Over time, this gap increases in size due to shrinkage of the jawbone and changes in the gum tissue. As this space enlarges, the denture becomes less stable and retentive – especially in the lower jaw where the tongue can easily dislodge the denture.

Dentures adhesives were developed to fill in this space. The sticky contact between the denture base and the gum tissue will improve suction and make the denture more retentive. Most patients prefer thin pastes compared to powders, since they are easier to manage and apply.

However, the use of denture adhesives, while creating better retention, creates a false sense of security for the patient. It serves as a temporary fix for an ill-fitting denture that needs to be relined or replaced. Also, denture adhesives are very messy and difficult to remove from the denture or the mouth. These adhesives need to be cleaned off the denture and mouth at least once a day. Add to these disadvantages the cost factor of purchasing adhesives on a regular basis, and many would conclude there are much better alternatives for denture wearers.

One such option is to have ultra narrow implants installed that will provide the same retention and stabilization for your denture without messy, time-consuming adhesives. Their placement will also slow down the shrinkage of your jawbone and minimize or prevent sore spots from dentures rubbing on the gum tissue.

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Conversely, dry mouth [Xerostomia] may lead to loose dentures, irritations, sores and possible infection for denture wearers.

Common Causes of Dry Mouth:

• Medications-

  There are over 500 commonly taken medications that can cause dry mouth as a side effect. Some of these include blood pressure medicine, decongestants and anti-depressants.

• Illnesses-

  There are systemic conditions such as Sjogrens’s Syndrome, chronic diarrhea, salivary gland tumors and liver dysfunction that can reduce the amount of saliva production.

• Habits-

  Breathing through one’s mouth regularly or inadequate consumption of fluids, causing dehydration may also contribute to dry mouth.

• Radiation Treatment-

  A side effect of some radiation therapy that is use to treat certain cancers is reduced salivary gland function.

• Aging-

  As a person ages, it’s common for their salivary glands to produce less saliva, and, thus, a dry mouth results.

Managing a Dry Mouth

If a particular type of medication is a contributory factor to a patient’s dry mouth, they should consult their physician to see if there is an acceptable alternative drug that doesn’t produce dry mouth side effects. No medication should be arbitrarily stopped without first checking with the doctor whom prescribed the medication.

There are substances [Sialagogues] that stimulate the production of saliva such as sugar-free hard candies and/or pharmaceutical sialagogues that may be prescribed by a physician or dentist. There are also commercial salivary substitutes that can keep the mouth moist and more lubricated. Often, just regularly rinsing with water and consuming increased amounts of water will hydrate the oral tissues, and in some instances, facilitate increased saliva production. However, there are specific medical conditions such as congestive heart failure where increased consumption of fluids is not healthy, so your physician should be consulted first.

For those individuals that are unable to wear dentures comfortably because of severe dry mouth conditions, another alternative would be the installation of ultra small implants to retain and cushion your dentures.

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However, atrophy of edentulous jaws may limit implant placement in the mandible. Anatomic limitations and resorbed alveolar ridges may compromise implant number, length and inclination. The use of standard diameter implants to support an overdenture often requires ridge augmentation procedures in order to place the implant in bone of sufficient volume. On the other hand, in patients of advanced age, having serious medical problems or using anticoagulant therapy, placing more than one standard implant has been shown to have statistically significant increased risk of surgical complications. Small diameter implants placed with flapless surgery to support pre-existing conventional dentures present a method of restoring patients with atrophic mandibles. Advantages of this procedure include implant placement without any bone augmentation surgery, minimally invasive surgery resulting in virtually no bleeding, decreased pain and a decreased cost of treatment.

Clinical data in this study was obtained from an Implant Dentistry Database (IDD) at thr Department of Periodontology and Implant Dentistry New York University College of Dentistry (NYUCD) Kriser Dental Center. This data set was extracted as de-identified information from the clinical information stated from this routine treatment of patients. The IDD was certified by the Office of Quality Assurance at NYUCD. This study is in compliance with the Health Insurance Portability and Accountability Act (HIPAA) requirements.

