dentistry Dominic Thorncroft

Denture Cleaner

Denture cleaners at home consist of manual cleaning, chemical cleaning and both.

All dentures must be cleaned in a similar fashion as cleaning natural teeth because oral bacteria will still build up on surfaces of all dentures. If the denture is not cleaned regularly, it will soon build up bacteria which can harm your gums and any remaining teeth if you still have any.

In addition, an infection called denture stomatitis can arise which is quite difficult to treat once it has taken hold in your mouth.

A denture cleaner can be one that a dentist uses or one that you can use at home.

For a small fee, you can ask your dentist to clean any stubborn marks or calculus on your dentures. Many patients don’t know that calculus or tartar which used to build on your teeth can also build upon the surface of the denture.

This cannot be brushed off manually and needs to be cleaned mechanically using an ultrasonic scaler which the dentist or the dentist’s laboratory have access to.

Denture cleaners at home consist of manual cleaning, chemical cleaning and both.

Manual cleaning consists of using a denture brush with a cleaning agent in the form of a paste. It is perfectly acceptable to use a normal manual toothbrush with a normal toothpaste. However, denture brushes seem to have harder bristles so they can be seen to be more effective.

Chemical cleaning usually consists of tablets which are dissolved in running water and then the denture is soaked in them.

You can also buy mechanical ultrasonic cleaners under the counter.

 A cleaner must have several characteristics in that it must be able to remove bacteria that builds on the denture, must have a pleasant taste, must not alter the colour of dentures and must not weaken the physical nature of your dentures.

Which is the best denture cleaner to use? Without a doubt, manual cleaning using a toothbrush and paste is the best but some patients may have difficulty using this so additional denture cleaners as mentioned above can be used either on their own or as an adjunct.

When you are at the dentists, always ask if they have samples of denture cleaners which they get for free and which you can try out yourself.

dentistry Dominic Thorncroft

Dentures Or Implants

This is a common question amongst patients and it can sometimes depend on who you go to. If you go to an implant dentist, he or she will tell you that implants are the best solution. However if you go to a dentist who specialises in dentures, he will tell you that dentures are better.

In reality, the answer lies between the two.

Implants are not suitable for all situations and likewise, dentures are not suitable for all patients either.

To make an informed choice, various bits of information need to be made available to you. This includes costs. But within this, you need to know the initial costs but also ongoing costs and long-term costs of treatments and possible complications that can occur with any treatment.

How long will the treatment take is a good question to ask. You may not want to or be able to undergo a lengthy complex treatment involving long sessions and many visits.

The chances of success also need to be weighed up appropriately. Although implants may seem a good solution for you, complications may arise and you should be aware of these and how these could be dealt with.

Your expectations with a certain treatment are important. You may need to be aware that if you are having dental implants and dentures made, they may move about and you may not become used to them very easily. On the other hand, having an implant may not have the exact aesthetic results that you expect and you could be disappointed.

Finally, when exploring the decision between implants or dentures, you need to also explore subcategories of each. For instance, dentures have evolved and different types are available as with implants as well.

Always take your time in making the correct decision and be prepared to get second and even third opinions.

dentistry Dominic Thorncroft

Denture Problems

Here is a list of the eight most common denture problems that patients usually experience.

  1. Dentures making you gag and feeling sick/retching. A denture is essentially a foreign body and some patients gag or gip when they have to wear dentures. Many patients gag or gipe initially but over a period of days or weeks, they become accustomed and it no longer bothers them.

If the giping or gagging feeling continues, then a different design of denture may need to be considered or a different alternative treatment altogether.

  1. Rubbing, pinching and gripping dentures, especially new dentures, can rub on the skin inside the mouth called the mucosa. When this happens, it becomes painful and ulcers develop. You can either take your dentures out until the mucosa has fully healed up or you can ask the dentist to adjust your dentures accordingly.
  1. Dentures not being sufficiently tight is an all too common problem. This is known as inadequate retention. Inadequate retention of dentures has several causes and sometimes, dentures just cannot be made any better than they already are.

This is especially true of full dentures rather than partial dentures. Lower dentures also have poorer retention than upper dentures. In addition, the amount of remaining gum you have also has a bearing on the retention of dentures.

  1. Infection can develop under dentures and a common type of infection is called denture stomatitis. This usually develops when the oral hygiene around a denture is poor and when the dentures are kept in overnight whilst asleep.

