Dentures

• Dentures: How to care for your new dentures?
• Immediate Dentures: What are immediate dentures?
• Relines
• Denture Soft Liners:What is a soft liner and instructions how to care for it?

Your New Dentures

You've just received your new dentures. Whether you're a seasoned veteran or a new denture wearer, we're sure there are many questions which may need to be answered. We hope that the following information will prove to be helpful during the next few weeks of your denture adjustment period.

• Learning to wear a new denture can take time. Don't become discouraged if you find some difficulty in the beginning. YOU'RE 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. Everyone's mouth is different and some people have more bone and therefore more gum support than others.
  In addition, a person may have forgotten what it was really like getting use to his or her dentures.
  We will help you through any difficulties you may face or any situations that may arise during your adjustment period.
  
• A lower denture usually takes more time to adjust to than an upper denture. The tongue may feel restricted and will tend to play, sometimes even subconsciously, with the new prosthesis. It will soon adapt to the restrictions and to the new feeling that a denture presents.
  
• Try to eat only soft foods for the first couple of days. Then, as you progress to more solid foods try to eat slowly and deliberately. In addition, place even amounts of food on both sides at the same time during the chewing cycle. By placing food on both sides of the mouth, you balance the biting forces on the new denture and will help to make it more stable. The longer you take to eat your meal, the faster you will learn to master your new prosthesis.
  
• Try to take small bites at first. Cut all your food into small portions. If, and when, your gum tissues are strong enough to try foods which are bitten off, (bread, corn on the cob, etc.), try to press the food against the back teeth on the upper in order to stabilize the denture.
  
• It is perfectly normal to experience some discomfort associated with sore spots during the adjustment period. Nature did not intend for us to wear hard plastic against soft gum tissue. It takes a while for the gum tissues to firm up and to accommodate to the hard plastic denture.
  
• If sore spots should develop (and in some cases they do not), please be sure to wear the denture for at least 24 hours prior to your adjustment visit! If we can't see the sore spot visually, it is sometimes impossible for us to make the necessary adjustments.
  
• Reading aloud during the first couple of days will go a long way in reducing any minor speech problems which may result from wearing a new denture. If speech problems continue to persist, please let us know.
  
• An unclean denture is neither healthy, attractive or comfortable. Clean you new denture every morning and night with a denture toothbrush and denture toothpaste - do not use regular toothpaste since it is too abrasive and will wear away the denture surfaces prematurely. You can also use one of the commercially available denture cleaners. Please be sure to check with us to make sure that the commercial cleaner will not interfere with the type of denture liner you may have in your prosthesis. Soft liners react poorly to most commercial cleaners.
  
• We prefer that you sleep without your dentures in place. This allows your gum tissues to breathe and also relieves them of the constant pressures of biting.  When left out of the mouth, all dentures should be placed in a container with water to prevent warpage.
  
• Gum tissues are in a constant state of change but dentures are not. Therefore, periodic relining of your dentures may be necessary. If you find your denture getting loose and chewing more difficult, this may be a sign that a reline may be needed. It is very important for us to see you regularly to evaluate the state of your oral tissues and to determine if additional treatment is required. Dentures typically need to be relined or remade every 3-5 years.
  
• NEVER try to adjust your dentures yourself. We have seen dentures ruined by home adjustments. 

  If any problems arise or if you have any additional questions, we are always available to help.

You've been advised to have an Immediate Denture. But what is it and how is it done? We hope that this information will help to explain the concepts and clear up any of the questions you might have regarding this type of prosthesis.

Suppose, for instance, that you have six remaining upper teeth that are not able to be saved, and therefore can not be used to support a new prosthesis. If you were to have a traditional denture made, it would be necessary to have all of these teeth extracted first, the bone and gums would have to heal, and then a denture could be fabricated.

This process could take several weeks, if not longer, and for that time period you would be without any teeth. In order to avoid this type of problem, we utilize an Immediate Denture technique.

This involves taking impressions of your mouth while your teeth are still present. A special plaster cast is made from the impression and the dental laboratory fabricates the denture by removing the teeth off of the plaster cast, and estimating what the gums will look like without teeth. 

