The healing time also depends on individuals as some patients heal faster than others. It is important to adhere to the post extraction instructions and medications given by the dental surgeon. This helps to curb the risk of infections.
Unlike conventional dentures which cannot be made or worn until the healing process it completed, immediate dentures are worn on the same day of extraction. The patient goes home wearing a replacement tooth or teeth which has been already modeled for the patient during a previous appointment. Thus, the patient does not have to be without teeth during the healing process.
This is a marked advantage especially for self-conscious patients, and those in customer service that constantly deal with the general public on a daily basis. The disadvantage of immediate dentures is that it requires constant adjustments as the gums shrink over time during the healing process whereas complete dentures requires little to no adjustments. To most people, this may not be cost effective.
Q: Are checkups after the completion of the procedure and normal use of the dentures has commenced necessary?
A: Of course, it is absolutely necessary. Just as everyone is advised to visit a dentist at least every 6 months, and smokers every 3 months, denture wearers should do so too especially;
If a patient wears an immediate denture which requires constant adjustments until it fits properly after the healing process. Over time, dentures can start slipping off as the patient’s bones and gum ridges shrink, and also due to wear and tear. These loose dentures can cause sores or infections that will need proper medical attention. Wearers may experience bad breath and bleeding gums due to improper oral hygiene and maintenance of the dentures. Dentures can break, crack or one of the teeth may become loose from slips and falls. With proper care and constant checkups, these conditions can be avoided or contained.
Q: Will dentures affect the way a person looks, feels, eats, and speak?
A: Dentures are made to look like your natural teeth. You do not have to live with a decayed tooth, and a constant hollow or fallow space in between your teeth. They restore your confidence, your smile, and compliment your facial expressions and appearance. This eliminates the constant embarrassing questions that may come from persons around you, such as, what happened to your teeth? Why are your teeth fractured? Is that the color of your teeth or is it just discolored?
Eating with new dentures takes practice. It may be uncomfortable because it is not part of your natural teeth. With many adjustments as time goes on, it will fit perfectly. Start out by eating soft foods, drinking beverages and chewing slowly using both sides of your mouth. Avoid sticky foods, hot meal, bony meat or fish, and the use of took picks. You may experience difficulty in speaking like you used to, and the sound of your pronounced words may sound weird. Saying those words out loud, and repeatedly in practice, helps you get accustomed to speaking properly with dentures.
Q: How does one take care of dentures?
A: By maintaining a good oral hygiene. Brushing your gums, tongue and palate with soft bristled brush every morning and evening before wearing and after removing your dentures. This removes plague that increases tooth decay and stimulates blood circulation in the mouth. Use of special denture brush and not the regular toothbrush in cleaning the dentures. Clean the dentures with mild toilet soap instead of tooth paste. This is because normal tooth brushes and toothpastes especially whitening toothpastes contain bleach which are abrasive. They may cause the material used in making the dentures to harden.
Rinse your dentures properly and store in a storage case filled with clean water as dentures could lose their proper shape if not kept moist. While cleaning or wearing your dentures, spread a clean towel on your bathroom counter or fill your bathroom sink or a bowl with water to avoid dropping it on the hard floor causing damages to it. Proper nutrition by eating balanced diet also helps in maintaining a healthy mouth and lifestyle.
Q: What is the estimated cost of dentures?
A: Partial (temporary) dentures cost around N10,000 per unit. Permanent dentures cost around N20,000to N25,000 per unit. The higher end dentures cost around N40,000 to N50,000. These prices are dependent on the dental clinic of course. It is usually more expensive in European countries.
Q: How long do dentures last?
A: Dentures can be used for a period of 5 to 10 years. Proper oral hygiene, cleaning and storage of the dentures and constant checkups with a dentist helps in its longevity.
Q: Are adhesives used for dentures, if yes how safe are they?
A: Most dentures are meant to be removable for easy oral hygiene and maintenance. Using adhesives on them defeat that purpose unless it is absolutely necessary. Proper adhesives from a dental prosthetics which can be removed with water, soap and damp soft flannel can be used to make the dentures more comfortable.
Most denture adhesives contain zinc mineral which is a micro nutrient, but if taken for a long period of time and in excess can cause health hazards such as low copper levels, lower immunity and low level of the good cholesterol. Tiny strips of the adhesives can be applied on the dentures if needed but it is better to go for a proper adjustment and realignment of the dentures rather than the use of adhesives.
Q: Does insurance cover the cost of dentures?
A: Yes, but depending on the policy details, the type of insurance, and the plan’s restrictions. Most dental insurance plans include some restorative coverage which usually means paying up to 50% of the costs of dentures. In Nigeria, I do not think the National Health Insurance Scheme (NHIS) cover it. You may have to contact your healthcare insurance company for more details.
Q: Are there alternatives to removable dentures?
A: Yes, alternatives to removable dentures are permanent prosthesis called bridges. A bridge replaces missing tooth by placing a crown on the tooth next to the fallow space. An artificial tooth is then attached to both of the crowns and cemented in place. They are usually made of porcelain, porcelain fused to gold, all gold, or zirconium. Another alternative are implants.
They are the more advanced and expensive option of teeth replacement. They are metal posts inserted into the bone of the upper or lower jaw. The post is then attached to a crown, and the crown is then attached to a bridge to multiple implants.
Dentures maybe the best solution for you if you are missing a tooth or teeth. It has the advantages of boosting your confidence, assisting you with eating and chewing, ensuring little to no impact on your speech, and also giving you that perfect smile without being self-conscious of the condition of your teeth. Visit a dentist for professional advice and diagnosis while you can to avoid deterioration of your dental health. Do not forget that a good oral hygiene keeps your entire mouth healthy.