Full dentures
The process of producing quality dentures is a blend of art and science.
Straightening teeth
Straighten your smile without anyone noticing.
A loose, ill fitting, painful or un-aesthetic denture can substantially reduce your self-image and enjoyment of life.They can effect your daily eating habits putting you at risk of developing nutritional problems and multiple health disorders.
The functionality, look and feel of a denture doesn’t have to be compromised when manufactured with expert knowledge as a Premium Appliance.
Premium Appliances are created with ideal aesthetics in mind, combined with your own personal take on how you would like your teeth to appear. A good set of false teeth can be made to look as good as the real thing.
Smile design is no longer left to chance. At Melbourne Dentist a range of digital technologies are combined with sound design principles to create stunning outcomes.
Digital Smile Design
Digital Smile Design is the modern take on the art of smile transformation.
Blending art and science, high-resolution digital images are used to map your ideal smile based on facial landmarks and your chosen teeth shape, shade and form.
This then enables you to visualise and effectively ‘test-drive’ an individually tailored cosmetic dental ‘mock-up’, before committing to treatment.
The result is more predictable than ever. Digital videography can be used to capture important elements of the smile. Your current denture will be assessed this way and when a proposed set-up is produced, its appearance and effectiveness will also be evident from the same process of digital video manipulation and assessment. You may bring along old photos of yourself, siblings, children (who often have similar facial structures and teeth shapes as you once had) or images from magazines. Along with this, you can utilize a fantastically simple program with our direction to help you chose appropriate teeth shapes and set-ups.
Modern dentistry offers a vast array of design and production options for full dentures, but these appliances can be grouped into two broad groups:
- those that are fixed and are only removable by a dentist and
- those that are removable and require you to do so for daily maintenance.
Fixed full dentures
With the support of multiple implants a plate or denture doesn’t have to be a compromised method of treatment, but can now be designed to bring you the same comfort and style that you would expect of natural structure.
Removable full dentures
The experience and skill required to fit quality removable dentures sees many dentists avoiding providing this service.
Here at Melbourne Dentist we enjoy the challenge of this discipline and feel these devices remain a viable and cost effective treatment to restore function and wellbeing.
Sometimes a fixed full denture just isn’t viable. Tooth loss leads to the loss of bone that supported it. The longer the tooth is lost, the more shrinkage occurs – it’s only made worse with excessive forces on the bone from ill-fitting appliances.
Only the ‘flanges’ of a removable full denture can replace this lost bone and thereby rejuvenate appearance by returning adequate lip and cheek support.
Removable full dentures can be produced in the traditional fashion, or they can be made to work with a small number of implants resulting in a decrease of their size and a vast improvement in their stability.
Denture-Implant hybrids
A small number of people just can’t tolerate a traditional full denture. Perhaps they dislike the sensation of having their palate covered. Sometimes the remaining lower bony ridge may be so worn away that a lower denture doesn’t have a definite seating position.
For these people, hybrid forms of implant-supported dentures can be life changing.
Multiple implants can be splinted together to rigidly support a denture much reduced in size – the necessary support for the lips and cheeks can remain with the palate remaining almost completely uncovered.
In the lower jaw, as little as two implants can be utilized to provide amazing stability to an otherwise mobile denture.
Traditional full dentures
When well made these time-tested appliances can be elegant and affordable solutions for replacing missing teeth, gums and supporting bone.
The production process.
In the service industries of the modern world, speed of service can be valued higher than all else.
Some dental providers proudly advertise that dentures can be made in a few short visits.
Here at Melbourne dentist, if speed and cost are paramount to you, we have the necessary experience to condense the process to deliver economy appliances fast.
However, a Premium denture can not be made in this fashion.
A Premium denture requires a meticulous adherence to process, where the inclusion of extra steps ensures the absolute best quality appliance. Below is an outline of this process:
Getting to know you
Conventional evaluation.