The patient satisfaction questionnaires showed that after two months of immediate function with small diameter implant supported overdentures (SDISO), patients cleaned very well three times a day and removed the dentures at night. Patients reported wearing the SDISO for longer periods of time than the complete denture (CD) during the day. There was also a significant increase in patient satisfaction with improved denture retention during function, improved patient comfort, and a decreased use of denture adhesives with SDISO compared to CD. There was a higher satisfaction level reported with the occlusion of the prostheses, as well as an improvement in reported ability to understand the patient’s speech with SDISO. The data from the present study also showed that patients had a significant overall appreciation for increase comfort and confidence in social life with SDISO compared to complete dentures.

This is an abstract from “Immediate Loading of Small Diameter Implants in Severely Atrophic Mandibles” Tai, Chih-Han; Lee, Ming-Che; Saito, Hanae; Classi, Anthony; Cho, Sang-Choon; Froum, Stuart; Elian, Nicolas; Tarnow, Dennis at the Ashman Department of Periodontology and Implant Dentistry, New York University.

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Common Problems/Concerns:

• Change in Facial Expression–

  It takes some time for your facial muscles, cheeks and lips to adjust to the feel and position of your new denture. So don’t be surprised if your normal expressions appear altered a first.

• Excessive Saliva–

  The digestion process starts in your mouth. Any time something foreign is placed in your mouth, like food for example, your salivary glands are stimulated to produce increased saliva. Usually, it takes several days for excessive salivation to return to normal.

• Soreness–

  The soft tissue in your mouth is very sensitive and can become inflamed or irritated by pressure or rubbing caused by your new dentures. It is normal for sore spots to develop. The denture may need to be relieved [cut back] in the sore spot areas and bite adjustments may have to be undertaken by your dentist during follow-up visits for several weeks after receiving your dentures.

• Speech Problems–

  Our teeth affect they way we speak and how we pronounce certain sounds. By definition, a denture is different than your natural teeth and may, at first, create some speech difficulties. Be patient. Practice reading out loud and repeat words that are not coming out clearly.

• Difficulty in Chewing–

  Chewing may cause discomfort until all the initial adjustments are made to your dentures and the sore spots have healed. Pending the adaptation of your facial muscles to the new denture and correction to your bite by the dentist, chewing may present problems. Begin the relearning process with small bites of softer food and gentle chewing. Minimize side-to-side jaw movement at first, and use an up-and-down chewing motion. As chewing becomes more natural, try some harder foods.

• Kitchen Sink Syndrome–

  Initially, the presence of new dentures may create the sensation that you have everything in your mouth except the kitchen sink. The new dentures are strange to your mouth, and you will need several days to several weeks before this fullness felling will dissipate.

• Feeling of Looseness–

  Until your dentures settle into place and your dentist makes the final adjustments, your cheeks and tongue might try to dislodge your dentures, causing looseness and sliding or rubbing. If this sensation occurs, try closing your mouth, bringing your lips together, and suck gently on your dentures. Be patient. Before long, your dentures will settle into place, and the suction and fit will improve.

• Gagging/Nausea–

  For some people, new dentures may set off a gagging reflex or bring on some nausea. Often, it is related to the “feel” of the denture on the upper palate. Adjustments can be made by your dentist to alleviate this situation. Usually, any nausea will dissipate in a few days.

Many of these initial problems and concerns can be minimized or prevented with the installation of ultra small implants as part of the treatment plan.

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Signs/Symptoms
Oral cancer can affect any area of the mouth, including the gums, tongue, cheeks, roof of the mouth, lips, and hard or soft palate. The tongue is the most common area to develop intra-oral cancer with the floor of the mouth close behind. Individuals can look for the following signs & symptoms: (1) White patches, mixed red & white patches and/or bright red smooth patches. (2) Sores on the face, neck, lips or mouth that haven’t healed in two weeks (3) Difficulty swallowing (4) Swellings or lumps in your neck, lips or mouth (5) Bleeding in your mouth (6) Numbness, pain and/or loss of feeling in your face, neck or mouth. (7) Hoarseness that lasts for a long time.

While self-examination is recommended, these signs & symptoms can be caused by many other conditions that are not cancer. But it is prudent to be cautious. There is no substitute for having semi-annual examinations at your dental office. If the dentist has concerns a biopsy can be performed to confirm any diagnosis. Early detection if the key to higher survival rates.

