It is possible to receive dentures even with gum recession, but the process is more complex and requires specific planning. Gum recession involves the loss of gingival tissue and the underlying alveolar bone that supports the dental structure. This condition makes securing a comfortable and functional denture challenging. The primary goal is to adapt the denture design to the reduced foundation, ensuring both fit and long-term comfort for the patient.
Traditional dentures rely on a seal created over the broad ridges of the residual alveolar bone. When recession occurs, the surface area for this seal shrinks significantly, making adequate retention difficult. The foundational ridge becomes narrower and shorter, allowing the prosthetic to shift and dislodge easily during functions like speaking or chewing. This lack of stability compromises the denture’s ability to remain seated securely.
Reduced gum tissue often means the underlying alveolar bone is closer to the surface, sometimes presenting as sharp or irregular bony projections. Dentures placed over these thin, compromised tissues create localized high-pressure points when biting forces are applied. These points of intense friction and compression frequently lead to chronic soreness, inflammation, and the development of painful ulcers, making denture wear uncomfortable.
The continuous movement of an ill-fitting or unstable denture applies disruptive forces to the underlying bone structure. This constant micro-trauma stimulates the body’s natural process of bone resorption, causing the remaining alveolar ridge to diminish at an accelerated rate. As the bone continues to resorb, the fit of the denture worsens over time, creating a cycle of instability and further tissue loss.
Necessary Preparatory Procedures for Denture Placement
Adjusting existing appliances often involves relining or rebasing. Relining adds new acrylic material to the fitting surface to improve the seal and adaptation to the changed gum shape. Rebasing replaces the entire acrylic base while preserving the artificial teeth, necessary when the structure has drastically changed due to recession.
Before taking final impressions, inflamed or damaged gum tissue must heal. Dentists often use a temporary soft liner, known as tissue conditioning material, placed inside the existing denture. This pliable liner distributes pressure evenly and encourages the gingiva to recover its shape before the definitive prosthetic is constructed.
If recession has left sharp or irregular bony projections, minor surgical intervention may be required to create a smooth foundation. This procedure, known as alveoloplasty, involves contouring and smoothing the residual alveolar ridge. Removing these sharp edges reduces pressure sores and allows the denture to rest on a uniformly shaped, stable surface.
Minor grafting procedures may be used to improve ridge quality. For example, vestibuloplasty aims to deepen the functional area where the denture rests by repositioning muscle attachments and soft tissues. These procedures are reserved for individuals with severely flattened or compromised ridges to enhance retention potential.
Denture Options for Reduced Gum and Bone Support
The most effective solution for severely recessed gums and diminished bone is the use of implant-supported overdentures. These appliances do not rely on compromised gum tissue for retention, instead snapping onto two or more surgically placed dental implants. The implants provide a secure anchoring system, eliminating movement, restoring chewing efficiency, and improving the quality of life compared to conventional dentures.
The stability provided by implants halts the destructive cycle of bone resorption. By transferring chewing forces directly to the jawbone, the implants stimulate the bone, helping to preserve the remaining alveolar ridge volume over time. These prosthetics can be designed to be removable for cleaning or fixed semi-permanently, depending on the number of implants and the patient’s needs.
For patients opting against implants, maximizing the fit of a conventional denture requires high-precision impression techniques. Specialized impression materials capture the exact contours of the compromised ridge and surrounding soft tissues. This custom approach ensures the denture base covers the maximum available surface area, distributing forces broadly to enhance limited suction and stability.
To address discomfort associated with thin or sensitive residual ridges, specialized soft liners are incorporated into the final denture base. These permanent soft liners are made of silicone or other resilient polymers that remain pliable for an extended period. The cushion provided by the liner absorbs some of the impact from chewing, reducing the pressure transmitted to the delicate, recessed gum tissue.