Dentures are removable replacements for missing teeth and the surrounding soft tissues. While they offer a functional and aesthetic solution to tooth loss, many people are concerned about the drawbacks associated with long-term wear. Understanding the challenges of using dentures, which range from an initial adjustment period to ongoing biological changes, is important for managing expectations and maintaining oral health.
Common Complaints During the Initial Adjustment
The introduction of a foreign object into the mouth triggers an initial adjustment period that can feel awkward and frustrating for new denture wearers. Immediately following placement, many individuals experience a temporary increase in saliva production, as the mouth perceives the denture as an irritant. This hypersalivation usually subsides within a few weeks as the body adapts to the new appliance.
Learning to speak clearly with dentures presents a significant challenge because the tongue and cheek muscles must re-learn how to form sounds around the acrylic base. Initial difficulties may include a lisp or slurring of certain words, which can be overcome by reading aloud and repeating difficult phrases. Chewing efficiency is also greatly reduced; patients must start with soft foods, taking smaller bites and learning to chew on both sides simultaneously to stabilize the appliance.
Local discomfort is a frequent complaint, manifesting as sore spots, pressure points, and generalized gum irritation. These areas of pain result from uneven pressure distribution as the denture settles onto the soft tissues. Sore spots often require prompt adjustments by the dental professional to relieve the pressure and prevent mouth sores. This transitional phase requires patience and several appointments for minor fit corrections to ensure long-term comfort.
The Biological Reality: Accelerated Bone and Gum Recession
The most significant long-term drawback of traditional dentures is the chronic, progressive loss of the jawbone, known as alveolar ridge resorption. This occurs because natural tooth roots provide constant mechanical stimulation to the jawbone during chewing, which is necessary to maintain bone density. When teeth are lost, this stimulation ceases, and the bone begins to atrophy.
Traditional dentures only rest on the gum tissue and underlying bone, applying pressure rather than stimulating the bone, which can accelerate the resorption process. The highest rate of bone loss occurs in the first year after tooth extraction, continuing indefinitely at a slower rate, especially in the lower jaw. Over time, this bone loss changes the shape of the jaw, causing the denture to lose its stable fit and become progressively looser.
This structural change necessitates frequent professional adjustments, or “relines,” where the denture base is modified to conform to the shrunken ridge. As the jawbone shrinks, the lower third of the face can appear compressed or “sunken,” contributing to an aged facial appearance. Poor hygiene can lead to chronic gum irritation, such as denture stomatitis, which is an inflammation of the tissue beneath the denture. This condition is associated with a fungal infection called candidiasis, which thrives in the warm, moist environment created by an ill-fitting or poorly cleaned denture.
Mitigating the Drawbacks: When Dentures Work Well
Despite the biological challenges, traditional dentures can function well when patients commit to consistent maintenance and care. Daily cleaning involves removing the dentures and meticulously brushing all surfaces to prevent the buildup of plaque and food particles. Soaking the dentures in a proper cleaning solution is necessary to sanitize the acrylic material and prevent the growth of bacteria and fungi that lead to infections and odors.
Regular dental appointments are important, ensuring the appliance remains functional and does not harm the supporting tissues. The dentist can perform relines every few years to compensate for bone loss, restoring the fit and stability of the denture. Denture adhesives can be used as a temporary measure to enhance retention and stability, offering increased confidence while eating and speaking.
The most effective way to eliminate the long-term drawbacks of bone resorption and instability is through implant-supported alternatives. These prosthetics are secured to titanium posts surgically placed into the jawbone, acting like artificial tooth roots. The implants provide the necessary stimulation to the bone, halting or significantly slowing the progressive bone loss that occurs with traditional removable dentures. Implant-supported dentures offer superior chewing efficiency, greater stability, and a more comfortable, natural feel compared to conventional devices.