Dentures
Many of our patients have full or partial dentures to cover over single or multiple tooth gaps. These prostheses are a simple and economical form of restoration of gaps which does not require cutting of tooth structure or surgical dentistry. They are an alternative means of restoration of gaps to a fixed dental bridge or a dental implant. They are also available in a variety of materials, all of which are durable however with different thicknesses and comfort associated. The 5 main materials used in denture fabrication are:
- Polymethyl Methycrylate
- Thermoplastic Nylon Resin
- Cobalt-chromium (with trace elements of berilium and nickel)
- Vitallium (cobalt-chromium-molybdenum without trace elements of beryllium and nickel)
- Titanium
While there are a number of denture base materials , all with their various benefits and limitations there are also a variety of retaining methods, some of which rely on the initimacy of fit of the denture base material itself , the flexibility of the material, or the integration of a variety of clasps made out of stainless steel, wrought gold, and acetyl resin (which is a tooth coloured material to minimise show).
Partial dentures fit one or more smaller gaps whereas full dentures will replace a full jaw. Not al materials are suitable for all situations. Your dentist will assess your tooth gaps, the health of the surrounding teeth, and make a recommendation of the products that will be suitable for your mouth.
Please be aware that simpler, non-cosmetic dentures are available under the NHS, typically the economical polymthyl methacrylate dentures if you are registered with an NHS practitioner. Rather than accepting this solution you should allow your practitioner to explain the many benefits of the many alternative products including the associated benefits and costs, and explore the best prosthetic solution for you to provide comfort, self esteem and functionality of your dentition.
This page will provide a summary of the various considerations in denture design for your assistance.
Acrylic Denture base materials
Acrylic denture bases are made of a very tough and durable plastic called poly-methyl methacylate. This material has been used for several decades in the manufacture of dental protheses. The material :
- has a relatively acceptable fracture toughness
- does not dissolve in the mouth and is resistant to the effects of saliva and other fluide
- is non-toxic
- is relatively easy to use, add material to and repair
- is relatively economic to use
In normal function this plastic will survive many years in the mouth without breaking. Over time, some of the resin which keeps the denture slightly flexible leaches out and the denture becomes slightly more rigid. When this happens, the material gradually suffers crack propagation and peeling. This may cause plaque stagnation and retention. This is a very significant problem for partial dentures as the plaque retention will affect the adjacent teeth and may contribute to loss of gum attachment.
It is better to not let your dentures reach this state before replacing them. Our recommendation is to normally replace acrylic dentures every 5 years unless the fit is exceptional good or there may be concerns about tolerance to new dentures.
Thermoplastic nylon resin (Flexible Dentures) denture base materials
Thermoplastic dentures look similar to traditional acrylic dentures. They are however thinner and more flexible than traditional acrylic dentures. They can flex into tooth undercuts and can be self-retaining without the need for excessive clasping with ancillary materials. They are commonly referred to as their brand names, namely Valplast (TM) or Sunflex (TM) dentures.
Thermoplastic nylon resin can be highly polished and are ultra-resistant to stain. As the dentures can readily deform, they are not suitable as a complete denture material for a full jaw as these dentures need to be rigid, and need to NOT deform when biting firmly into position. These dentures are also not ideal for large missing tooth gaps as these extended sections of the denture also need to NOT deform when clenching firmly.
Chrome and Titanium Denture materials
Chrome is an ultra-thin, highly polished metal which can be used as a denture base material. Unlike polymethyl methacrylate and thermoplastic nylon, it generally cannot be used as a denture base for partial dentures. Poly-methyl methacrylate is actually is actually cured to the chrome mesh base to engage the soft tissues. Elements of the chrome denture do however sit directly on the teeth as ‘rests’ and ‘clasps’. The denture can also wrap around several teeth and yet passively slide around the intricate shapes of the teeth to ensure a very snug fit with tremendous resistance to rotation both vertically and horizontally. For this reason, the chrome denture should ideally sit on very healthy teeth which are non-mobile, and have adequate gum such that they can take the support of the denture. A detailed knowledge of chrome denture design, and a very careful design sequence is required to properly construct the chrome denture.
