The information contained here is to help you adjust to denture wear, a new way of life shared by millions of people in the United States alone. It’s a learning process that requires both time and patience.Perseverance will be your key to success. This information has been compiled to answer the most common concerns and questions our patients have asked over the years.
An immediate denture is one where the denture is placed in the mouth at the same appointment that the remaining teeth are extracted so the patient is never without teeth. There will be soreness and tenderness for several weeks in the area of the extractions. This simply cannot be avoided because the denture has been placed directly over fresh extraction sites. As tissues change during healing, the denture remains unchanged; therefore adjustments will be necessary. The changes occur most rapidly at first and gradually taper off. The soreness varies greatly from person to person, and depends upon many factors such as age, health, adaptability, number and difficulty of extractions, ridge shape, muscle attachments, bite pattern, etc. As a result, some patients will require more adjustments than others, which is to be expected.
Please follow these instructions to promote healing and to prevent complications:
- We must see you for a short follow-up visit 24 hours after surgery and insertion.
- DO NOT remove the dentures until then. This helps to control bleeding and swelling which could keep you from reinserting the dentures.
- After you 24 hour post-op visit you should start to remove them periodically as needed and rinse your mouth with hot salt water (One teaspoon salt in a glass of hot tap water. Swish five minutes, five times a day. Do this for the first week, or until the tenderness subsides.) Your mouth will feel fresher and the hot water rinses aid healing.
- Avoid any mouthwash containing alcohol (Listerine, Scope, etc.) for at least one week.
- Oozing of blood and discoloration of saliva is normal for the first 48 hours, but you should report excessive bleeding at once.
- Take the prescribed medications as needed to control the pain.
- Please report any fever over 101°F, rashes, nausea, or other unusual conditions immediately.
- If sutures are placed, we will schedule a short visit to remove them 7-10 days post insertion.
- The dentures may change your appearance at first. The face may seem full and the teeth appear a little long. As soon as the swelling subsides and the dentures fully settle into place these conditions take care of themselves, allowing your teeth to look as natural as it was possible to make them.
As the gums heal, they change shape and recede, and the dentures will gradually loosen. This is completely normal, but after 6-8 weeks the dentures will need to be refitted (relined) to conform to the healed ridge, sooner in cases of extreme shrinking. A reline is a laboratory procedure that can be done the same day at Northgate Dental, if first scheduled by prior appointment. By the time a reline is scheduled, most of the healing and shrinking necessitating a reline has occurred and the ridges have stabilized, but the shrinking will slowly continue for the rest of your life. This is why additional relines will be necessary every so many years to help preserve the remaining ridge as best as possible. The better the ridge, the better the fit. We will be happy to evaluate this for you on an individual basis.
ADJUSTING TO NEW DENTURES
A great deal of care has been exercised in every step of the process to construct your new dentures. Esthetic factors cannot be overestimated and were given considerable attention. Detailed attention was given to the construction of the dentures to help your comfort when initially accommodating and then adapting to wearing new dentures. Accurate impressions of the tissues were taken and then the proper vertical dimension (space between your jaws) was registered to optimize function and comfort. Tooth arrangement and position was selected to help you attain a pleasing appearance and clear speech. Our goal has been to maximize your chance for adaptation to denture wear, to present a nice appearance, and to have comfort.
Up to this point, the process has involved a mutual cooperation with the dentist doing most of the work. Now the responsibility for success tips heavily towards you. It has been estimated that 75% of the success rate depends upon the patient’s ability and motivation.
Learning to wear new dentures can take time. Don’t be discouraged if you find it difficult at first. You are not alone!! Please do not listen to friends who tell you how easy it was for them to get used to their dentures and how they can eat everything and anything. Their circumstances were different. They are either bragging, have better bone and gum support, or they may have selective memories.
If you are wearing dentures for the first time, it is a little like learning to ride a bicycle; it can be hard and frustrating at first, but with practice and perseverance you will gradually learn to master the new skills needed. The best way is just to wear them continuously. Experience has shown that continuous wear of a denture for a 2-3 week period will get nearly all patients through the adjustment period. You will know that the adjustment period is over when you realize that you feel better with the denture in your mouth rather than having it out. As with other learned skills, the amount of time and effort fluctuates widely among different people. Some seen to master dentures almost immediately and a few have a lot of difficulty, but eventually all succeed by having a positive mental attitude. You should remember that it does take an average of about 4 times longer to master a lower denture than an upper denture.