Oral tissue health, bite and jaw joint function as well as oral cancer screening are amongst the things we check.
Aesthetic evaluation.
This analysis focuses on the your aesthetic wants and needs.
You are guided by us in this process by using a digital smile guide and smile test questionnaire.
This process will help us determine your preferences for teeth shape, colour, teeth positioning, improved lip and cheek support and numerous other processes used to customise the dentures.
Video capture
Captured moments from video recordings allow us to assess how your current denture relates to your face during normal speech, smiling and laughter. By studying these we can readily determine what will be needed to improve your smile.
Impressions of your mouth are taken.
Plaster study models are fabricated from these impressions.
Before you come back for your next visit:
- A digital smile blueprint is produced using information we discovered from your aesthetic evaluation and video capture.
- ‘Wax rims’ will be fabricated by our laboratory to be used at your next visit.
Design preview and set-up
Smile design preview and feedback
The digital smile blueprint is presented to you using computer-generated images simulating your new teeth.
Adjustments to the design are made if necessary based on feedback from you.
‘Wax rim’ Registration
Horseshoe-shaped rims made of wax are made to fit the plaster study models.
Multiple additions and subtractions are made to these rims after repeatedly trying them in the mouth.
The final shape of these rims will simulate the position of the teeth, gums and level of lip and cheek support.
Video capture
Captured moments from video recordings allow us to assess whether the proposed dimensions of the wax rims are indeed correct.
Before you come back for your next visit we direct the lab to place new acrylic teeth in the wax rims to produce a denture mock-up or ‘Try-in’
Denture Test-drive
Denture ‘Test drive’
Wearing the wax ‘Try-ins’ produced in the lab allows you to preview the proposed dentures in your mouth.
Adjustments to the ‘Try-ins’ are made if necessary based on feedback from you.
Video capture
Captured moments from video recordings allow us to assess whether the proposed ‘Wax try-ins’ are indeed correct.
Before you come back for your next visit the dentures are processed in hardened acrylic. The laboratory returns the dentures with the fitting surface hollowed out for the final ‘functional’ impression.
Denture delivery with a “Walking” impression
Insert ‘Provisional’ dentures with a soft liner
The internal fitting surface of the dentures is fitted with a ‘Soft liner’.
This is a thin layer of self setting material that will continue to mould and remodel over the next few days as you wear the dentures. It provides an impression of your mouth while in function.
This technique breaks from tradition and adds extra time to the denture production but a ‘functional impression’ of this type provides the most accurate and comfortable fitting surface possible.
The denture teeth are custom adjusted to ensure comfortable chewing.
Final denture delivery
A ‘Wash’ impression is taken over the soft liner.
After 3 – 4 days, you return to our practice to have a very thin and accurate impression material placed over the soft liner to pick up ultimate surface detail.
This appointment usually takes place early in the morning. The denture is returned to the lab to have its final fitting surface processed to acrylic. The bite is also further fine tuned in the lab. A balanced bite in dentures allows each denture to stabilize the other so that chewing and speaking are normal
Five hours after the ‘Wash’ impressions are taken, the denture will arrive back from the lab, ready for you to pick it up!
Visit 1
Getting to know you
Conventional evaluation.
Oral tissue health, bite and jaw joint function as well as oral cancer screening are amongst the things we check.
Aesthetic evaluation.
This analysis focuses on the your aesthetic wants and needs.
You are guided by us in this process by using a digital smile guide and smile test questionnaire.
This process will help us determine your preferences for teeth shape, colour, teeth positioning, improved lip and cheek support and numerous other processes used to customise the dentures.
Video capture
Captured moments from video recordings allow us to assess how your current denture relates to your face during normal speech, smiling and laughter. By studying these we can readily determine what will be needed to improve your smile.
Impressions of your mouth are taken.
Plaster study models are fabricated from these impressions.
Before you come back for your next visit:
- A digital smile blueprint is produced using information we discovered from your aesthetic evaluation and video capture.