Whereas chrome cannot be used as a denture base material for partial dentures, it can be used as the denture base for a full denture. Typically, a purer form of chrome is used, known as ‘Vitallium’. This denture is very thin, ultra-light and very strong. The metal palate is thinner than the usual poly-methyl methacrylate and can conduct hot and cold temperatures to the palate much more quickly than the traditional poly methyl methacrylate denture. It is much more comfortable and natural to have a light-weight chrome palate.
Titanium metal dentures carry similar advantages to ‘Vitallium’ denture materials described above. The use of Titanium as an alternative to ‘Vitallium’ is gradually increasing and its use is determined by the experience of your dentist and the lab that is used to fabricate metal based dentures.
If your dentist accepts care under NHS arrangements then under those arrangements, you are entitled to denture care that is “clinically necessary” to “secure and maintain oral health”. Many of the options described here are ‘quality of life’ options and are not “clinically necessary” options. As such you may be quoted for clinical options under private care arrangements after being given a basic denture option under the NHS to “secure and maintain your oral health”.
Dentures restore function and facial appearance and our view is that she should explore the vast array of options and consider a solution that is bespoke to your needs to help you enjoy the function of your teeth and value the aesthetics that are personalised to your facial appearance and characteristics. This is challenging to achieve under NHS arrangements and may need to be supplied under private care arrangements.
We hope that you will read some of the tabs below to help explain the benefits of private dentures to help you in making your decision. You can also speak to one of our Treatment Coordinators today, who will give you free, no obligation advice.
Before a decision is made on :
- the best denture base material for you and
- the best quality tooth that will suit your facial form
a full functional and facial assessment will be needed to identify shortfalls with your current denture and requirements to provide you with the very best denture possible. If your dentist feels that your case is complicated he/she may refer you to a ‘prosthodontist’. This is an expert in fixed and removeable dental prostheses. We have several ‘prosthodontists’ who work within Antwerp Dental Group, and who only work under private care arrangements.
A comprehensive facial assessment will include:
- assessment of the upper lip support and fine lines and wrinkles around your lips. The new dentures need to provide sufficient ‘fullness’ to ensure that the facial appearance around your lips is supported and not allowed to sag
- assessment of your lip line during a normal smile. This is to consider the optimum position of the teeth. Your upper teeth must not be protruded, nor must be sunken. The correct show of front teeth is partly subjective, by determining the ideal aesthetics of your smile. The fullness of your smile is also determined phonetically as you will need to enunciate speech sounds correctly
- when you count from 50-59, your lower lip must just touch the incisal edges of your front teeth. This will ensure optimum speech.
- the upper and lower front teeth must be set characterfully, and not dead straight (unless this is your wish) to make these appear natural
- while considering some irregularity, the smile must not be slanted, and the middle of your upper teeth must confirm with the middle of your face otherwise the dentures will appear to be incorrect
- finally, the lower teeth must be set with some ‘room’ between your upper and lower teeth so that you are not always biting together at rest (this is known as freeway space). This will give your jaw a rest when not in function and prevent headaches and neck aches
Fabricating an outstanding denture is a very skilled task that requires tremendous expertise.
The NHS generally does not fund advanced denture options within a primary care practice. If paying for private care is not an option for you, then please mention this to your referring surgeon who can refer you to one of the teaching hospitals for NHS care.
Denture teeth are made our of single colour, or layered high density polymers, namely coloured acrylics. There are different qualities, shades and shapes of acrylic teeth which are bonded onto the denture base. The range of quality with different texture, reflectivity, translucence and opalascence, which describe the different effect on how light plays on the surface of the tooth will have a dramatic effect on aesthetics.
