In adolescence, nearly everyone has almost all their permanent teeth. Over time, these teeth may be extracted one by one until eventually, some people may have no natural teeth left. Thus, it becomes necessary to use dentures to assist in chewing, improve aesthetics, and aid in clear speech. Additionally, teeth help reduce or prevent the deterioration that can occur in the organs associated with chewing. For example, extracting a single tooth can cause adjacent teeth to tilt, creating gaps where food particles get trapped, leading to tooth decay, gum inflammation, and periodontal disease. The opposing teeth will then wear down due to the lack of stimulation from chewing, leading to the resorption of the periodontal ligament bone, causing these teeth to elongate or protrude over time. These protruding teeth may need to be extracted, and the protruding bone trimmed. In cases where the back teeth are completely extracted, it can cause the chin to retract, causing the front teeth to meet at the tips, leading to the wearing down of the tooth tips, or the lower front teeth may bite into the palate causing gum pain or bite into the upper tooth neck causing the upper teeth to protrude.
Prosthodontics (Dentures) Prosthodontics involves repairing and replacing teeth and related structures in the mouth, face, and jaw using various materials, preserving the functionality, comfort, and aesthetics of the oral cavity by restoring natural teeth or replacing lost teeth.
Dentures (Denture) Dental Bridge (Bridge) Dental Crown (Crown) However, using dentures can also pose risks to the remaining natural teeth and areas between the denture and natural teeth junctions. Food particles can get trapped, leading to tooth decay. Areas covered by dentures, such as the palate and gum edges, lack stimulation and cleaning, which can cause inflammation. Natural teeth supporting the dentures may be damaged and become mobile and painful later on.
Various Types of Dentures
Removable dentures are made for those who still have some natural teeth left, providing partial tooth replacement that can be removed and cleaned. Situations suitable for removable partial dentures:
- If there are no back anchor teeth for a dental bridge.
- If several adjacent teeth are extracted, making a bridge unstable.
- Newly extracted areas where the gums have not yet fully receded. A removable denture can be worn temporarily until the gums fully recede and then permanently fitted. Early fitting helps maintain the shape of the gums.
- Removable dentures require clasps for attachment, which can be uncomfortable, trap food, make eating difficult, and are less aesthetically pleasing. Details of the procedure and methods for inserting removable dentures (plastic-based dentures):
Mouth impressions taken after examination followed by fitting Checking bite and chewing function after fitting Adjustments for proper function Treatment duration involves about 2-3 sessions, varying by patient depending on the number of missing teeth, bite, and tooth position.
Full Dentures: Suitable for cases where:
- No natural teeth are left.
- Limited remaining space with poor bone support around tooth roots; significant tooth mobility requires extraction.
- Poor oral health with extensive decay necessitates extraction and full dentures.
- Remaining areas are unattractive or poorly positioned; if removable or fixed dentures using existing contours would not provide strong attachment and aesthetics, extraction might be necessary. Dental Bridges (Bridge)
A dental bridge closely resembles natural teeth by filing adjacent teeth to serve as anchors.
Suitable cases for a dental bridge:
If the tooth gap from extraction is 3-5%.
Front teeth with normal gum conditions after extraction. Unsuitable cases for a dental bridge:
If the tooth gap from extraction is more than 4 teeth long.
If the anchor teeth are not strong enough.
If there are no inner anchor teeth. Dental Crowns (Crown)
A dental crown restores natural teeth that have lost too much substance for other treatments like fillings, inlays, or onlays. Crowns require filing of the natural tooth for attachment and come in full or partial veneer types. Post-extraction areas typically have less good tooth substance, making teeth more prone to breakage, thus reinforcing with a crown and post-and-core is advisable. Front teeth and small molars after root treatment should have a post and crown; large molars with sufficient good substance may just need a filling before crowning.