Risk factors:

• Tobacco–

  Almost 90% of individuals that develop oral cancer use tobacco in the form of cigarettes, cigars and pipes or as “snuff” [chewing tobacco]. The risk increases with the amount of tobacco taken and the longevity of the habit.

• Excessive Alcohol Consumption–

  About 75-80% of all oral cancer patients drink a lot of alcoholic beverages. The combination of smoking and excessive alcohol is a combination that significantly increases a person’s chance of developing oral cancer.

• Exposure to Sunlight–

  Constant exposure to the ultraviolet light from the sun greatly increases the odds of developing cancer of the lip.

• Age–

  The majority of people who are diagnosed with oral cancer are over 40 years old. The likelihood of developing oral cancer increases with age. Half of all patients with oral cancer are over 65.

• Irritation –

  Chronic, long-term irritation of the soft tissue in the mouth causes sores and ulcers that may be precancerous. Poorly fitting dentures have been implicated as a risk factor for developing oral cancer. However, there have been research studies that have shown no difference between denture wearers and non-denture wearers in the incidence of oral cancer. There is some speculation that ill-fitting dentures tend to trap proven causative agents such as tobacco particles and alcohol residue against the gum tissue, thus increasing the chance of oral cancer developing.

Your dentures can be stabilized so that rubbing against the gum tissue causing irritation can be minimized.

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Your jawbone and gums may shrink. If the dentures are allowed to dry out for an extended period, they can change shape. If dentures are placed in boiling or very hot water, they can warp and no longer fit. If a gap develops between the denture and the gummy ridge, the denture may need repeated relines. Shrinkage of the bone and gums can be minimized or prevented with a proven technique. Click here to learn more about implant-retained dentures. [link this to “How it works.”]

…Denture Wearers Should Visit a Dentist Regularly – Just because you no longer have teeth that doesn’t mean you can no longer have problems. Your dentist needs to assess your oral conditions, and this should be done twice a year. You should receive an oral cancer screening, and the dentist can check for other systemic diseases, such as diabetes, that may show up in the mouth. Over time, changes in your jaws and/or face affect the fit of your dentures or cause irritations or infections. Some medications that you may be taking for high blood pressure or chest pain can cause an overgrowth or enlargement of gum tissue and affect the way your dentures fit. Your dentist may also review your medical history and medications as part of the examination. Odors, calculus [tartar] and heavy stains can be professionally removed by the dentist or the hygienist.

…Dentures can Appear Natural Looking – Some people are embarrassed by the “tell-tale” signs of a person wearing a denture [“plate”] because of the slipping or clicking of their dentures or their flat, worn teeth. Denture wearers should be able to speaking normally and eat without their dentures popping out of their mouths. Not only can dentures be constructed to look cosmetically pleasing and natural, but dentures may actually make a person look younger. The red plastic “gum” of your dentures may increase the fullness of your face and support your facial muscles so that aging lines and wrinkles are minimized. Stability and retention are critical to these factors.

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The most effective method to preserve your dentures is daily brushing combined with soaking the denture in a denture cleanser. To keep your dentures clean, rinse away loose food particles with running sink, lukewarm water after each meal. Using a soft nylon brush with mildly abrasive denture toothpaste or cleaners, scrub all surfaces gently.

You may soak your dentures in a denture cleaner solution for 30 minutes each day to prevent odors caused by absorption of fluid and/or bacteria and remove deeper stains from the acrylic. Rinse off with water.

Precautions

1. Dentures may break if dropped on a hard surface; bush over a water filled sink or a towel.
2. Refrain from soaking your denture in boiling or hot water. These may cause the denture to warp and become ill-fitting.
3. Avoid hard bristle brushes, scouring powders or abrasive cleaners that might scratch the denture. Scratches make the denture more susceptible to sticky plaque, debris and stain.
4. If hard deposits [tartar] attached to your denture, refrain from using sharp metal instruments to remove the tartar. This is the time to take them to a dental practitioner for a professional cleaning.
5. Do not let your dentures dry out. Keep them moist when outside the mouth, so they will maintain the proper fit.
6. As part of the maintenance process, it is recommended that dentures be left out of your mouth while you sleep to give your gums a chance “to breath” without the irritation of rubbing dentures. However, there is now a proven procedure that will allow you to sleep with your teeth.
   

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