If you have previously worn dentures, your accommodation period may not be as severe or as extensive. Here, it’s a little like breaking in new shoes. You know how the old shoes used to feel, and the new ones feel different for awhile. The same will be true with your new dentures.
Do not switch back and forth between your new dentures and your old ones. The tissues have changed considerably from the time that your previous dentures were made. The new dentures have been made to fit the tissues as they are today. If you attempt to switch back and forth between old and new sets, you will be uncomfortable in both. Wear only your new dentures to allow for proper adaptation.
Some people have a strong gag reflex. Often it is simply the though of having a denture in the mouth that triggers this reflex almost immediately after insertion. If you are persevering, this feeling will pass within a day or two in most cases. If not, this situation can be helped by shortening the back of the denture.
This is why any adjustments are done very conservatively and judiciously. We are always happy to take care of that for you.
At first most people will experience some difficulty in speaking. This is a very common occurrence because the shape of the inside of the mouth affects the quality of individual speech. The denture changes this shape where it fits across the roof of the mouth. For instance, when saying the letters D, N, G, and T the tongue in accustomed to touching a specific spot in the palate, a spot that is now covered by the denture. However, as soon as the muscles of the tongue and mouth have adapted to the change, the problem is overcome. Practicing by reading aloud in front of a mirror speeds up this new learning process.
FEELING OF FULLNESS
When a denture is first inserted, many patients experience a feeling of fullness in the mouth, and at the same time the salivary glands start to work overtime. That is because the brain thinks food is present. Both of these sensations pass after the first few days. The lips may even stick out or bulge a little, but soon settle back to a normal position.
WEARING A NEW DENTURE AT NIGHT
Many people wear their dentures day and night. They get so accustomed to their dentures that they prefer not to be without them. Also, if you are sleeping without them and you find that the muscles of your face ache because you are able to close your jaws too far together, it would best to leave them in. At first you may find the teeth on the pillow or in the bed upon waking up, but you will learn to retain them at night. On the other hand, if it bothers you to wear them at night because you grind your teeth and wake up with a sore mouth, or if your teeth keep you awake, it would be best to leave them out. We will advise you if there are specific conditions present that would require you to leave them in or out. If it makes no difference to you, we lean more towards leaving then out to allow the gum tissues to rest and to allow for the normal stimulation and cleansing action of the tongue. In this case, please see the next section on denture storage for then your dentures are out.
CARE OF YOUR DENTURE
You should strive to clean your dentures, especially the underneath or tissue side, after every meal whenever possible. At the very least, they should be brushed daily to avoid plaque build up, stain accumulation, and mouth odors. The best way to accomplish this is with a denture brush or just a regular soft toothbrush. Toothpaste is OK but not necessary if you don’t tend to build up stain. Avoid abrasive smoker’s toothpaste, harsh household cleaners, or other gritty pastes that would eventually scratch and remove the high loss finish. This could cause microscopic, odor producing food particles to adhere to them. Avoid temperature extremes; very hot water can warp a denture. Freezing can cause cracks. Lukewarm tap water is fin. As a general rule, remember that if your mouth can tolerate it, so can your dentures. Commercial denture cleaners work fine. If you keep the denture out at night, it should remain submerged or it can dry out and crack or warp.
BREAKAGE OF THE DENTURE
This sure can ruin your day! Dentures are made of a special reinforced acrylic, but they can chip or break if dropped on a hard surface such as a bathroom sink or floor. As a precaution, we urge that when removing your denture you do so over a bath towel or sink filled with water. Dentures also endure extremely strong forces every time you eat, even more so with patients in need of a reline because forces are not evenly distributed. This often results in a spreading crack or a break in the denture base. If your denture breaks, save all the fragments. Most repairs can be done in one or two business days.
The ‘bite’ or configuration pattern of your new teeth is of utmost importance for the long-range success of artificial teeth. Denture teeth are narrower and flatter than natural teeth. This is easier on the supporting tissues and ridge underneath. Furthermore, dentures are not attached to the jaw like natural teeth are, there fore you need to learn to chew in a different way.
At first, many people find it difficult to eat, much like learning to use an artificial arm or leg. So practice, practice, practice! You should put small portions of food in your mouth and place half on one side and half on the other side, then chew on both sides at the same time. People with natural teeth do not ordinarily chew food in this manner, but people with dentures must learn to do so. Your dentures will never be efficient until you chew on both sides at the same time. Avoid sticky foods. Most people find that bread is a good food to start practicing with.
