Failure to wear prescribed dentures, which replace missing teeth and surrounding tissues, initiates a series of biological and functional changes. Dentures restore oral function and maintain the integrity of the jaw structure following tooth loss. Consistent use, as directed by a dental professional, is fundamental to post-extraction care. Not wearing the prosthetic leads to progressive alterations in the mouth, changes in the ability to speak and eat, and a noticeable shift in facial appearance.
Structural Changes Inside the Mouth
The most profound consequence of not wearing a denture is the progressive loss of jawbone mass, a process known as alveolar ridge resorption. The jawbone requires mechanical stimulation from the teeth or an appropriate prosthetic to maintain its density. When this stimulation is absent, specialized cells called osteoclasts begin to break it down and resorb the minerals. The rate of bone loss is not uniform; the lower jaw (mandible) typically resorbs at a rate up to four times greater than the upper jaw (maxilla). This continuous reduction in the height and width of the alveolar ridge directly impacts the ability to support any future dental appliance.
For individuals with partial tooth loss, the absence of a partial denture allows the remaining natural teeth to shift, tilt, or drift into the empty spaces. Teeth lacking an opposing contact may also “super-erupt” or grow out of the socket, seeking a bite partner. These movements disrupt the entire alignment of the bite, creating new areas of stress and potentially leading to further dental complications or joint issues.
Functional Impairments in Speech and Chewing
The primary function of a denture is to restore the mechanics of eating and speaking. Chewing, or mastication, becomes highly inefficient because the biting force is drastically reduced compared to natural teeth. This limitation forces the individual to avoid tougher, fiber-rich foods, leading to a restricted diet and potential nutritional deficiencies. Inefficient chewing also means larger food particles are swallowed, placing an increased burden on the digestive system.
In terms of speech, the teeth and palate are necessary for proper articulation, especially for specific sounds like sibilants (“s” and “z”) and fricatives (“f” and “v”). Without the denture filling the space, air may escape, causing a whistle, or the tongue may be unable to achieve the correct position, resulting in a lisp or muffled speech.
Alterations to Facial Appearance
The jawbone provides the foundational support for the muscles and soft tissues of the lower third of the face, and its loss has significant visible consequences. As the alveolar ridge resorbs, the vertical dimension of the face decreases, making the lower face appear shorter. This structural change causes the facial muscles to lose their support and sag. This phenomenon, often termed “facial collapse,” results in several distinct aesthetic changes. The cheeks may appear sunken, and the corners of the mouth can turn down. Deep folds may form around the mouth, leading to an exaggerated appearance of lines like marionette lines.
Remediation When Dentures Stop Fitting
A consequence of bone resorption is that the original denture will eventually become loose and unstable because the mouth’s contours have changed. If a denture is no longer fitting correctly due to non-wear and subsequent tissue change, the first step is to consult a dental professional, such as a prosthodontist. They can accurately assess the extent of the change in the oral anatomy.
Reline
For minor changes in the gum and bone structure, a reline may be recommended. This involves adding new material to the tissue-fitting surface of the existing denture to re-establish a snug fit.
Rebase
A more extensive procedure is a rebase, where the entire acrylic base material is replaced while preserving the artificial teeth. This is necessary when the structural change or damage is more significant.
Attempting to use excessive amounts of over-the-counter adhesive to stabilize a loose denture is strongly discouraged, as this only masks the underlying issue and can worsen tissue irritation and accelerate bone loss.