Patients normally look forward to the day when they receive their new dentures. They are happy about the prospect that former dental problems will soon be over. Then, the day arrive then the new dentures are inserted and they are frequently shocked that a new array of dental problems are just beginning. In order to receive the maximum service and satisfaction from new dentures, the patient must understand certain relevant and pertinent facts – whether they have previously worn dentures or not. Many misconceptions and erroneous ideas exist concerning the use and care of complete dentures.
Printed instructions have an important role in modern informed consent; and it is essential that the expectations of the patient and dentist are alike. It must be emphasized that both the dentist and the patient have an important role in the outcome of the complete denture service. The following patient instructions are based on the research and experience of many prosthodontists, over many years, and are intended to provide practical methods for mastering the use and care of new dentures.
Introduction
The art and science of prosthetic dentistry had advanced rapidly during recent years and new techniques and materials have greatly improved our ability to replace missing tissues with functional and natural looking artificial appliances or prostheses. However, it must be remembered from the outset that no prosthesis or artificial substitute, regardless of how painstakingly fabricated, will ever function as efficiently as the original living tissues. Research has shown that the chewing efficiency of experienced denture patients is, at best, less than twenty percent as efficient as the average chewing efficiency of patients with natural teeth.
Your mental attitude and adaptability are of utmost importance to learning to use new dentures. Do not expect too much from them, especially at first. The dentist can only provide the denture treatment and then advise you. You must have the patience and perseverance to learn to use the dentures.
Just as learning to swim, or skate, or ski, or ride a bicycle can be traumatic experiences, so it may be learning to use new dentures. These are all physical skills that must be learned and no one is an expert in the beginning. The length of time required to learn to use dentures varies and depends on many factors such as age, general health, nutrition, muscle tone, tissue condition, coordination, and mental attitude. Since no two patients are exactly alike, all patients cannot expect the same degree of skill or success in using dentures. However, it should be remembered that millions of other people have learned this skill and the odds are likely that you will too.
Please beware of relatives and friends who are denture wearers. Most dentures wearers consider themselves experts on the subject and are eager to give you advice based on their experience. Such advice can be inaccurate and harmful to you. Seek the advice of only one expert, your dentist, who has the training and experience to treat your specific problems.
Many denture patients would like to ignore the fact that they are, to a degree, handicapped. It is evident that a man with an artificial leg would have great difficulty becoming a professional football player. The denture patient must also learn to live with certain limitations. Since you will be wearing dentures from now on, it is no disgrace to use them in a manner that will help insure your ability to wear them in the future. Despite the limitations, your dentures will restore your appearance, speech and ability to chew – when you master their use.
The First Few Days
For the first days after receiving new dentures you should expect only to be able to keep the dentures in your mouth. Chewing should be limited to soft foods and the dentures should be worn all night the first night only. Dentists normally insist on an adjustment the next day. Movement of the dentures during function sometimes causes red spots to develop during the first 24 hours which would become painful denture ulcers, if not treated.
Some patients experience an initial abundance of saliva which is stimulated by the presence of the new dentures. Soon the salivary glands will adjust to the presence of the dentures and resume their normal production. Until then, you should simply swallow more frequently.
Occasionally, patients experience a gagging sensation when they first begin to wear dentures. Gagging is a reaction that will gradually disappear as the dentures are worn. Do not insist that the upper denture is too long. Anatomic landmarks determine the exact length of the denture and the seal or suction will be destroyed if the denture is shortened. If this problem occurs, consult your dentist, but remember that this is a problem that you must largely overcome through perseverance. Frequently patients have the sensation that the tongue is too confined and interferes with the stability of the lower denture. This is particularly true if the back teeth have been missing a long time or if a previous denture was not properly below the flattened, filling the space of the missing teeth. As the new denture is worn, the tongue will retain its muscle tone and become narrower and more rounded. The dentist may thin the tongue sides of the denture to help this problem.
Denture irritations or sore spots will invariably develop and will require adjustment by the dentist. These irritations are caused by movement of the denture during function. Time is available each week for such appointments, so please call and reserve a time if problems develop. Never attempt to adjust or repair a denture yourself. If an area is particularly sore, leave the denture out as much as possible until the day of the adjustment appointment and rinse your mouth frequently with warm salt rinses. If a severe sore spot develops which prevents wearing the denture and an appointment is made for adjustment, please wear the denture for 24 hours prior to the appointment. This will greatly aid in locating the exact location of the area, and make adjustments significantly easier and more predictable.
Difficulty in speaking is another hurdle which must be overcome with patience and practice. Speech may be altered, and may require adaptation of the tongue and lips. Speech patterns will improve only after the tissues of the mouth become accustomed to the new dentures and control of the lower denture is learned. If you watch yourself in a mirror and say the sounds that give you trouble, this sometimes helps the speech “computer” adapt to the new dentures.
Mastication (Chewing)
The greatest problem by far is relearning to eat. Eating with complete dentures is quite different from eating with natural teeth. Natural teeth are embedded in bone and have individual sensory nerves capable of sensing pain, pressure and temperature. A denture, however, functions as a single tooth, is anchored to nothing, feels nothing, and rests on soft, movable tissues covering the jaw bones. If a denture is to remain stable during chewing, the forces of chewing must be distributed uniformly over the denture bearing surfaces. Forces applied to only one side of the denture will compress the tissue under that side, while tipping the other side away from the tissue and breaking the seal. Although some patient are proud of the fact that they can take bites out of such things as apples and corn-on- the-cob, it must be pointed out that dentures were never intended for biting things off with the front teeth. A denture is like a canoe – if you stand up in front of a canoe, it will tend to upset. The long term result of this practice is damage to the underlying bone. One solution to the problem of chewing with complete dentures is learning to chew simultaneously on both sides. Brittle foods such as saltine crackers may offer good practice. Place half a small cracker on one side and half on the other side. Attempt to chew slowly and thoroughly and then swallow. At first, this two-sided chewing may seem difficult because we tend to chew on one side only with natural teeth. Two-sided chewing can be learning and it is probably better to chew on both sides at once with complete dentures.
Get in the habit early, especially in social situations, of selecting foods which can be eaten with a knife and fork. Cut the food into very small bites which can be placed on the back teeth. Methodically chew on both sides at once until it can be swallowed. Gradually, this process will become natural and rarely will anyone be aware of your denture limitations – unless you call attention to them yourself. Some patients find that the use of commercial denture adhesives are helpful during this learning period and they often become accustomed to the confidence provided by additional adhesion. Certain foods are often avoided by denture patients, i.e., tough fibrous meats, tough breads and hard rolls. Tiny, hard particles that cannot be softened by saliva can be extremely painful if they get under the dentures. Examples are strawberry and raspberry seeds and particles
Caring for the Dentures
Proper cleaning of your denture is important to prevent stains and bacteria from accumulating on your appliance. Since cleaning procedures differ for various types of appliances, please follow the directions given to you at your insertion appointment.
Do not wear your complete or partial dentures to bed. It is important to allow your gum tissues and jaw bones to rest in order to prevent further tissue irritation, infection, and future bone shrinkage.
Over time, or with weight loss or gain, the supporting gum tissues and bone may change shape and size. Periodic relines of your dentures may be necessary to ensure a retentive fit. Denture teeth may wear or chip over time. For this reason, an annual check of your tissues and dentures is recommended.
