The term “permanent dentures” often causes confusion because it is used loosely to describe various dental prosthetics. It typically refers to a restoration that remains fixed in the mouth, unlike traditional dentures that a patient removes daily. This fixed nature is usually achieved by anchoring the prosthetic to dental implants placed within the jawbone. Understanding the distinction between patient-removable and professionally-removable options is important when considering this type of tooth replacement.
Understanding Fixed and Removable Dentures
Dentures generally fall into two categories based on how they are secured. Traditional or conventional dentures are patient-removable, resting directly on the gum tissue and often relying on suction or adhesive for stability. They must be taken out nightly for cleaning and to allow the gums to rest.
The restoration commonly called “permanent dentures” is more accurately described as an implant-supported prosthetic. These fixed dentures are secured onto titanium dental implants that have fused with the jawbone, providing a much higher degree of stability. They are not designed to be removed by the patient, offering a more natural feeling and function similar to natural teeth.
Implant-supported options have variations, including those that snap onto ball or bar attachments, which the patient can remove. The true fixed or non-removable variety is attached directly to the dental implant abutments, typically using small screws or strong dental cement. This structural difference determines who can remove the prosthetic.
Can Patients Remove Fixed Dentures
The direct answer to whether a patient can remove a fixed denture is no. These prosthetics are specifically engineered to be a permanent fixture, mimicking the root structure of natural teeth. They are secured to the underlying dental implants, which are surgically placed fixtures in the jawbone.
Stability comes from the abutments, the connectors extending from the implant onto which the denture is attached. The prosthetic is either screwed directly into these abutments or permanently cemented onto them. These fixation methods require specialized dental tools and professional knowledge to safely undo.
Attempting to forcefully remove a fixed prosthetic would cause significant damage to the denture, the underlying implant structure, and the surrounding bone. The integrity of the dental implant system relies on the secure, non-moving connection between the jawbone, the implant fixture, and the final restoration.
When a Dentist Must Remove the Prosthetic
While the patient cannot remove the fixed denture, professional removal by a dentist is a necessary part of long-term maintenance and care. Dentists typically remove the prosthetic during routine checkups, often on an annual or semi-annual basis, to thoroughly clean the area. This professional cleaning is essential for removing hardened plaque and calculus that cannot be reached with daily brushing.
Removal is also performed to check for signs of potential complications, such as peri-implantitis, a bacterial infection affecting the gum and bone tissue around the implant. Accessing the underlying implants allows the dentist to assess the health of the surrounding bone and gum tissue. This assessment is fundamental to the restoration’s long-term success. X-rays are often taken during these appointments to monitor the condition of the bone and the implant fixtures.
The prosthetic may also need removal if it sustains damage or requires a reline or repair. Although fixed dentures are durable, they can sometimes chip or fracture, necessitating professional removal for laboratory repair. Components like the retention screws may occasionally loosen or wear out. This requires the dentist to access the internal structure of the restoration for replacement or tightening.
Cleaning and Maintaining Non-Removable Dentures
Since fixed dentures cannot be taken out for cleaning, daily home care must be adapted to clean the restoration while it remains in the mouth. Patients should clean the surface of the prosthetic just like natural teeth, using a soft-bristled toothbrush and a non-abrasive toothpaste. This process should be performed at least twice daily to remove food particles and plaque buildup.
A particular focus must be placed on the area where the prosthetic meets the gum line and around the implant abutments. Plaque accumulation in these hard-to-reach areas can lead to inflammation and infection if not addressed. Specialized tools are necessary to clean the underside and sides of the fixed denture.
Cleaning the space between the prosthetic and the gums can be achieved with tools like water flossers, which use a stream of water to flush out debris. Tufted dental floss or floss threaders are also recommended to maneuver beneath the arch of the denture to clean the implant posts. Diligent daily care is paramount because the appliance remains fixed, making professional cleanings a necessary complement to home hygiene.