Russo Dental Care | Ask the Dental Doc

Dentures

Dear doc.

I have been wearing full dentures for the past thirty years, for the past five years I have had trouble with my lower denture staying put. I have had three new sets made and was just informed that my problem wasn't the denture but in fact my jawbone was dissolving? My dentist is sending me to a specialist, what should I expect?
Thanks Richard.

It is important for patients have realistic expectations when replacing natural teeth with dentures. Traditional dentures are only a marginal substitute for your natural dentition, and as you have experienced, the lower denture is generally the more troublesome of the two. There are several inherent problems with lower dentures:

The lower denture has much less surface area to rest upon. The upper denture for example utilizes the entire roof of your mouth to help stabilize the denture.

The lower denture comes in contact with more movable mouth surfaces than an upper denture. These movable surfaces tend to dislodge the lower denture.

Loss of the jawbone ridge, allows the lower denture to come into closer contact with tissue extension , which cause destabilizing forces.

In as much as you stated you have worn dentures for thirty years I suspect that you have loss both height and mass in your jawbone ridge. Your lower denture rests on top and on each side of the ridge and relies on it to support your denture. Without a good ridge, the denture can move side-to-side and front to back, making it difficult to chew and speak.

When you got your first denture 30 years ago, you likely had an adequate jawbone ridge. Over the years, the pressure placed on your ridge has caused the underlying bone to re-absorb or “dissolve”. This re-absorption can progress to the point where there is very little ridge left, and thus little or no stabilization. At this point your denture just “floats” on your lower jaw causing you pain when you chew.

Your specialist may suggest that you have dental implants placed. Placing implants into the jawbone and fabricating a denture to connect with the Implant fasteners will greatly stabilize a lower denture. However, if your ridge is inadequate to accommodate implants, you will need to build up your ridge . To this end, the specialist may suggest a bone graft, or surgery to lower the gum tissue.

There is a relatively new procedure developed by a Russian orthopedic surgeon. With the use of small metal plates and screws, the jawbone is surgically cut creating micro-fractures, this results in simultaneous expansion of the soft tissue and bone volume. After a period of time the plates and screws are remoced and the dental implants placed. A lower denture is then fabricated that facilitates connection to the implants. The results are a greatly stabilized lower denture. Although early in its application to dentistry, this procedure looks very promising.

Better smiles for all,

Dr John Russo, “Ask the dental doc.” cannot diagnose or treat patients through the newspaper. Without all available information about a patient it is impossible to make a diagnosis. All answers will be in the form of general ideas. Only you and your dentist can make an appropriate treatment decision. It is the individual's responsibility to use due diligence to determine what is proper treatment.