Dentures don’t fit?

It happened in our office again just last week. And seemingly, it happens almost every week. Here’s the line—”I’ve just had a denture made, and it doesn’t fit right.” I check it, and it fits as well as it’s going to fit. What’s the problem? Often, it’s not the denture. It’s you.

Now this is not an excuse for a denture that doesn’t fit right. That sometimes happens too, and with minor corrections, that can be remedied. This is for the person who says, I’ve never had a denture fit as well as the first one.

Now why would that be? Denture materials, if anything, have improved over the years. The impression materials that we use likewise have improved. The denture impression procedure is critical, and this is a skill that most dentists master in dental school. It’s one of the fundamental procedures that we learn before we ever get into practice. So if it’s not the materials, and it’s not the dentist, what could be the problem?

The minute the teeth come out, the bone that held the teeth shrinks away. For some, it’s a gradual shrinkage. For some, it’s more dramatic. For almost all, the shrinkage continues over time, simply due to the pressure of the denture on the ridge. Every time you bite down, every time you clench your teeth, you are placing pressure on the ridge. And that pressure results in shrinkage of that ridge. We call it “ridge resorption.” Did your dentist tell you to take your dentures out at night? It was to help prevent shrinkage of the ridge, because we often clench our teeth at night.

The ridge shrinks, and of course the denture doesn’t. So what else happens over time? Do you notice that the lower third of your face is shorter? That your chin is closer to your nose? That’s because of ridge resorption. Do you notice that your lower jaw juts out when it didn’t before? Same thing—ridge resorption. How about your nose sticking out farther than it used to because your upper lip puckers in? Ridge resorption again.

Here are some methods that help limit ridge resorption. 1. Save your natural teeth, if you can predictably. 2. If you wear dentures, take them out as much as possible and certainly at night. 3. Get dental implants, preferably as closely as possible after you lose your teeth.

Resorption starts on the first day that you lose your teeth. Denture wearers are often the people least likely to see the dentist on a regular basis. But the need for dental care never stops. Your dentist can check for resorption, reline or remake your dentures, and adjust your bite to minimize the damage that may otherwise occur. Don’t let the loss of your teeth stop your dental visits. Just as you need your physician to monitor your health, you need your dentist to monitor your oral health.

Lee N. Sheldon, DMD