Hi, I’m Dr. Brett Langston. I’m the prosthodontist and owner here at Dental Implant and Aesthetic Specialist of Atlanta! Today we’re going to talk about some of the most frequently asked questions that our patients have about dentures.
For those of you who don’t know, dentures are a set of false teeth that are designed to replace your missing teeth. You can have a full denture, you can have a partial denture, but both of them are similar in that they’re something you take out at night. So you wake up in the morning, you put your partial in or your denture in, and you rock and roll throughout the day. You eat, you function, you chew, you smile, you talk, but then at the end of the day, you have to take ’em out so we can let the tissue rest and heal.
What is a Denture?
Dentures can come in two forms, either a full denture or a partial denture, when you’re missing some teeth but you have some natural remaining teeth, and the term is a removable denture or a removable partial denture. So you wake up in the morning, and you put it in your denture, and you wear it all day long. You go throughout your day with your normal functions. You chew, you eat, you talk, you sing, you laugh, you talk on the phone with your friends. You can make videos go throughout your normal day, but at the end of the day, it’s important to remember that you have to take it out, clean it, and allow your gum tissue to rest overnight.
How Long Does it Take to Go From Having No Teeth to a Complete Set of Dentures?
So, one of the most frequent questions we get is how long does it take to go from having no teeth to a complete set of dentures? And that’s a great question. So, before we talk about that, we need to talk about the two basic kinds of dentures.
Immediate Dentures
There are immediate dentures, which are designed to go on the same day of surgery when you lose your teeth, and then there’s the permanent set of dentures, which are designed to be more comfortable and fit and to last you longer because your tissue’s healed. So the immediate denture is a little bit different. Basically, we do all our impressions, we do all our data gathering, and we do our planning so that when you come to us for the day of surgery, we’ve already got that immediate denture ready to go. So you’ll actually leave that day with a full set of teeth, and then we will need to wait about three months. And that’s really important because what happens over those three months is your bone tissue is going to resorb, and your gum tissue is going to modify and change because if we made you a permanent set of dentures the day you had your teeth taken out, it might fit great on day one, but at day 30, day 60, it’s going to wobble and move around a lot, and we’re going to have to start over.
So it’s really important to give your body that time to heal. At about three months or four months, depending on how your healing is going, we’ll be ready to build your permanent denture.
Permanent Dentures
So once the permanent denture is ready to be started, your bone and tissue are formed, and it’s solid; it’s about a five-step process. And this process takes time because there’s a lot of measuring, there’s a lot of customization, there’s a lot of planning that goes into making your perfect set of teeth. So the first appointment is we come in, and we take impressions. So that can happen one of two ways. We can either do conventional impressions with impression material and trays, and this allows us to get a really accurate impression of your gum tissue and how your bone is. Alternatively, we can also scan with an intraoral scanner.
Now it’s a pretty neat process. We have the ability to use an intraoral camera to capture all your tissues and bone profiles, and we use that to digitally send it to the lab to create that initial master model on which we’re going to build everything. So once the final impressions are made, and they’ve been poured up to form the master cast, we’ve actually got models of your mouth, so we know exactly how your gum tissue and bone look, and we’ll also be able to figure out how to make your teeth come together.
Jaw Relations Record
So that’s the next step. The next step is what we call the jaw relations record. You come in, and we’ve basically got the inside of a denture with some wax rims, and I use that to sculpt and mold where we want to put the teeth. Now it’s really important because this stage is crucial to deciding how much lip support you have, how much tooth you show, and how much smile you show.
So if you want something that shows a lot of teeth, we need to kind of build those a little bit taller. If you want something smaller, if you want more of a gummy smile, if you want to show no gum, these are all things that we start figuring out at this stage. And it’s also important at this stage to determine where your bite is. We can’t arbitrarily decide where to put those teeth because if we make the teeth too big for your mouth, it’s going to look like you’ve got a mouthful of teeth. Everybody’s seen that. That’s not the look we’re going for. And conversely, if we don’t get that bite just right, it’s going to look like you’ve got a collapsed bite. Like the classic Hollywood scene with the collapsed jaw and the guy’s chin almost touching his nose also, we don’t want that.
So the jaw relations record, we get all those measurements, make all those determinations of where your mouth needs to be, and that’s the point where we also select your teeth. So, tooth selection is a really neat process. There are actually over 60 to 70 different tooth shapes and sizes that we can select from. And the main differentiation between those teeth is gender, personality, and age. So the teeth that you see on a 20-year-old who has dentures are going to look significantly different than an 85-year-old who needs dentures. So the most important thing is to select teeth that blend into your face, blend into your personality. Believe it or not, we can actually make teeth look more aggressive. We can make ’em look more passive, we can make ’em look cheerful, we can make ’em look worn down. So these are all things we spend a lot of time with you determining what type of tooth and what type of smile you want to have.
