Dentures are removable replacements for missing teeth and surrounding tissues. They restore function, speech, and appearance following significant tooth loss. The two primary types are full dentures, which replace all teeth in an arch, and partial dentures, used when some natural teeth remain. Obtaining a denture is a multi-stage process, moving from initial assessment and preparation through custom fabrication and long-term care.
Initial Consultation and Preparation Phase
The process begins with a comprehensive dental assessment, including an oral examination, X-rays, and a review of the patient’s medical and dental history. This initial consultation determines the patient’s candidacy and the most appropriate type of denture based on their oral health needs. The dentist also discusses the patient’s aesthetic goals, which informs the customized design process.
A fundamental decision is whether to proceed with conventional or immediate dentures. Conventional dentures are fabricated only after necessary extractions have been performed and the gum tissues have completely healed, a process that can take six to eight weeks or several months. While this delay means the patient is without teeth for a period, it results in a more stable fit because the underlying bone and soft tissues have stabilized.
Immediate dentures are prepared in advance and inserted immediately following the removal of remaining teeth, allowing the patient to avoid a period without teeth. However, the mouth changes shape significantly during the post-extraction healing phase as the bone and gums resorb and shrink. Immediate dentures require frequent adjustments and often serve as a temporary appliance until a permanent, conventional set can be created after four to six months of healing.
Impressions, Wax Models, and Custom Fabrication
Once the mouth is prepared and healed (or initial impressions are taken for immediate dentures), the fabrication process begins with taking dental impressions. Preliminary impressions, often taken with alginate, create a general mold of the patient’s oral structures. These initial molds are sent to a dental laboratory to create custom trays precisely contoured to the patient’s mouth.
The custom trays are used to take final impressions with a more accurate material, capturing the fine details of the gum ridge and surrounding tissues. Following this, the dentist determines the correct jaw relationship, or bite, using wax “bite blocks” or occlusion rims. These wax forms establish the vertical dimension of occlusion (VDO), ensuring the bite is neither too open nor too closed. This measurement is vital for comfortable function and facial aesthetics.
The laboratory sets the artificial teeth into a wax base plate, creating a prototype called the wax try-in. During this appointment, the patient and dentist evaluate the fit, shape, size, and color of the teeth before the final acrylic is processed. This crucial step allows for adjustments to the tooth arrangement, midline, and overall aesthetic appearance while the teeth are still movable within the wax. Once approved, the laboratory processes the wax model into the final hard acrylic denture base.
Delivery, Adjustment, and Long-Term Maintenance
The final stage is the delivery appointment, where the completed denture is placed into the patient’s mouth. The dentist checks the fit, the bite, and the overall comfort. It is normal to experience initial soreness, difficulty speaking, and challenges with eating as the oral tissues and muscles adapt to the new appliance.
The first few weeks require follow-up appointments for adjustments. As the tissues respond to the pressure of the denture, localized sore spots may develop, requiring the dentist to relieve these specific areas on the denture base. This adjustment period is expected and often requires multiple visits to achieve optimal comfort and function.
Long-term maintenance ensures the appliance remains comfortable and healthy. Dentures should be removed for at least six hours daily, typically overnight, allowing the underlying gum tissues to rest and recover. They must be cleaned daily with a soft-bristled brush and a non-abrasive cleanser, as regular toothpaste can scratch the acrylic, creating areas for bacteria to grow. Proper storage involves keeping the denture in water or a cleaning solution to prevent the acrylic from drying out and warping. Even without natural teeth, routine check-ups, often annually, are necessary to inspect the fit, check for pressure points, and screen for oral tissue changes.