The various attributes are listed below, which are typical of ‘Enigma’ private quality dentures:
- subtle mamelon effect, and translucent incisal edges. This is the subtle grey scallop of the incisal edges that is typical of good quality teeth
- demineralisation points. Natural teeth have subtle changes to the level of mineralisation across the teeth
- increased opalescence of lateral incisors. Upper lateral incisor teeth give off a more opal light effect
- darker necks, which are typical of all teeth
- longer necks which replicate the natural taper of real teeth
The more basic ‘Acrotone’ teeth are typical of budget dentures :
Have you ever wondered why your dentures do not look natural ? There is a misconception that all dentures will look artificial. This is not true. Very careful parameters must be considered to ensure that the teeth are manufactured in the correct 3 dimensional space.
Apart from the construction parameters, the quality of teeth are imperative. It is our experience that the layered ‘Ivoclar’ teeth are extremely natural and should be considered as one of the premium private denture options. See why by listening to the short video below.
Denture bases which are made out of poly methyl methacrylate will undergo polymerisation shrinkage on setting. This causes the denture fit surface to distort and the initimacy of fit of the dentures is lost. Injection moulding is an advanced processing technique to reduce the porosity and polymerisation shrinkage. The benefit of injection moulding is tightness of fit, stability, and excellent retention without the associated distortion of fitting surface as a result of polymerisation shrinkage.
Injection moulded dentures are only available by private contract within Antwerp Dental Group.
Denture acrylic, when processed and polished looks very bland and uncharacterful. This is not the normal appearance of gums and makes a denture look artificial, no matter what quality of teeth you place. Denture base characterisation involves creating a ‘stippled’ effect across the gums either with careful manipulation of wax (which is replaced by acrylic), or by surface characterisation of the acrylic using various pink composite resin materials.
If you are having a new denture made, please speak to your dentist about receiving characterisation to your denture to ensure that your denture creates the best aesthetics for you!
Wearing new dentures is very much like wearing a new pair of shoes. It takes several weeks to become accustomed to the new fit of the teeth. During this time, they may rub and cause ulcers, particularly if there has been a dramatic change from the fit of the old teeth. Some of our patients do become frustrated during this ‘bedding in’ period. When you are getting used to new dentures you need to have patience, and need to not keep going back to the old dentures otherwise you will never get used to the improved fit of the new dentures.
For individual specific advice, please speak to your dentist who will give your professional advice about your specific dentures.
It is possible to fabricate an ‘immediate denture’ and have several bad teeth removed and the denture fitted straight away. Please be mindful that ‘immediate dentures’ have a fit surface that needs to be partly guessed after your teeth are trimmed off the models. After extractions, there will be a biologically unique and variable tissue response where your gums and bone will shrink immediately. As a result your ‘immediate dentures’ will be ill fitting at the outset and will progressively worsen in fit. Please do not worry however – we will help you manage the difficulty by showing you how to use a denture fixative material for a brief period before your receive an early reline of your denture.
Immediate dentures are not typically made with expensive teeth as these dentures should be considered to be temporary. 3 months after your extractions, you should consider new dentures and you would do well to consider the benefits of ‘Enigma’ or ‘Ivoclar’ teeth.
Andrea, a young lady who had suffered from extensive decay had lost most of her teeth, and with that all her self-esteem. She could not go out to meet friends, or have the confidence to look for a good job.
Her confidence was renewed with the digital ‘Ivoclar’ denture which is provided by Raj Wadhwani, our Clinical Director. Her dental experience was life changing. See her photographic blog below.
Andrea’s transformation was life changing – you can see the renewed confidence in her smile. If you would like an evaluation on whether the Ivolar Digital Denture concept is right for you, phone us today for your consultation.
Are you reliant on the embarassment of using denture fixative several times per day ? Would you like to know if it is possible to achieve a stable denture that does not rock, and that can stick without needing adhesive.
Whereas it is challenging to manufacture dentures with impeccable retention, it is possible with careful attention to detail. Ideally you need to be treated by a ‘prosthodontist’ who is an expert in making high quality dentures. He/she can assess your gums or standing teeth and advise you on what needs to be undertaken to achieve a stable set of teeth.
We have several prosthodontists within Antwerp Dental Group who can help you achieve your denture goals.
