Prosthetics

If restorative dentistry has fallen short and some teeth are severely decayed or worse, completely missing or lost, there are several options for restoring or replacing lost tissue. One method for this is dentures. There are two types of dentures: full dentures and partial dentures also known as dentures. In partial dentures, another distinction can be made between a denture whose base is made of synthetic resin and one whose base is made of metal. The partial denture with a resin base is called a plate, the partial denture with a metal base a frame denture or frame.

1. The denture

When all the teeth of the natural teeth have been lost, there is only one way to restore their function and appearance, which is to make dentures. Dentures consist of a resin plate to which teeth are attached. The resin plate and teeth are adapted to the mouth as naturally as possible. The shapes and colors of the teeth in the natural teeth can be exactly replicated in the dentures.

How do dentures stay in place?

The plate of the denture rests on the jaw. The higher and thicker the jaw is, the greater the retention of the dentures will be. In addition, there is a layer of saliva between the plate of the denture and the jaw that causes the denture to attach to the jaw. The better the denture plate fits the jaw, the better the suction action, and therefore the hold of the denture will be. A denture in the upper jaw rests largely on the palate. A denture in the lower jaw cannot lie on the tongue. As a result, the surface area on which dentures in the upper jaw lie is much larger than the surface area on which dentures in the lower jaw lie. Therefore, a denture in the upper jaw has more grip than a denture in the lower jaw. On top of that, the dentures in the lower jaw can be pushed out of place by the movable tongue. Complaints about loose dentures therefore usually involve the lower dentures.

The pressure of the dentures on the jaw will cause the jaw to shrink over time. As a result, the dentures will fit less and less well and become looser. This is one of the reasons that, over time, dentures need to be adjusted, or even new dentures made.

Finally, we would like to point out the possibility of the dentist making a so-called overdenture instead of dentures. An overdenture is a denture that rests not only on the jaw but also on some roots or implants. If there are some good roots left from the natural teeth, the dentist can treat them so that they rise just above the gums. The dentures will then rest partly on these roots and partly on the jaw. This makes the dentures more secure. Moreover, because the roots absorb some of the chewing forces, the jaw will shrink less. If there are no more roots, there is sometimes the possibility of placing some artificial roots, also called implants, in the jaw and resting the dentures on them.

How do I get used to dentures?

First dentures take some getting used to. This also applies when the old dentures are replaced with new dentures. Especially eating and talking are a little different at first than one was used to. In the beginning, one eats somewhat uncomfortably and cautiously but soon notices what can and cannot be done with the dentures. It is wise to take mostly soft and liquid foods in the beginning. After a few days, people try to eat some heartier foods. After a few weeks, one also starts eating the somewhat difficult foods such as an apple or meat. It is best not to bite off large pieces of food with dentures because this can cause the dentures to loosen.

Speech may be difficult at first. It is like speaking with a full mouth. This usually passes after a few days. In doing so, it can help to have extra practice on the words that cause problems. However, sometimes it takes up to 6 to 8 weeks before one can speak again as one used to. New dentures can sometimes be painful at first. Due to imperfections in the fit, the hard synthetic resin can press too much on the soft mucosa in some places and damage it. So-called pressure points occur on the mucosa that can be very painful. For severe symptoms, it is best to remove the dentures.

The dentist can correct the symptoms by adjusting the dentures. Before going to the dentist to have the dentures adjusted, one should put the dentures back in so the dentist can clearly see where the pressure points are on the mucosa. In any case, never sand or file the dentures yourself. We do not recommend returning to wearing the old dentures in case of complaints with the new dentures because habituation to the new dentures will never occur.

When is denture adjustment necessary?

We have already told you that over time the jaws will shrink causing the dentures to fit less well and become loose. Dentures that are loose are not only annoying, they also accelerate the shrinking of the jaws. Therefore, the dentist should check the dentures once every 2 years and adjust them if necessary. If one does not remove the dentures at night, the dentist should even check them once a year. Timely inspection and adjustment of the dentures prevents discomfort and unnecessary shrinking of the jaws. The dentist adjusts dentures by inserting a new layer of synthetic resin into the denture that fits the jaws precisely. The use of adhesive pastes to make the prosthesis in place is only an emergency solution. Applying a so-called liner or cotton wool under the dentures yourself can even have harmful effects on the jaws. Therefore, we recommend that if you have poorly fitting dentures, always have them checked and adjusted by your dentist. Generally, dentures will need to be replaced after about ten years because by then it will no longer be possible to adjust the fit, or the teeth will have become worn or unsightly.

2. The Picture

If some teeth are missing in the mouth, they can be completed with a plate. A plate consists of a resin plate that fits precisely on the part of the jaw where the teeth are missing. Teeth and molars are attached to the resin plate. The hold of a picture is usually limited. Therefore, small brackets are often attached to the plate that will fit around the natural teeth. This increases the holding power of the plate. A disadvantage of a plate is that it often presses on the gum line of the natural teeth. The gums are pushed down causing the gums to recede. As a result, the natural teeth often suffer from a plate. Another disadvantage of a plate is that, like dentures, it presses on the jaw, causing the jaw to shrink over time.

So a plate is definitely not an ideal solution to replace missing teeth. Better solutions are a frame prosthesis or, if possible, one or more bridges. As a temporary solution, such as in the case where a front tooth has erupted and the jaw needs to heal before a permanent solution is possible, a plate will do just fine. Even in those cases where it can be expected that a full denture will need to be made in the future, a plate can provide a solution.

3. The Frame Prosthesis

An alternative to the plate is a frame prosthesis, or frame. In a frame, the resin plate is replaced by a metal plate that forms a whole with the brackets that attach around and to the natural teeth. Because the plate is made of metal, it is stronger than a plate. Because a frame is stronger than a plate, it can be made thinner and smaller. As a result, unlike a plate, it is often possible not to cover the entire palate with the plate. This is more comfortable and also gives less loss of taste and feeling than with a plate. Because the brackets are one with the metal plate, they fit better around and on the teeth, making the frame more secure than a plate. Moreover, because the brackets also rest on the chewing surfaces of the teeth, the chewing forces are transferred to them, and not to the jaw. As a result, the jaw will shrink much less than with a plate.

Method
Prosthetic fabrication is a complex collaboration between patient, dentist and dental technician. Treatment within our practice consists of about five appointments.
– During the first appointment, impressions are made in a fast-curing paste. This appointment takes about 20 minutes regardless of whether a frame is to be made for both the lower and upper jaw. If an impression needs to be made of both, it may take a little longer.
– The second appointment is for individual spoons. The impression made during the initial treatment is poured into a separate plastic spoon that fits better in the mouth. These plastic spoons are used to make the final prints. Also, wax bites are made. These are imprints used to watch jaw movement during biting.
– At the third appointment, the vertical relationship between the lower and upper jaw is measured so that You have a normal bite.
– In the fourth appointment, all the information is converted into a wax arrangement. Minor adjustments can still be made to it. Once patient and dentist are satisfied, the final denture can be fabricated. This final prosthesis can be placed at the last appointment.

Due to delivery to the dental laboratory, certain appointments must be made before a certain time on a day. This may possibly cause problems with your working hours. Therefore, please keep in mind that at work you should indicate in a timely manner that you need to visit the dentist multiple times and at specific times.
Manufacturing a plate takes less time.
Below is a timetable showing the practice’s times for the fabrication of various prostheses.
The following appointments are made for all prosthetic work. Therefore, please keep in mind that if you need a prosthesis , you cannot have it right away. It involves a comprehensive and complex treatment plan.

Questions