Denture Colors
And also another thing that’s great about dentures is we can select the tooth color so we can make them super bright white. We can make ’em Hollywood like Ross from friends, knock you over white, or we can make ’em more natural. We can even make them blend in. Let’s say you’ve got an upper denture and you have lower teeth that are stained. And let’s say you’re a smoker and you have really dark teeth. It would look really weird if we gave you bright white teeth on top. So we’ve got the ability to make teeth that blend in and match your natural teeth if necessary. So the next appointment, and this is probably the most crucial appointment, is called our trying appointment. So we’ve got basically the inside of your denture with the teeth that we’ve all selected set in a wax substrate, and we put ’em in, we let you smile, let you talk the mirror.
This is a great appointment to bring a loved one that they can look at, give you some feedback, and say, wow, that looks really great. Those teeth are perfect. Or they say, you know what? It’s not quite right. Let’s try a little lighter. Or let’s try opening the bite up. Let’s try changing. At that point, it’s still very easy for us to tinker with it and make it perfect. Sometimes it takes more than one appointment because, at this stage, we want to make sure it’s absolutely perfect where you love it, we love it, and everybody’s happy. Once we’ve done that appointment, then it’s about two weeks from that appointment we get the denture processed. You come in, that’s delivery day. We call it Happy Tooth Day because everybody loves getting teeth that they can take home, and it’s a great thing to go from having no teeth to suddenly having a full set of teeth.
And I will warn you, getting dentures is a learning curve. It’s not the first day, and it’s not the best day in the world. It’s great because you have teeth, but there are things you have to reteach yourself. You have to learn how to talk again; you have to learn how to chew, you have to learn how to kind of use your tongue and cheek muscles to hold everything in place because your mouth is getting used to the whole new set of things in there. And so there’s a lot of adjustments and changes that go on. But the advantage of waiting until everything is stable is that we know the dentures are going to fit and they’re going to be comfortable. It just takes an adaption time to get used to having so much in your mouth when you’re not used to it. And probably the biggest take home that I tell patients is that a denture, while we make it as great as we can, will never replace your natural teeth.
A denture is a solution for having no teeth. So if you come into that mindset of we can’t ever do anything as great as your natural teeth, and we’re going to do our best to get you as close as we can, if you realize that it is going to be different and you’re ready to adapt to that change, I think you’re going to love your dentures.
What Will My Dentures Feel Like?
That’s a tricky question to answer, especially if you’re going from having regular teeth into the world of something removable. It’s a big change. A lot of times, it’s going to feel like a mouthful. It’s going to feel bulky. Believe it or not, your tongue, I call it, is a very greedy muscle because if you don’t have teeth, your tongue will actually expand to fill the space.
And if you’ve ever had anything caught in your teeth or a sore spot or anything, your tongue is a very curious muscle. It lives there. It always wants to know what’s going on. And so when you first get your dentures, your tongue has to learn its new boundaries. It’s had all this room to roam and explore, and now all of a sudden, it’s got a set bound of teeth that are kind of holding it back. So, it’s not uncommon to bite your tongue or bite your cheek for the first couple of days while you’re getting used to everything. And another thing to remember is your tongue is the primary driver of speech. And so when you talk and go through your P sounds, your plosive sounds, anything like that, your tongue is used to going to the roof of your mouth or going to the front of your teeth, and all of a sudden, now things are changed.
And so you may have a lisp, you may have a little bit of a sound, not like yourself. And so what I always tell patients is that’s a learned thing. The more you can talk with these dentures, the more you can speak out loud. I always tell patients as soon as you get ’em, you go home, you read the newspaper, you go home, you read the internet, just talk out loud. Your brain doesn’t have to know what you’re doing. But the more you can get your tongue trained up and learn where there are new boundaries, the quicker you’ll go back to sounding like yourself. And another thing, you’re going to make a lot of saliva the first couple of days. That’s something I always tell patients that they’re not prepared for to your tongue and your mouth. When you put something in there, it’s going to think it’s food.
So it gets the mouth ready, it prepares, it makes saliva. Eventually, over time, your mouth is going to learn that’s your new normal. And so don’t fear. You’re not going to become a drool-producing mastiff all of a sudden that’s slobbering all over the place. You will adapt, and the body is pretty quick about that.
How Long Will It Take For Me to Adapt to My Dentures?
