Conventional dentures are removable dental appliances designed to replace missing teeth, restoring some chewing function and supporting facial appearance. These prosthetics typically consist of artificial teeth set in an acrylic base that mimics gum tissue. They are custom-made to fit over the remaining gum ridges where natural teeth once stood.
However, their interaction with the underlying bone structure is a significant consideration for individuals who have experienced tooth loss. The primary concern revolves around whether these common tooth replacements can prevent the natural process of jawbone deterioration that often follows tooth extraction.
Jawbone Loss After Tooth Extraction
When a natural tooth is lost, the jawbone that once supported it no longer receives the regular stimulation from chewing forces. This absence of stimulation initiates a biological process known as bone resorption, where the body begins to reabsorb the bone tissue. The jawbone, like other bones in the body, continuously remodels itself, with old bone being removed and new bone being formed.
Without the mechanical stress transmitted through the tooth root, the signals for bone regeneration diminish. This leads to a gradual reduction in the density and volume of the alveolar bone, which is the part of the jawbone that holds the teeth. Bone loss can begin as early as six months after tooth extraction, with the most significant changes often occurring within the first year. The jawbone can resorb significantly, losing approximately 4mm in the initial months following tooth loss. The lower jaw can experience bone atrophy at a rate up to four times faster than the upper jaw, around 0.2mm per year after the initial rapid phase.
Dentures and Bone Preservation
Conventional dentures, both full and partial, do not prevent jawbone loss. Their design involves resting directly on the gums and underlying bone. Unlike natural tooth roots or dental implants, they do not integrate with the bone or provide the direct stimulation needed to maintain bone density.
Instead of stimulating the bone, the pressure from conventional dentures during chewing can accelerate bone resorption. This occurs because the denture presses on the gum and bone, rather than transmitting forces through a root-like structure that encourages bone maintenance. This constant pressure can lead to further jawbone shrinkage over time.
While partial dentures offer localized support by connecting to remaining natural teeth, they still do not stimulate the bone beneath missing teeth. Areas where teeth are absent will continue to experience bone loss, even with a partial denture. The primary function of conventional dentures is to replace the visible portion of teeth and restore some oral function, not to preserve the underlying bone structure.
Living with Dentures and Bone Changes
The ongoing process of jawbone loss has practical implications for individuals wearing conventional dentures. As the jawbone shrinks and changes shape, dentures that once fit securely can become loose and ill-fitting. This change in fit can lead to discomfort, rubbing, and sores on the gums.
Loose dentures can make it difficult to chew food effectively, impacting nutrition and enjoyment of meals. Speech can also be affected, as dentures may slip or click during conversation. To compensate, denture wearers often require frequent adjustments, relines, or even complete replacement of their prosthetics. Denture relines are needed every one to two years to restore a proper fit.
Beyond functional issues, jawbone loss can alter facial structure, leading to a sunken or aged appearance. The lower third of the face may appear shorter, and the lips and cheeks can lose support, creating a collapsed look. These changes can affect a person’s confidence and overall quality of life.
Strategies for Jawbone Preservation
For individuals seeking to preserve jawbone health, dental implants are a widely recognized solution. Unlike conventional dentures, dental implants are small, biocompatible posts, typically made of titanium, that are surgically placed directly into the jawbone. Over time, the implant fuses with the surrounding bone in a process called osseointegration.
Once integrated, these implants act as artificial tooth roots, transmitting chewing forces directly to the jawbone. This stimulation mimics natural teeth, helping to maintain bone density and prevent further bone resorption. Implant-supported dentures, which attach to these integrated implants, offer superior stability and bone preservation compared to traditional dentures.
In cases where significant bone loss has already occurred, bone grafting procedures may be necessary to rebuild adequate bone volume before implant placement. Bone grafting involves adding bone material to the jaw, creating a stable foundation for implants. These steps help ensure long-term jawbone health and provide a more stable, functional tooth replacement option.