Your First Denture: what to expect
- Sapan Bhatt, DMD
- Jun 2, 2020
- 5 min read
Dentures can be a scary topic for anyone who needs them, especially when you're transitioning into your first set. Many people will ask friends or family members who already have dentures about their experience and what foods they will be able to eat. Understand that while there are similarities between cases, dentures are a unique experience for each individual. Your journey and what you can expect afterwards will be outlined to you by an experienced dentist who can assess your personalized situation.
Most people requiring dentures will fall into 2 main categories. They either have bad teeth and strong gums (broken teeth) or healthy teeth and bad gums (loose teeth). In either case, the first step to getting dentures is taking molds or impressions of the mouth.
A denture technician will use these impression to make immediate dentures. The turnaround time for this is about 2-3 weeks. Immediate dentures are the set of dentures that go in the mouth the same day the remaining teeth are removed. This is also the time when implants are placed for implant-supported dentures which is highly recommended, especially for lower dentures. These dentures stay with you for about 6 months, during which the gums will heal and change shape. Now some people will say "I know someone who waited 6 months for their gums to heal before they had dentures made so they could skip the immediate dentures." This is often a bad idea for 3 main reasons
Immediate dentures act like a bandage that compress the gum tissue and prevent food particles from getting inside during healing. This allows for the gums to heal quickly and reduce the risk of infection
Immediate dentures give you teeth to chew and smile with during the healing process. The gums take about a week to heal over but the bone underneath will continue to change shape for 6 months or more.
Immediate dentures help you get use to having dentures in the mouth before final dentures are fitted. This helps condition the body's reflexes to help the dentures feel more natural and minimize the adjustments needed on the final set.
Once the immediate dentures are made, we'll have you back to have the teeth removed and the dentures inserted. Depending on the number and type of teeth, personal preference, and medical history, your dentist will recommend either local novocaine or IV sedation for the procedure, both of which are commonly done. Once the dentures are inserted, your dentist will make adjustments to the bite and fit and send you home with post-operative instructions and a home care package. Use any medications your dentist prescribes as directed. Most discomfort after the procedure lasts 2-3 days after which swelling and tenderness decrease.
The main thing we're focused on at this point is proper healing of the extraction sites. You'll keep the dentures in until your follow up appointment 24-48 hours after the surgery. You'll stick to a soft, cool diet (think mash potatoes, bananas, oatmeal, smoothies, scrambled eggs). You want to avoid food that require a lot of chewing or have small, hard particles (like rice or corn chips) that can get caught in the extraction sites. You also want to avoid smoking or drinking through a straw as suction can damage the healing.
Getting use to dentures is a process. Common areas that may need to be adjusted are how far back the dentures go (people have various gag reflexes) and how much material is next to the tongue. Food will taste different as the denture must cover the palate (something that can be avoided with an implant supported upper denture). Patients will often state their dentures are 'too big'. Remember, while teeth come straight out of the gums, dentures wrap around the gums so there will be more material than before. You're coaching your body to accept something new but your dentist will work with you to get the most comfortable result.
About 1 week after the surgery, the first soft liner is placed in the immediate dentures. A soft liner is a silicone material that coats the inside of the denture and fills in the space created as the gums shrink from the healing process. dentures feel and fit much better once the first liner is placed and are able to start incorporating more regular food back into their diet (think boneless chicken pieces, sandwiches, pastas). Soft liners are replaced about once a month for the next 6 months as the gums continue to heal. During this time, you are taking the dentures out at night and cleaning them with a brush or polident tab. During these periodic visits, the dentures are also adjusted to alleviate sore spots and correct bite discrepancies.
At the end of 6 months, new molds are taken to create the final set of dentures. Some people may ask if they can get their immediate dentures relined with hard acrylic to avoid having another set made. This is often a bad idea because as the gums heal, the immediate denture teeth don't move to the new gum position. This creates imbalances in the denture that cause pain and poor function. A new denture allows the denture technician to set the teeth in the proper position. It also allows for the teeth the be modeled in wax so the bite and appearance of the teeth can be approved by the patient. This was impossible to do with the immediate denture because existing teeth were still present. If going to implant supported denture route, the implants have now healed into the bone and are ready to be uncovered and connected to the final denture. Once the final dentures are inserted, 2-3 more adjustments are commonly needed. Retentive powders or pastes (Fixodent, Poligrip) are often recommended to create a tighter fit and form a seal to limit food from getting underneath the denture.
You may hear a dentist say "Dentures are a replacement for not having teeth, not a replacement for your natural teeth". Dentures do have their limitations (certain foods like corn-on-the-cobb or uncut apples are unlikely) and learning to chew and talk with them is a process that is developed over time. We recommend replacing dentures every 5-7 years to ensure best fit to the gum tissue, but every case is a little different.
An experienced dentist will help guide you through this transition; I like to focus on why we're making the change in the first place. Maybe it's because you've invested a lot of time and resources into your teeth only to see them breakdown again, maybe you've had sleepless nights and called out of work because of toothaches. Dentures can be the start of a rehabilitation process that can be improved with implants as your circumstances allow it. The first step is eliminating decayed teeth or infected gums which have become a reservoir of bacteria in the body. By having an experienced dentist guide you on this journey, dentures can be the start to a healthier mouth and a happier smile.
As always, this blog is intended for informational purposes only. For a full disclaimer, click here.
Comments