That’s a great question, and it sounds like a cop-out, but everybody’s different. If you’ve had a removable appliance before, you generally adapt quicker because you’re used to learning the ropes, if you will. If you’re brand new to the world of something removable, it can take a while. And so our suggestion is to start with softer foods. Obviously, you want to get used to the feel of having the teeth in there, having something pushing on your gums, forming the muscles to hold everything in place as you kind of chew and work through your food.
So softer foods are great, scrambled eggs, cottage cheese, things like that. You’re not on a liquid diet. I definitely wouldn’t suggest that. I want you to start using them and get used to them. And pretty quickly, you can progress to pasta, and you can progress to things that are a little bit more involved. One of the key things that we always tell our patients when kind of learning about dentures is you have to retrain how you eat when you have natural teeth. Everybody’s got a favorite side. It sounds weird, and most people don’t really think about it, but the next time you chew and eat your food, you might find yourself shoving stuff to one side or the other just because that’s your natural inclination, like being right-handed or left-handed with dentures. We can’t do that because even if we have a perfect well-balanced denture, if you put something really hard on one side and you bite, the other side is going to rock and come down; now we can overcome that with implants, but that’s a conversation for another day.
But with natural dentures, you have to learn how to balance and eat on both sides of your mouth. And so that’s a big change for people because they’re used to the right side and left side, and I challenge you when you eat the next meal to think about if you can chew on both sides. So it’s just kind of getting a little bit of empathy for people who are learning how to do that balancing act.
Can I Keep My Dentures Down at Night, and Why Do I Have To Take Them Out?
Great questions. I do get it. And we actually have patients who, I probably shouldn’t say this, but whose spouses don’t even know they have dentures. And they’re really good at finding the time during the day to take them out. And that’s important because we usually tell patients you need at least six to eight hours out of a 24-hour cycle to have the dentures out.
And the reason for that is because the mouth is a very wet environment. So I always compare it to if you went to bed with wet socks on your feet. You wake up in the morning, and that tissue on your feet is going to be gross, wrinkled, and nasty. The mouth is a very wet environment, so if you keep that tissue covered, it doesn’t have a chance to breathe and recover. It can lead to fungal infections, bacterial infections, and just an overall kind of gross environment. So we tell patients the easiest time to take it out is at night because you’re not going to miss the teeth. You’re not eating, you’re not doing anything, you’re not talking. Hopefully, you’re not around other people. But if your lifestyle is such that that is not a reality, you do need to find windows of time during the day to allow that tissue to kind of rest decompress, and heal. Otherwise, you are going to run into issues with fungal infections, and it’s not the end of the world, but that’s never the most pleasant thing to deal with.
Is My Face Going to Change When I Lose My Teeth, and I Get This New Denture?
That’s a great question. The answer is yes, the body’s amazing, and the bone is there to support the teeth. And when you lose those teeth, that bone is going to remodel and change. And so it’s very important for us with dentures to not only replace your teeth but also replace the gum tissue and the bony support that you have because it’s very common when you lose teeth to have tissue collapse and kind of facial lower midface collapse. And so the advantage of dentures is that in addition to those teeth, we provide fullness to the mouth and we provide support to the gum and bone. So it’s very important to adequately take your time and make sure we’re building everything correctly.
Unfortunately, there are other places where you can get a quick, cheap denture, and that’s not going to give you the support that you’re looking for. It’s going to be very obvious that you have lost your teeth. It’s also amazing how even something as small as just your smile and your teeth can change your overall appearance. So it’s very important to take your time and make sure you go to somebody who can create a smile that recreates your look and makes it look natural.
Home Care for Your Dentures
So home care for a denture is just as important as home care with natural teeth. Now it’s a little different, but it’s equally important every night you need to take the dentures out. And we’ve got a home care kit that we go over with every patient to explain how to use the denture brush, things to avoid, things to not use.
One of the big things that we always tell patients is they may be tempted to brush their dentures with whitening toothpaste or bleaching toothpaste. I cannot stress this enough. That is not a good idea. Natural teeth and acrylic denture teeth react very differently. And the reason that the bleaching toothpaste works so well is that they’ve got some abrasive particles in there that kind of knock the stain off. Now on natural teeth, you’ve got a hard enamel layer that’s resistant to that to a degree. Acrylic denture teeth don’t have that same resistance. So, by doing this, you’re creating little scratches and little grooves in the surfaces. And now, all of a sudden, when you’ve got those grooves, they can pick up stains and show wear and tear a lot quicker. So definitely don’t use bleaching toothpaste. The best thing, believe it or not, is a nice anti-microbial soap on a nice soft denture brush.