Now, when your teeth are extracted, we have a denture ready to be inserted. In this way, you never have to walk around without teeth. Immediate Dentures do present certain situations which you should be aware: 

• Since we are unable to try in the denture prior to extracting your teeth, certain esthetic compromises may have to be made. This should not present any significant problem, however, and your esthetic result should be satisfactory.
• Since our goal is for you never to be without teeth, we will be inserting your new denture immediately after the extraction of your remaining teeth. Typically, after extractions, there may be some swelling. By placing your denture in immediately, this swelling can be kept to a minimum. If you did not place the denture immediately, the swelling that occurs might not allow you to wear your denture until the swelling subsided.
• It is very important that you follow the post-operative instructions that we give you very carefully. You must wear you new immediate denture for three (3) days, after the surgery, without removing it. This will help to control the swelling.
• Once healing has occurred, after approximately three (3) months, you will either need a reline of your existing denture or the fabrication of an entirely new denture. If a new one is to be made, we will then be able to make any esthetic and phonetic changes that you want within the limits of denture prosthodontics. Also a new denture can be made much thinner and it will conform to your gums and cheeks much better than an immediate denture. This is especially true if you had several teeth extracted, which causes more unpredictable shrinkage and gum changes.
• If a new denture is to be made, you will then be able to use the immediate denture as a spare ( emergency ) denture. This can come in handy if your final denture should break and need to be repaired at the laboratory in the future. 

• There are basically two (2) different types of denture relines.
• A hard permanent reline which can either be done here at the office with an office-cured acrylic or else it can be sent to the dental laboratory and processed with a laboratory cured acrylic. Due to the special heat and pressure processing, the laboratory reline tends to last longer. Unfortunately this will require taking your denture from you for a day. Our Appointment Coordinator will arrange the scheduling so that you will be inconvenienced as little as possible.
• A Soft reline can be done here at the office or else it can be done at the laboratory in a more permanent fashion. The longer lasting, lab processed type, may function up to one year without having to be replaced. The office processed soft liner tends to be more fragile and will need to be removed and replaced with greater frequency.
• Denture relines are necessary in order to accomplish several goals. These goals include:
  • Increasing retention of old, existing dentures or new dentures that, for one reason or another, have lost retention. Sometimes this may be due to recent extractions or alteration in the gum tissue due to other surgical procedures or weight loss.
  • Repairs.
  • Relining of old dentures hoping to avoid the necessity of remaking them entirely.
  • Gum tissue conditioning which usually relies on the gentle action of soft tissue materials ( soft liners ) to allow your abused gum tissue to return to a proper state of health prior to the fabrication of new dentures.
    

What is a soft liner and why did your dentist place it in your new denture(s)?

A temporary soft liner is placed in a new or old denture in order to 1) help improve the health of your gum tissues by absorbing some of the pressures of chewing ( acts as a tissue conditioning material ) and 2) helps to determine the maximum retention possible by utilizing undercuts in the gum which hard liners may not be able to negotiate without causing irritation. Soft liners will spring around these undercuts and allow for greater retention than hard liners might be able to produce. If we find that temporary soft liners provide enhanced retention, we will then be able to determine if we should replace them with a more permanent type of soft liner in the future or whether a hard liner is indicated.

Important Instructions

Temporary soft liners require special care and attention in order for them to produce the desired results. The following suggestions are designed to assist you in the maintenance of your new denture.

1. Do not remove the prosthesis from your mouth for the first 24 hours. This is extremely important ! The material that is placed in your denture will stay pliable for the first 24 hours and will shape itself to your oral tissues during that period.
2. After the first 24 hours, you may remove the denture once every 12 hours for the first two days. At each removal, please rinse the denture with lukewarm (not hot) water only. Do not use any of the commercially available cleaners. If need be, you can brush only the tooth part of the denture with denture toothpaste (not regular toothpaste) and a soft toothbrush. The softliner is still very fragile and will tear if subjected to chemical soaking or mechanical cleaning with a brush.
3. During the next week you may remove the denture as often as you like, still keeping in mind that the liner is fragile and must be treated with care. The tooth side of the denture may be brushed gently, and the liner side carefully swabbed with a moistened Q-tip to remove debris.
4. If possible try not to use any denture adhesive, especially during the first 3 days. We are, once again, trying to ascertain the amount of available retention. Using adhesives will only tend to confuse the issue.
5. For the first 24 hours you should try to maintain a softer diet. After that trial period, you should eat as regular a diet as possible so that the softliner can mold itself to your tissues until normal function.
6. We may be replacing this softliner on a regular basis until 1) the tissues heal adequately or 2) we have determined that the retention for your new denture is maximized. Further instructions will be given to you at that time.

Please be sure to bring your old dentures with you at each recall visit just in case we determine that relining your softlined denture is required. This may necessitate sending your denture(s) to the laboratory, so you would wear your old dentures home.

If you have any additional questions regarding this treatment process, do not hesitate to ask!