American Medical Association Family Medical Guide - American Medical Association [799]
Denture Problems
Most dentures, or false teeth, look natural and fit well, but no denture is as efficient and comfortable as your own teeth. With natural teeth, the stresses of biting and chewing are absorbed by the teeth, the roots of the teeth, and the periodontal ligament (a tough, elastic, shock-absorbent tissue that holds bones together and lines the tooth sockets in the jawbone). With dentures, the stresses are absorbed in unnatural ways. The most critical of these stresses is the pressure that the baseplate (the false gums of the dentures) places on the ridges of the natural gums, especially if the dentures are worn both day and night. This pressure can cause inflammation of the gums and eventually can lead to mouth ulcers and to degeneration of the jawbone under the gum tissue.
The base of a partial denture also places abnormal pressure on the natural teeth that are used to anchor the denture base. Partial dentures, especially poorly fitting ones, can trap plaque and food particles, causing tooth decay in the remaining teeth and possibly leading to periodontal disease (see next page). If you wear dentures and have been taking antibiotics, your risk of developing a yeast infection in the mouth called oral thrush (see page 744) is increased.
Symptoms
The early symptoms of excessive pressure on the ridges of the gums are pain when the dentures are in place, especially when you are eating, and white and patchy or red and inflamed gums. If the inflammation persists, your gums may become deep red and soft and may bleed easily—for example, after rubbing them with your toothbrush. An open sore may form on any spot where your dentures rub your gums. After a denture has been worn for many years, hard, pale pads called dental granulomas may form at the main pressure points on the gums, especially near the edges of the denture.
Other symptoms develop when the gums and jawbone shrink, which usually occurs after a few years of continuous pressure, even if the denture has caused no other problems. When the gums and jawbone shrink, you must close your mouth more to bite properly, and even more if your dentures are worn down. Common symptoms of gum and jawbone shrinkage are loose dentures, sunken cheeks, and a protruding lower jaw. You may have pain in the joints of the jawbone from the extra movement needed to bite down. The appearance of your mouth may change a great deal. Also, persistent irritation from friction, inflammation, and pressure can lead to infection or sometimes to cancerous changes in the tissue of the gums.
Treatment
If you have full dentures, have your dentist check their fit and any effect they have on your gums. You should have an oral examination at least once a year. If you have a partial denture, see your dentist regularly to make sure it fits properly and to safeguard your natural teeth and the general health of your mouth. If you have pain, sores, or bleeding in your mouth, see your dentist immediately.
Always remove your dentures at night, to rest your gum tissues and to allow you to adequately clean your mouth and dentures. Many dentures must be kept in a glass of water; they can warp if they dry out. It is normal for partial dentures to feel a little tight when you insert them in the morning, but the feeling passes quickly. Thoroughly clean your dentures daily, according to your dentist’s or hygienist’s instructions, and clean your natural teeth and gums thoroughly, especially around the base of the teeth. If you wear dentures and have a sore mouth, keep your dentures clean and soak them overnight in a cleaning solution designed for this purpose. You should also clean and massage your gums with your finger, a damp cloth, or a soft brush.
How long dentures last can vary, depending on the condition of the gums and jawbone, the denture material, and how well the dentures fit. When your dentures become worn or your gums and jawbone shrink,