- ‘Wax rims’ will be fabricated by our laboratory to be used at your next visit.
Visit 2
Design preview and set-up
Smile design preview and feedback
The digital smile blueprint is presented to you using computer-generated images simulating your new teeth.
Adjustments to the design are made if necessary based on feedback from you.
‘Wax rim’ Registration
Horseshoe-shaped rims made of wax are made to fit the plaster study models.
Multiple additions and subtractions are made to these rims after repeatedly trying them in the mouth.
The final shape of these rims will simulate the position of the teeth, gums and level of lip and cheek support.
Video capture
Captured moments from video recordings allow us to assess whether the proposed dimensions of the wax rims are indeed correct.
Before you come back for your next visit we direct the lab to place new acrylic teeth in the wax rims to produce a denture mock-up or ‘Try-in’
Visit 3
Denture Test-drive
Denture ‘Test drive’
Wearing the wax ‘Try-ins’ produced in the lab allows you to preview the proposed dentures in your mouth.
Adjustments to the ‘Try-ins’ are made if necessary based on feedback from you.
Video capture
Captured moments from video recordings allow us to assess whether the proposed ‘Wax try-ins’ are indeed correct.
Before you come back for your next visit the dentures are processed in hardened acrylic. The laboratory returns the dentures with the fitting surface hollowed out for the final ‘functional’ impression.
Visit 4
Denture delivery with a “Walking” impression
Insert ‘Provisional’ dentures with a soft liner
The internal fitting surface of the dentures is fitted with a ‘Soft liner’.
This is a thin layer of self setting material that will continue to mould and remodel over the next few days as you wear the dentures. It provides an impression of your mouth while in function.
This technique breaks from tradition and adds extra time to the denture production but a ‘functional impression’ of this type provides the most accurate and comfortable fitting surface possible.
The denture teeth are custom adjusted to ensure comfortable chewing.
Visit 5
Final denture delivery
A ‘Wash’ impression is taken over the soft liner.
After 3 – 4 days, you return to our practice to have a very thin and accurate impression material placed over the soft liner to pick up ultimate surface detail.
This appointment usually takes place early in the morning. The denture is returned to the lab to have its final fitting surface processed to acrylic. The bite is also further fine tuned in the lab. A balanced bite in dentures allows each denture to stabilize the other so that chewing and speaking are normal
Five hours after the ‘Wash’ impressions are taken, the denture will arrive back from the lab, ready for you to pick it up!
Are you looking for a premium, standard or economical denture?
At Melbourne Dentist we offer three different ‘grades’ of dentures:
| Premium | Standard | Economical | |
|---|---|---|---|
| Teeth | Superior grade, Custom shaping and positioning. | Premium grade, Custom positioning. | Standard grade |
| Denture resin | Premium grade, high impact. | Standard grade | Standard grade |
| Gum tinting | At your discretion | X | X |
| Rugae | At your discretion | X | X |
| Mock restorations | At your discretion | X | X |
Options to customise your dentures…
Setting up teeth for a premium appliance is as much an art as it is a science.
There are many options you can choose to individualise your denture to exactly suit your needs.
Premium grade teeth
Not all teeth are created equal. Premium grade teeth are made to appear more natural in appearance and are much harder wearing. This is an important factor given the primary cause of denture replacement is tooth wear.
SR Phonares II video
Premium grade denture resin
For premium results, our dental laboratory can use the SR Ivocap heat curing injection system. Its advantages are:
Superior strength.
The resin is far less likely to fracture while allowing it to be very thin.
Excellent adherence to denture teeth
The denture teeth are far less likely to become dislodged with the improved bond to the denture base.
Exceptional accuracy of fit.
With minimal shrinkage in production, the dentures look exactly as predicted and provide ideal stability, fit and comfort.
Exceptional polishability
The ultra smooth surface finish makes cleaning easier and helps reduce the build up of plaque and calcified deposits.
