For patients who already have dentures, or those whose teeth are too far gone to save, complete dentures are necessary. Upper dentures work quite well, as suction and the shape of the jaw holds them in place. Lower dentures are another story; they float around during talking and eating. Using them is an acquired skill, and some people never acquire it. Because of this, we strongly recommend trying to save at least one root on each side if possible. Small clips can be attached to these roots to stabilize the lower denture. If no teeth are restorable, implants and clips are an option.
“Immediate Dentures” are inserted at the same appointment as the teeth are extracted. This has obvious advantages, since it takes up to six months for the gums to heal after extractions, and nobody wants to run around without teeth that long. The procedure is a bit more complex, and there are more follow-up appointments to adjust the denture. The denture has to be “relined” later to fill in where the gums have shrunk, and the cost is thus higher.
Sometimes a number of teeth are missing—not enough to require full dentures, but too many to allow for a bridge (or making it too expensive). In this case a removable bridge or “partial” is an option. For about the cost of two crowns, this replaces all missing teeth. Disadvantages are that the partial is not as solid as natural teeth; there are clips, usually visible, holding it to the remaining teeth; and unless brushing and flossing is done exceptionally well, the remaining teeth can get cavities. Partials can be combined with implants or the root clips mentioned above.
Dentures must be removed and cleaned after meals, and should not be worn at night. Wearing them at night leads to yeast infections, and increased bone loss–the tissue needs access to oxygen to be healthy. In the past we have advised those who cannot tolerate them at night to at least remove the for 30 minutes a day–perhaps before/during/after showering. A recent study has shown that wearing dentures at night leads to increased risk of pneumonia. Evidently the bacteria on the dentures get inhaled during sleep. The best option is to clean them before bed, store them in liquid, then clean them again in the morning before wearing.