Denture Intolerance
About 30 million Americans wear dentures. However, just because it’s a common condition doesn’t mean that people don’t struggle with dentures. Many wind up with denture intolerance. Let’s take a look at what’s behind the intolerance and what you can do to combat it.
Dentures vs. Teeth
First, it’s important to understand that dentures aren’t the same as teeth. They don’t chew the way teeth chew; they move when biting forces are placed upon them. Many people feel that they should be able to do and eat anything with dentures; unfortunately, that is simply not true. When people understand the limitations of dentures, they can begin learning how to use them, and, if desired, how to rebuild their lost bone to supplement their chewing with the addition of dental implants.
Someone with all of their natural teeth generates 250 pounds per square inch of biting force to chew a raw carrot. People who have been wearing dentures for four or five years may have biting forces of 25 pounds per square inch for eating over-cooked carrots. After your teeth are gone, there is no longer a connection with your brain that tells it how hard you are chewing. The longer the teeth are gone, the harder it is to generate high biting forces with plastic plates that are sitting on your gums. Using dental implants is one way to reestablish this neurological connection between the brain and biting forces. In fact, implant-over-denture wearers are able to return to almost the same forces they had when they had all of their teeth.
Getting used to dentures takes time. New denture wearers have many questions. Here are some of the most common ones, along with tips and suggestions for increasing the comfort of your dentures:
Sometimes my dentures make me gag. What causes this?
It could be your bite. If teeth hit and cause the denture to be driven back into the soft palate, it can cause a gagging sensation. Adjustment of the bite can help eliminate this feeling. Also, the back of the denture where the soft palate attaches to the hard palate is very sensitive and can cause gagging if the hard acrylic rests on the movable soft palate. The dentist can adjust this area until the soft palate isn’t irritated.
My dentist has adjusted it several times and I still gag. What can be done?
Have your dentist keep adjusting it until you don’t gag. Sometimes dentists think that a patient will just get used to it. But for some, the gag reflex is so strong that tremendous denture acrylic must be removed so the patient can comfortably wear the denture.
My upper dentures feel good, but my lowers constantly hurt. Why is this?
Upper dentures rest on the palate or upper jaw. Upper jaws, or maxillas, are a bigger bony area and have larger surface area, so they have more for the upper denture to grip on to. Upper dentures are usually the easier of the two prostheses to get used to.
The upper jaw is attached to the skull so it doesn’t’ move. The lower jaw, or mandible, is on a hinge and moves. When chewing, for example, the lower jaw moves up and down while masticating your food. The tongue moves and the lower denture looks like a horseshoe around the tongue. Every time the tongue moves, the denture moves. The lower denture sits on a smaller bone, and the muscles under the tongue move so when a patient yawns, swallows or sneezes, these muscles all move and work to dislodge the lower denture.
Why does my lower jaw ache with my new dentures?
Another complication of lower dentures is the pattern of bone loss. When lower jaws atrophy, the remaining bone erodes inward and downward and makes the remaining bone sharp and thin so the lower dentures become progressively more painful. It becomes harder to make lower dentures comfortable the longer the bone loss occurs. To make matters worse, as a patient wears her dentures, the bone wears away and the nerves in the lower jaw can be exposed, which can cause “zingers” shocks, or nerve pain. The upper jaw doesn’t have the same nerves that hurt with prolonged denture use. Lastly, lower dentures can move up to ¼ inch with every chewing cycle, which can result in sores, pain and accelerated bone loss.
What can I do to make my lower denture more comfortable?
Ask your dentist if you could get a soft silicone liner in your lower denture.
This liner acts like a cushion and can often grip undercuts in the bone that a hard denture base cannot grip without pain.
Can my dentist do something to help me today with my pain?
Yes they can do temporary soft liners or tissue conditioner treatments to help your gums rest. It’s like putting a band-aid in your denture, as it will take all the pressure off your teeth until another solution can be addressed.
My denture moves a lot, and I use a lot of denture glue to hold it in. Is this normal?
While denture adhesive is recommended, a denture that moves excessively should be relined or remade.
How long should my denture last?
Dentures should be relined (fresh coating of acrylic so it fits tighter) or remade every three to five years. Wearing dentures longer than recommended will not cause physical pain, but it will accelerate denture tooth wear and bone loss.
What happens if I wear my dentures too long?
When denture teeth wear out, a person’s nose and chin get closer together, which will lead to bigger wrinkles and an increasingly difficult time constructing the next set of teeth. When the denture tooth goes away, forces from chewing cause spreading on the denture acrylic and will lead to denture teeth popping off and fractures through the denture base.
Can I superglue my teeth back on to my denture?
No. Using superglue ruins the acrylic and makes the repair more costly and can render the denture non-reparable.
What about denture pads?
Use of adhesive pads may serve a person temporarily but is an indicator that the denture needs to be remade or relined. Using a pad will push the denture up on the skin, change the person’s bite and make it move even more with chewing. This can lead to further bone loss and will result in chewing forces that the dentist did not plan – causing rocking, tipping, sores, pain and bone loss.
Use of adhesives in general can help to create an oxygen-free zone and can help make the denture move less. So small amounts of adhesive can be a wonderful adjunct for denture wearers.
I feel like my dentures look like horse teeth. What can I do?
Bring in photos of when you had your teeth, regardless of your age, to help the dentist construct a smile you are more familiar with.
I want to eventually get rid of my dentures. How many implants would I need to get rid of the upper and lower plate?
Some dentists use an all-on-four implant philosophy; others require a minimum of six implants in the upper and lower arch to make a palate-free maxillary denture or upper and lower fixed bridges. If a full arch of teeth is 14 teeth, using six implants is the minimum number many dentists use to place a palate-free denture. It is always better to over-engineer a reconstruction so that if an implant fails, it doesn’t necessarily mean the entire prosthesis will fail.
What can I do to prevent denture sores?
See the dentist twice a year for a professional denture cleaning, oral cancer examination and an occlusal evaluation to check your bite and ensure your dentures are in good condition. It is also a great idea to have two sets of dentures, so that if a denture tooth pops off or the acrylic breaks, you never need to be without your teeth! These are called spare dentures (or embarrassment dentures) and can be a very worthwhile investment.
How should I clean my dentures?
Using washcloths dipped in Listerine (or any mouth rinse of your choice), scrub the gum tissues. This keeps your gums clean and bacteria- and yeast-free and helps toughen up the tissues. The dentures should be scrubbed with a denture brush and denture cleaner and then soaked in a denture bath to further eliminate germs that can cause bad breath and lead to accumulation of debris on your dentures.
One final word: it is a good idea for a dentist to use soft-tissue conditioners prior to making a new denture to ensure the gums are at rest, there are no sores and they aren’t duplicating the fit of your new dentures to traumatized or sore gums.