Customising shape and positioning of teeth (‘Hollywood’ smile vs ‘Natural’ smile)
There are two types of smiles people generally request:
- The “Perfect” Smile (the Hollywood Smile)
- The “Natural” Smile
Simulating natural gums
Some people have a wide range of motion of the top lip that regularly exposes the gums.
When there is gum show, its best to use the highest grade acrylic and consider the addition of various colour tints and textures to simulate the appearance of real tissue.
SR Phonares II video
‘Mock’ restorations placement
Teeth can be stained or gold additions can be made to mimic restorations in natural teeth.
Rugae placement
The little ridges you find behind your upper front teeth on the roof of your mouth are called palatal rugae. They are important in reducing spitting when talking, helping with chewing lumpy food, and assist in clear speech (particularly the ‘th’ sound).
Rugae can be applied to the appropriate area of the palate of a premium denture.
Transitioning to full dentures…
For most people, loosing their last remaining teeth can be a traumatic time both physically and psychologically.
A common fear for those planning this process is that they will be without teeth for a significant period after teeth removal.
However, with adequate planning you need never be without teeth.
Maintaining the outcome
Both the teeth and the gum and bone tissues the dentures rest on change in shape over time.
The loss of bone that supports the denture is the real enemy and its rate of loss varies from person to person. This shrinkage leads to a poor fitting denture which in many instances is not noticed by the wearer as it is actually the surrounding muscles that holds old poor fitting dentures in place. However, the poor fit leads to more movement and heavier loads being distributed to the supporting bone that only helps to accelerate the bone loss.
Poorly fitting dentures can often cause infections, sores, speech problems, eating difficulties and discomfort.
For all these reasons its important to seek professional monitoring of dentures.
They should be relined regularly to ensure ideal fit and replaced once they are too badly worn.
They are generally considered beyond repair once the teeth wear excessively. Worn teeth become unaesthetic, inefficient and force the jaw joint into a more stressed working position. It’s wise to consider the addition of the best denture teeth to a new full denture.
Loose dentures
Why do dentures loosen?
Loose dentures is a common problem for full denture wearers, particularly if the dentures have been worn for a long time. It is generally less of a problem with the upper denture as a much greater surface area is involved and the palate is a very stable bone.
The bone that used to support your teeth will naturally shrink away over time without the teeth present. It is not designed to withstand the forces generated by a denture and in response it shrinks away at a faster rate. This is made worse by the forces generated by an ill fitting denture. For some people, the natural rate of bone loss is faster necessitating more frequent relines.
Should you reline or replace a loose denture?
Melbourne dentist can help you assess if its in your best interests to refit your existing dentures, or if they should be replaced.
The considerations involved in this decision are:
- Are you happy with the appearance of the teeth?
- Are your lips adequately supported?
- Are the teeth heavily worn?
- Is your bite functional?
- Is the bite curvature correct?
- Is the denture base material in good condition?
- Has there been minimal bone shrinkage since the dentures were last made?
If the answers to any of these questions is no, it’s probably best to consider a new denture.
If the answers are are all positive, you may be able to refit or ‘Reline’ your current denture.
If you chose to, there are 3 ways to reline a denture
Temporary reline
This a simple procedure and it is carried out in the dental chair. It will only stabilize the denture for a very short time.
It is generally used as an interim measure to firm up an immediate denture (placed directly after teeth removal) while we are waiting for healing. When healing is complete, this denture can be permanently relined or remade.
It may also be used to refit a poor fitting denture that has contributed to an underlying tissue infection. When the infection subsides, swelling will subside, and a new denture can be made.
Permanent hard reline
There are two ways we can complete this:
Soft liner wash impression
- This will provide the most accurate result but requires a little more time and therefore a slight increase in cost.
- The internal surface of the denture has a ‘soft liner’ added to which you wear home for a couple of days. This will produce a very accurate ‘functional’ impression where the material molds to the shape of your mouth as you move.