In time, you will learn how to bite into foods. For example, when eating a hamburger with natural teeth, you would bite, and then pull it away (backward). With dentures you should bite and twist as you push it towards you (forward). This motion helps to seat and stabilize the dentures onto the ridges. Otherwise, they will come right out. In time you may be able to master biting into harder foods. Nevertheless, do strive to keep excessive biting forces off the front of the ridge. Remember, smile with the front teeth and chew with the back teeth.
You must learn to control your tongue because it will consider dentures to be foreign objects and do its best to play with, i.e. dislodge them. This is particularly true for the lower denture. When opening your mouth, move your tongue forward a little so that it touches the inside of the lower denture all the way around. This will seal the edges of the denture and help to preserve suction. Otherwise, the lower denture will float and may even pop out when you open your mouth. If after learning to correctly place your tongue the denture still wants to rise out when you open your mouth, consult with our office as there may be an over-extension of the borders of the lower-denture.
Nature did not intend for us to wear hard acrylic against soft tissues. This can result in sore spots whrever the pressure is too much. It takes a while for the gums to toughen up and accommodate to the pressure from dentures. Sore spots can also be caused by new immediate dentures as they settle into place. A visit to our offie will correct this problem. Several such appointments may be necessary because indiscriminate over adjustments affect the stability and fit of a denture. Sore spots can also be cause by other factors cush as a bone spur under the gum, a high spot on a tooth, canker sores or what is known as a ‘knife edge ridge’ of bone under theridge. Therefore, you shouldn’t attempt to adjust your own denture. Please be sure to wear the denture for at least the last 24 hours leading up to the visit, because if we can’t see the sore spot, it is sometimes impossible to adjust it.
FIT VERSUS LOOSENESS
The fit of a set of dentures depends upon many factors. Natural conditions play a role. Some patients are ideally suited while others have very little or poorly shaped ridges, dry mouth, high muscle attachments or adverse lip and cheek muscle tension. For example, when opening the mouth wide, the tissues of the floor of the moth rise up, resulting in an upward dislodgement of the lower denture. The shorter the ridge, the more the denture is affected. Another factor is the presence of saliva. Lots of saliva is good because it helps to create suction, a little like water between two flat plates of glass. More important than close fit is the patient’s ability or will to learn the tricks necessary for controlling dentures. The idea is to train the muscles of the lips, cheek, mouth, and tongue to keep air from getting underneath the denture because that causes it to immediately loose suction. Be especially careful when coughing, laughing, yawning, sneezing, or even talking to maintain control. Drinking can introduce liquids underneath the denture and float it loose.
Other factors affecting the stability or fit are the bite when there are natural teeth left in the opposite jaw. If there are natural teeth on one side but not the other, uneven dislodging pressures are applied when chewing because natural teeth do not give. This is especially true in a very common situation where only the lower front teeth remain. Learn to only bite into that one position where all the teeth contact simultaneously.
Various illnesses, medications, daily cyclic blood pressure fluctuations, dehydration, weight gain or loss and hormonal changes affect the water content of body tissues and there fore the relative tightness of a denture at a given time. The denture may fit differently upon waking up than later on. Leaving the denture out for a long time may cause the tissues to relax’ and then when you put it back in, the fit may be loose while the gums re-conform to the inner shape of the denture. Sometime, nothing much can be done for these conditions but to get along as best as possible.
POWDERS, PASTES & RELINERS
We don’t have any objections to the use of powders, pastes and reliners and in manycases they are helpful for the initial few weeks with immediate dentures until a reline is done.
Avoid using these products to postpone a reline. Human tissue can stand only so much pressure. If there is too much pressure in some areas, the ridge underneath these areas shrinks away and the denture becomes less stable. This shrinking process goes on for the rest of your life and the more pressure you exert, the more shrinkage that results. At some point in time all of the ridge is gone and nothing is left to hold the denture in place. This is a common plight with senior citizens. Our goal is to help you maintain the ridge so that it outlasts you.
A ‘reline your denture at home’ kit that uses a polymerizing process to create a hard liner can be destructive to your ridge if the bite is not balanced. ‘Soft’ relining kits harbor disease causing yeast and bacteria due to their porous nature. Avoid these.
Some people want teeth with a firmer or more secure fit. This used to be impossible to achieve. Implants have changed that, thanks to the concept of osteointegration, which was developed in the 1970’s. Implants can now be placed in the jaw to serve as anchors for individual teeth, bridges or existing dentures. Ask us if you want further information on this subject or to see if you are a candidate for this procedure.
We wish you a smooth transition into denture wear. Remember that perseverance is the key to success. Feel free to call us with any further questions.