You want to clean ’em, get in there, get in all the nooks and crannies inside and out. You want to make sure that all stain is removed all debris is removed, and then you want to soak ’em in. Ideally, some kind of denture cleaning. Now, I wouldn’t advocate one brand over another brand. They’re all essentially the same. They have the same basic mechanisms, but the advantage of them is they clean the denture off. They get in all those little tiny nooks and crannies that you can’t get into. They give it a nice clean taste, and they have it ready to go the next morning.
Which Brand of Denture Cleaner is Best?
I always respond each brand has its own kind of different flavor, and different style. The most important thing, and this is effort, is one of the brands that we offer to our patients at our office.
I don’t have a sponsorship, but if you’re from Efferent, call me. But the most important thing is the accepted seal. That’s the biggest thing. As long as the ADA has vetted them, you’re putting a safe material onto your dentures. So essentially, you’ve got a tablet, you’ve got to put it in the water, put your denture in, let us do its business, and read the back of the box. Some brands want you to keep it in overnight. Some brands only want it for 15 to 20 minutes. But either way, the most important thing is your denture needs to be wet overnight. If you leave it out, just put it on the counter; one or two things are going to happen. Either it’s going to dry up, and then it runs a risk of warping or cracking, or your dog or cat is going to get it.
And I say that not jokingly because that is a very common issue that we deal with. Dogs love dentures, they love to chew on them, and that will be the most expensive chew toy you ever buy your dog because once it’s been eaten and chewed, unfortunately, we have to start over from stage one. By default, we tend to be very conservative in our practice.
Bone Loss, Periodontal Disease, and Dentures
Our goal is to help you save your teeth and maintain your teeth for as long as possible. Unfortunately, there does come a time when we can’t save the teeth, whether it’s periodontal disease, which is basically bone loss caused by bacteria, that you lose the bone around the teeth and the teeth become mobile. It gets to the point where it’s painful to eat; it’s painful to chew teeth start falling out when you’re eating. As horrible as that sounds, unfortunately, it is a relatively somewhat common occurrence, and the underlying cause of bone loss causes that.
And at that point, with the bacteria in the mouth, it’s best to take those teeth out. And like I said, generally, we want to save teeth if we can, and we’ll build a partial denture to kind of build around and sculpt around your existing teeth. But unfortunately, there does come a time when all the teeth are involved to the point where we can’t save them. And so at that point, you’re going from a painful mouth, not able to chew anything, not happy with your smile, embarrassed by the aesthetics to all of a sudden a fresh start with a full set of teeth that allows you to chew, allows you to function, allows you to eat dinner, allows you to go on dates, allows you to sing at church. So, I know there is definitely a mental component to losing teeth, and we don’t take that lightly.
I know, especially front teeth, there’s a lot of personality. There’s a lot of empowerment tied up in your front teeth and your smile because that’s how people have seen you for your whole life. So like I said, we don’t take it lightly, but there is a time when it would benefit you greatly to make that step and transition to a full denture. One of the other main reasons that we have patients who are in need of a denture is because of cavities. Cavities are bacteria that build up on the teeth and if they’re not cleaned off properly, they can create a cavity, which is dental decay. And as that decay gets further and further, it can either cause the teeth to break or it can get into the nerve, which needs root canals. Sometimes it gets to the point where the teeth have so much decay that in order to remove that decay and try and restore them with fillings or crowns or bridges, it would be not only a really costly endeavor but also the long-term prognosis of those teeth would be pretty poor.
And so we’re not here to make money and get as much as we can out of every tooth. Our goal is to get you to a stable, happy oral situation in the most efficient way possible. And sometimes, that means taking out teeth that have cavities to the point where we can’t restore them. So if you found our information helpful, and if you think you’re in a situation where you have teeth that are hopeless, teeth that are painful, and you might be in need of a denture, please call our office. We would love to have you come in no matter where in the world you are, high South Africa, high London, no matter where in the world you are, we would love to come in, talk to us, let us go through the situation, your personal situation, because sometimes it’s not as bad as you think, and other times you would be amazed at what people are putting up with and working through.
And oral pain is not a fun thing. It can impact your whole life. And if we can get you out of that and into a nice set of dentures that looks nice and functions nicely, it’s a game changer. Because if you think about it, your mouth is involved in pretty much every process you do all day long. And so there’s no reason to go through life handicapped, go through life not happy with your mouth, and we can improve your situation. So reach out to us; we’d love to help you and take care of you. Again, I’m Brett Langston. I’m the prosthodontist and owner of Dental Implant and Aesthetic Specialist in Brookhaven, Georgia, and we are here to help you watch your mouth.