Denture stomatitis can spread and can cause other problems with the oral mucosa, especially soreness at the angle of the mouth around the lips. It can be cured but may take time to fully eradicate.

  1. Dentures can, if incorrectly designed, cause damage to the remaining teeth or gums in case of partial dentures. Normal amongst the profession are acrylic dentures also known as gum strippers. The design of the partial denture is very important in reducing this damage but also a patients oral hygiene.
  1. Dentures can break at any time. Sometimes they break when a patient drops them but they can also break with continued use in the mouth. A denture reflexes under normal chewing forces and eventually can break due to fatigue.
  1. Dentures can be un-aesthetic if clasps are used and these clasps are in the aesthetic zone. The aesthetic zone is usually around the canine and premolar areas where clasps can be utilised.

Alternatives to this can be by using tooth coloured clasps instead of stainless steel ones or by using flexi dentures such as valplast and flexite dentures which have tooth coloured thermoplastic acrylic as clasps.

  1. Denture teeth can wear away, especially if they are opposed by natural teeth and the enamel of natural teeth is harder than the plastic of the denture teeth. This can reduce chewing efficiency but also cause changes to the bite.

Most common denture problems can be treated; however , every patient is different.

dentistry Dominic Thorncroft

How A Dentist Does A Denture Try-in?

When constructing a full or a complesite denture for a patient, a dentist needs to go through various stages of construction that is common to all denture fabrication processes. 

The minimum number of visits required is four but that can increase to 8 or more.

The first stage is called the impression stage. This is when your dentist will record the details and the shape of your mouth. The more accurate this is, the more accurate the final denture will fit in your mouth.

The impression of your mouth is sent to the dental technician who creates a negative of this and produces something called a stone study cast. The technician will use this stone study cast in order to fabricate your new dentures.

The second stage in fabrication of full or complete dentures is called the bite stage. The  dental technician constructs wax bite rims on the model that has been produced in the first stage. You, as a dentist will then place these wax bite rims in the patient’s mouth and carry out various adjustments.

The various adjustments will represent how the patient will bite when they have the new final permanent dentures. These various adjustments will also include the length of the teeth, the amount of teeth that the patient will ultimately show, the forward protrusion of the teeth, the midline and importantly the curve of the smile line.

There are two curves which are very important and these are known as the curve of Manson and the curve of Spee.

The wax bite pattern is sent back to the technician again and he will then construct a denture try in. 

The denture try-in stage is really like the final stage before constructing the permanent denture and it is a final opportunity to make any adjustments. There are many factors to check at this stage.

 Here is a list of the important practice points to check at this stage.

Firstly, let’s look at the appearance of the teeth and positioning which at this stage are set in wax.

Most importantly, is the shade of the teeth which correlates and is correct as to what a patient would like. It is always important to ask the patient for the opinion because as a dentist you may think that the teeth may be too light in colour but the patient actually prefers  this colour.

We also need to take a careful look at the size  and shape of the teeth. Does the size of the teeth fit in with the patient’s facial size and features? Next the actual detail of the teeth needs to be looked at. This is largely governed by the patient’s finances. On the NHS, you can’t really expect too much other than basic teeth with little fine detail.

Using teeth on a private basis, you have a lot more choice and variety and control over how realistic you want the final teeth to look like. On a private basis, the technician has a larger list of moulds that he can use and many of these are so good that they are almost indistinguishable from normal healthy natural teeth.

The following aspects include that you need to look at the angulation of the teeth. Are the teeth too proclined or are they too retroclined? Once again if there are errors at this stage, they can easily be corrected.

The length of the teeth is important because if they are too long, the patient will look like a horse and in addition the teeth will encroach excessively on the patient’s lower lip.

Finally, we mentioned the curve of Manson and the curve of Spee. In general and as a general guide the curve could mimic the curve of the lower lip with the teeth corresponding to the midline and be vertical and not at a slant.

 Once the denture try-in has been finalised, then you can go ahead and instruct the dental technician to construct the final permanent denture which you will then fit at the following visit.

Although the minimum usual number of dental visits to make a denture is 4, often additional visits are required when taking secondary impressions using special trays, or when an additional try-in is required or when a process has to be repeated.

The photo diagram above is actually a photograph of a denture try-in that we recently did for a patient. We actually replicated what her natural teeth looked like. 

Unsurprisingly, when she received her final denture, she received many compliments and even when she spoke to somebody that she had not seen for a long time, they would be totally surprised to hear that these were not her own teeth but they were in fact denture teeth because they just looked so natural and realistic.