The question of whether dentures can be worn with receding gums is common among those seeking tooth replacement. Receding gums involve the loss of gingival tissue and the underlying alveolar bone structure. While recession complicates achieving a stable fit, it does not prevent a person from wearing dentures. Maintaining a functional denture requires adapting to the continuous changes caused by the loss of this foundational tissue.
Why Receding Gums Affect Denture Stability
The success of a conventional denture relies heavily on the structure of the alveolar ridge, the remnant of the bone and gum tissue that once held the natural teeth. This ridge provides the necessary height and width to support the denture base and create a peripheral seal for retention. When natural teeth are lost, the jawbone no longer receives stimulation, leading to bone resorption, where the alveolar ridge gradually shrinks.
Gum recession accelerates this resorption, diminishing the volume of bone that provides the foundation for the appliance. As the ridge shrinks, the denture’s fitting surface no longer conforms precisely to the underlying tissue. This lack of congruence compromises the peripheral seal, making the denture prone to rocking, lifting, and dislodgement.
The instability caused by the poor fit introduces pressure points and friction on the remaining gum tissue. These forces can irritate the mucosa, leading to chronic soreness, inflammation, and potential infection. A loose denture also reduces chewing efficiency, often forcing individuals to restrict their diet, which can impact overall nutrition. Continuous movement of the ill-fitting appliance encourages further bone loss in areas of concentrated pressure, creating a cycle of instability and accelerated recession.
Adapting Conventional Dentures to Changing Gums
For individuals experiencing minor to moderate gum recession, maintaining conventional dentures involves routine adjustments to compensate for changing oral contours. The most common procedure for improving fit is relining, which involves adding a new layer of acrylic material to the fitting surface of the denture base. This material fills the gap created by the resorbed gum and bone, recontouring the appliance to the current shape of the alveolar ridge and restoring retention.
Relining can be done with either a hard acrylic material in a laboratory setting or a softer, temporary material applied chairside. A soft reline is often used as a palliative measure to allow irritated tissues to heal before a more permanent hard reline or rebase is performed. These procedures are typically necessary every one to three years, depending on the individual rate of bone resorption.
A more extensive procedure, known as rebasing, is sometimes necessary when the entire denture base material needs replacement, but the artificial teeth remain in satisfactory condition. Rebasing requires taking a new impression and replacing all the acrylic base material with new material, using the existing teeth. This provides a stronger and more accurate fit than a simple reline. Some individuals may temporarily use denture adhesives to enhance stability between professional adjustments. Adhesives act as a temporary cushion and sealant, but they are not a long-term substitute for a properly fitting appliance, as they can mask underlying fit problems.
Advanced Options for Severe Gum Recession
When gum recession is severe, the residual alveolar ridge may be too low and narrow to provide sufficient support or retention, even with frequent relining. In these situations, more advanced solutions are required to create a secure foundation for the denture. The most effective long-term solution is the use of implant-supported dentures, often called overdentures, which are secured by dental implants placed into the jawbone.
Dental implants act as artificial tooth roots, providing stable anchors that bypass the limitations of the receding gum line and underlying bone height. The denture is fabricated with attachments that snap or clip onto these implants, eliminating movement. Retention relies on the implants rather than the compromised alveolar ridge. This approach improves chewing function and provides stability comparable to natural teeth, regardless of the extent of the gum recession.
In cases where the jawbone volume is insufficient for implant placement, surgical augmentation procedures may be necessary before proceeding with an overdenture. Bone grafting is a technique used to rebuild the resorbed jawbone, increasing its height and width. This is done by transplanting bone material or using synthetic substitutes. This process provides the necessary structural support to place dental implants.
Soft tissue augmentation, or gum grafting, is a different procedure used to cover exposed root surfaces or increase the volume of the gingiva. This may be done to improve comfort and appearance. While grafting procedures are more involved and require a healing period, they restore the necessary foundation. This makes a stable and comfortable denture a viable option even after substantial gum recession.