When natural teeth are lost, the jawbone, no longer stimulated by tooth roots, begins to shrink and remodel. This process, known as alveolar ridge atrophy, causes the overlying gum tissue to recede. Since dentures rely on the bony ridge and surrounding gum tissue for support, recession is a persistent challenge for maintaining a comfortable fit. Dentures can be fitted to receding gums, but the process requires specialized adjustments or advanced structural solutions to ensure stability and comfort.
Understanding Gum Recession and Denture Fit
Gum recession for denture wearers refers to the continued shrinkage of the alveolar ridge, the bone structure that once held the teeth. This gradual bone loss occurs after teeth are extracted when no roots or implants are present to provide stimulation. As the bone atrophies, the overlying gum tissue changes shape, creating an altered landscape inside the mouth.
This anatomical change complicates the fit of a traditional denture, which relies on suction and the precise contour of the ridge for retention. A receding ridge reduces the surface area available for the denture to grip, causing the appliance to become loose, shift, or rock during speaking and chewing. Ill-fitting dentures exacerbate the problem by creating uneven pressure points that irritate the gums and accelerate further bone loss. This lack of stability leads to discomfort, sore spots, and reduced ability to eat and speak properly.
Adjusting Traditional Dentures for Receded Gums
For minor to moderate recession, the most common approach is to modify the existing denture appliance to conform to the new gum contour. This modification is achieved through two procedures: relining and rebasing. Relining involves adding new acrylic material to the fitting surface of the denture to fill the space created by the receding tissue.
There are two main types of relines: hard and soft. A hard reline uses a rigid acrylic material that provides a durable, long-lasting fit, often recommended every two years to maintain stability. Soft relines utilize a more pliable, cushioned material, which is beneficial for individuals with sensitive or severely receded gum ridges, acting as a shock absorber. Because soft material is porous and prone to hardening, it requires more frequent replacement, typically every one to two years.
Rebasing is a more extensive procedure than relining, necessary when the denture base is structurally compromised or the gum contour has changed dramatically. This involves replacing the entire pink acrylic base material while retaining the original prosthetic teeth. The process creates a completely new foundation for the denture, ensuring a strong, accurate fit against the current shape of the alveolar ridge.
Structural Solutions for Severe Recession
When recession is severe and the underlying bone structure offers insufficient support, simple adjustments like relining are no longer adequate. In these cases, a structural solution is required, with implant-supported dentures being the preferred option. These devices, sometimes called overdentures, use dental implants surgically placed into the jawbone to serve as stable anchors.
The implants mimic the function of natural tooth roots, providing a secure foundation that prevents the denture from shifting or rocking, even with an atrophied ridge. This approach bypasses the need for the denture to rely solely on the gum tissue for retention, offering improved chewing function and comfort. Furthermore, the integration of the titanium implants with the bone provides stimulation that helps preserve the jawbone and reduces the rate of future bone loss.
In instances of extreme bone loss, a preliminary procedure such as bone grafting may be necessary before implants can be placed. Bone grafting adds volume and density to the jawbone, rebuilding the foundation to ensure the implants have enough secure structure for successful integration. This surgical step is often required to qualify a patient for implant placement, allowing the jaw to support the new prosthetic.
Preventing Further Alveolar Bone Loss
While adjustments and structural solutions correct the fit, long-term maintenance focuses on slowing the natural progression of bone loss under the denture. Regular professional check-ups are necessary to monitor the fit and the health of the underlying tissue. During these visits, the denturist can detect minor changes in the ridge contour and recommend a reline before the appliance becomes noticeably loose or causes chronic irritation.
Patients can also take daily steps to maintain the health of their oral tissues and slow bone resorption. It is recommended to remove traditional dentures for a period of six to eight hours, such as overnight, to give the gum tissue a rest from the constant pressure. This rest allows for better blood circulation and prevents chronic inflammation of the mucosa. Proper systemic health also plays a role, as a diet rich in calcium and vitamin D is necessary to support bone density, including the jaw.