- On your return to our practice, a very thin, accurate ‘wash’ impression material is smeared over the soft liner and allowed to set in your mouth. This picks up incredible detail.
- The denture is sent to the lab for 5 hours where a new internal surface is applied to your denture.
Simple wash impression
- A thin, accurate ‘wash’ impression material is smeared over the fitting surface of the denture and allowed to set in your mouth.
- The denture is sent to the lab for 5 hours where a new internal surface is applied to your denture.
Permanent soft liner
This is not a common procedure as its more costly to produce, difficult to adjust in surgery, and may only last 18 months. It is generally reserved for those people who have little bone remaining to support the denture, with very sensitive and easily damaged soft tissue overlying it.
The process of production is the same as that described above under ‘Soft liner wash impression’. Considering the cost and short longevity of this process, its often best to instead consider stabilizing the denture with the help of implants.
Implants to “Fix” loose dentures.
For those who have limited remaining supporting bone or find it difficult to tolerate dentures, implants are likely the best solution.
Probably the best reason to consider this procedure is that the implants will slow the denture supporting bone loss considerably.
As few as 2 implants can be used to provide incredible stability to a denture. With so few implants required, the cost is not as great as you may think. This is particularly the case when you compare it with the ongoing maintenance costs of continual unsatisfactory relines.
Denture adhesive?
A denture adhesive should not be required with a well fitted denture. There are some who believe that silicone can be harmful to the human body. If large amounts of paste are used regularly, a reasonable amount of product could be being ingested.
It should be possible to refit an existing denture so that adhesives are not necessary.
Rarely, denture powder can be considered with a well fitting denture. For example:
- In the early phases of getting used to wearing a new appliance, particularly where little of the bony ridges remain. Over time, the surrounding muscles will learn to stabilize the new denture in place.
- Sometimes, in certain social situations, you may just want the reassurance that your dentures wont dislodge or that annoying food particles working under the denture will not force regular trips to the bathroom.
- When there are very minimal bony ridges remaining.
How much will Dentures Cost?
The cost of dentures can range widely and is mostly dependant on the quality of materials, time taken and laboratory used. They are handcrafted items. Like a made to measure suit or dress they are made to suit only you. Given the average denture is worn day in and day out for a period between 5 to 10 years, they are probably one of the most cost effective items that you will ever invest in.
The number of appointments and the time taken at each appointment can also vary the cost. For example, the production process shown above lists 11 steps over 5 visits – this is the process used to produce a Premium full denture.
The Economical option we offer is made much more quickly using 5 of these steps over 4 visits. This is the average process used to produce a denture across most dental practices and allows for cheaper production as considerably less time is involved in making them.
Consider Premium appliances as a long term cost saving measure. They are less likely to break, and most importantly, the teeth will not wear as quickly. All dentures require regular refitting. If the teeth are still in excellent condition at this time, a much cheaper and simpler reline process can be carried out rather than complete replacement.
Instructions and care of new Full Dentures
Well-fitted and aesthetically pleasing dentures will provide years of satisfaction and use.
The Following information will be helpful to you.
The First Few Weeks:
New dentures always feel strange when first placed in your mouth – particularly if you have never worn dentures before. The surrounding muscles actually play a major role in holding the denture in place – this is why some people have old, very poor fitting dentures that actually stay reasonably still. Therefore it can be several days or even weeks before you feel accustomed to them.
Sore Spots:
It is not uncommon to have a few sore spots after wearing the dentures for 24 hours. Don’t worry about these areas as they can be relieved with very little effort at your next visit. We would usually expect you to attend to make small adjustments to ease any residual sore spots after 7 days.
Eating and Speaking:
The new bite may not feel completely comfortable initially. The bite is generally best finalized about a week after insertion – after the dentures have settled into place.
Eating may take a little practice. Start with soft foods cut into smaller pieces and chew slowly using both sides of your mouth at the same time.
