Upper and Lower Full Dentures
Total Tooth Replacement with Full Dentures
Full dentures replace all of the teeth on one or both of the dental arches. They are often called upper (maxillary) or lower (mandibular) dentures. In some vernaculars, they are called plates. The full conventional denture is not the same as a removeable partial denture or a fixed partial denture (fixed bridge) as they only replace part of the teeth. And it is different from an over-denture which derives additional support from implants or a few remaining roots which have had special treatment.
Immediate dentures usually are placed at the same time the front teeth are removed but must be relined approximately four months later as the bone and gums will shrink and create looseness. The good thing about them is that the patient is usually never without front teeth, but the the reline adds an additional expense. Immediate dentures will be discussed in another article.
Teeth are usually lost due to severe periodontal disease with resulting bone loss, or from rampant or excessive decay. Replacement of these extracted teeth with full dentures improves appearance (esthetics) and self-esteem, enunciation, proper chewing of food, and also creates a healthier mouth.
The success of full dentures is dictated by the skill of the dentist who creates extremely accurate impressions or moulds of the oral cavity, by also very accurately reproducing the proper amount of opening, by proper selection of the replacement teeth, and by creating excellent esthetics and function. Speech and esthetics, along with comfort, retention, and function are very important. The height and width of the remaining bony ridge often determines retention…the wider and taller, the better. Commercial denture adhesives may be able to compensate for the lack of the optimum bony ridge.
Modern dentures are made with dental acrylic which contain tiny fibers resembling blood vessels. They may also incorporate some color preferences for ethnic traits. All of this is in the “gum” area of the denture. Sometimes on the palatal area of an upper denture, the acrylic area is replaced with very thin chrome cobalt. This adds to the cost of the denture but increases the “feel” by the patient of thermal differences in food and drink. It also is more comfortable for the patient as there is very little thickness on the palate.
The teeth themselves are very esthetic, come in a large variety of shapes and shades, and are carefully matched to the patient’s head shape, speech pattern, and smile line. The teeth should look very natural, can be made just slightly out of line if preferred, and not look like “false” teeth. The patient should aid the dentist in the tooth-selection process.
In general, an upper dentures is more successful than a lower denture as it will have better suction due to the existence of the palatal area. Not so in the lower denture as it covers a much smaller surface area, has less suction, and has a big tongue in the middle. A far better treatment option for the lower arch is an over-denture which snaps on to implants in the mandible and has superior retention and biting force.
It should be noted that bacterial plaque and tartar (calculus) form on dentures just like on natural teeth. Dentures must be kept very clean on a daily basis to insure pleasant breath and tissue health. A commercial agent for soaking the dentures may be recommended.
Dentures may cost anywhere from $400 to $4,000 per arch, depending on location, quality of materials and teeth, and the skill of the dentist.
American Dental Association-Life Member, Emeritus Fellow of Academy of General Dentistry, American Academy of Implant Dentistry