The concern about receiving dentures while having gum disease is common. It is often possible, but only after addressing the underlying infection. Gum disease, also known as periodontal disease, must be treated and controlled before any prosthetic device like a denture can be successfully placed. The health of the mouth’s remaining tissues provides the foundation for the denture. This initial treatment phase stabilizes the oral environment and prevents the infection from compromising the new dental appliance.
Understanding the Stages of Gum Disease
Gum disease progresses through distinct stages, beginning with gingivitis, the mildest form of the condition. Gingivitis is characterized by inflammation of the gums, which may appear red, swollen, and bleed easily during brushing or flossing. This stage affects only the soft tissue and is typically reversible with professional cleaning and improved home care.
If gingivitis is left untreated, it progresses to periodontitis, a more destructive stage of the disease. Periodontitis involves the infection moving below the gumline and attacking the bone and fibers that support the teeth. This causes the gums to pull away from the teeth, forming pockets where bacteria can thrive and accelerate bone loss.
Periodontitis significantly impacts denture eligibility because it destabilizes the entire oral structure. The inflammation and infection must be fully resolved, as placing a denture over diseased gums would trap bacteria and allow the infection to worsen rapidly. Advanced periodontitis leads to significant bone loss, which complicates the future fit and stability of any denture.
Treating Periodontal Disease Before Denture Placement
Before any denture impressions are taken, the active periodontal infection must be fully eradicated. This process typically begins with a deep cleaning procedure called scaling and root planing, which removes hardened plaque and tartar from both above and below the gumline. Root planing then smooths the tooth root surfaces, making it more difficult for bacteria to reattach and promoting the reattachment of gum tissue.
In cases of advanced periodontitis, teeth that have lost too much supporting bone or are severely infected must be extracted to eliminate the source of the disease. The dental professional will develop a comprehensive treatment plan that prioritizes the removal of infection and the healing of the gum tissues. This stabilization of the oral environment is a necessary prerequisite to denture placement.
Following any necessary extractions or deep cleaning, a significant healing period is required before a final denture can be fabricated. Gums may take approximately four to six weeks to heal completely after a deep cleaning procedure. If teeth were extracted, the bone and gum tissue need several weeks or months to stabilize and form a firm ridge. This waiting period allows the tissue to shrink, ensuring the final denture fits accurately.
How Gum and Bone Health Affects Denture Selection
The type of denture used is determined by the amount of remaining jawbone and the health of the gum tissue. Periodontitis causes bone loss, known as bone resorption, which reduces the height and width of the alveolar ridge where the denture rests. Traditional conventional dentures rely entirely on this residual ridge for support and suction, and a reduced bone structure can make them loose, unstable, and prone to irritation.
Immediate dentures are placed directly after tooth extraction, serving as a temporary appliance while the gums heal. The jawbone shrinks rapidly following extractions, with some studies suggesting up to 25% of bone density can be lost in the first year alone. This rapid change means immediate dentures require frequent relining and adjustments until the final, customized denture is made several months later.
For patients with significant bone loss, implant-supported dentures are often the most stable and long-lasting solution. These dentures snap onto dental implants surgically placed into the jawbone, providing stability traditional dentures cannot match. The implants also mimic natural tooth roots by stimulating the jawbone, which helps to slow or prevent further bone resorption.
Long-Term Management and Oral Hygiene with Dentures
The placement of dentures does not eliminate the risk of future gum disease or irritation, making a specific daily hygiene routine mandatory. Denture wearers must clean both the prosthetic and the underlying gum tissue every day to prevent the buildup of plaque and fungus. The denture itself should be brushed with a soft-bristled brush and a non-abrasive denture cleaner, not regular toothpaste, which can scratch the material.
The appliance should be soaked daily in water or a dedicated denture cleaning solution, often overnight, to keep it moist and kill bacteria. Equally important is cleaning the soft tissues of the mouth, including the gums, tongue, and palate, with a soft toothbrush or a damp cloth while the denture is removed. This action stimulates blood circulation and removes accumulated bacteria, preventing irritation and potential infections like denture stomatitis.
Regular dental check-ups remain an important component of long-term care, even for those with full dentures. The dentist needs to monitor the health of the gum and bone ridges, checking for any signs of disease recurrence or tissue irritation. They will also assess the fit of the denture, as the bone structure naturally continues to change slowly over time, necessitating periodic relining or adjustments.