Initially food may not taste the same, but as your taste buds are mainly on your tongue, this effect will be short lived. Also, avoid very hot food and drinks earl on as your ability to sense hot food and drink may also be affected.
Speaking may require some practice – the lip and tongue muscles need to learn to touch slightly different surfaces than before. Reading out loud may speed up this process.
If you find that your dentures occasionally slip when you smile or cough, reposition them by gently biting and swallowing.
Upper vs. Lower Dentures:
A well fitting upper denture has the whole palate to support it so it is likely to have moderate to strong suction. The lower denture on the other hand is supported by a U-shaped ridge and has the tongue pushing it around. A good fitting lower denture should have good stability, but the lack of suction may see it move around a little in the early stages. In time, the surrounding muscles of the tongue, lips and cheeks will help keep it in position. In the short term, you may use a denture adhesive powder to reduce this mobility until the muscles gain control.
Regular use and Denture Adhesives:
During the first few days wear the dentures full time, including while you are asleep. This will allow you to adjust to your new dentures and let them settle in. Thereafter, you should remove them before going to bed. Leave them in water to prevent any cracking or warping. Leaving them out allows your gums to rest and helps ensure oral health.
Even if you have excellent fitting dentures, there are times when an adhesive will help. A denture adhesive powder should be used rather than a paste if the denture fits well. It expands to fill any gaps and blocks access to bits of food. They can give you more confidence in public and social situations. You will feel better about eating, talking and even playing sports, especially swimming, which puts the suction of complete dentures at risk when water gets into the mouth.
Denture fixatives work by reacting with saliva in the mouth to develop adhesive properties so a good tip is to rinse your mouth before inserting your dentures. Press the dentures firmly into place for a few seconds and wait several minutes before eating and drinking.
Cleaning the Denture:
Your dentures should be cleaned at least twice a day after eating by using a soft bristle toothbrush and liquid soap. A denture brush may make the process more efficient. It should be done over a basin filled with warm water, so that if you drop them the water will cushion the fall. The main purpose of cleaning is to remove the dental plaque and food debris that builds up on dentures – particularly on the fitting surface. Proper cleaning will prevent inflamed gums, or bacterial and fungal infections.
Avoid using regular toothpastes as they can be too abrasive and damage the highly polished, easily cleaned new surface of the dentures.
Avoid using bleaching products as they can lead to weakening of the denture as well as making it look unsightly. Also, the use of very hot water to soak the denture can weaken the denture causing it to break.
Denture cleaning solutions can help to remove staining and bacteria. Brush your dentures before soaking, to help remove any food debris. Soak the dentures in the cleaner for a short time and then brush the dentures again.
Denture Maintenance:
Tartar can build up on dentures just as it can on natural teeth. If plaque is not removed properly, it can react with your saliva and harden into tartar. Once present you will not be able to remove it completely by yourself and eventually it can make the denture uncomfortable and unsightly. We can organise to remove this tartar using an enzyme solution in an ultrasonic cleaning machine and thereafter a lab re-polish.
Dentures can also pick up staining – especially if you smoke, or drink a lot of tea, coffee or red wine. In most cases you should be able to remove this staining with regular cleaning. However, more stubborn stains may take a little more cleaning, which we are able to help you with.
The Future:
Your dentures are made from materials that are softer than your natural teeth and will eventually need replacing. Also, your jaw bones and gums continue to shrink after your teeth are extracted, and even losing weight can change the shape of your mouth. This shrinkage is one of the main problems with dentures. Because of this shrinkage, you should plan to have your dentures and oral tissue evaluated once a year by us. A thorough check of all of the soft parts of the mouth is carried out, including the tongue and cheeks, to ensure we spot any infections, mouth conditions or even oral cancer at the earliest stages. We will let you know when refitting of the dentures are necessary as wearing ill-fitting dentures for too long can cause severe bone loss and serious oral diseases.
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