Summary
Dentures can be a very cost-effective solution.
Cast dentures are smaller and more comfortable than acrylic dentures.
Full dentures can move around and cause pain or irritation. Partial dentures are usually a better alternative.
The big picture
Dentures come into their own when a patient is missing a lot of teeth. The upper or lower denture can usually be made to replace all of the missing teeth at once, as such they are a very cost-effective solution to many problems, but they have their downsides.
They are removable and should be left out of the mouth every night to allow the oral tissues to ‘breathe’. An excellent example is to put a band-aid on your finger and leave it there for a few days. When the band-aid is removed, the tissues are all pink and puffy. The mouth is much softer than a finger and it need time to recover from being covered by the artificial materials.
The two types of partial denture are a cast denture or an acrylic denture. The cast dentures have a metal framework, and because the metal is so strong the denture can be made very thin. As such, these dentures tend to be smaller and more comfortable. They can also be made to fit the teeth much more precisely, and the load from the bite is taken mainly by the remaining teeth.
An acrylic denture is a ‘plastic’ denture. They are relatively easy to make and are easy to repair. These can be partial (for some of the teeth) or full dentures. Because acrylic is not as strong as metal, the partial dentures tend to be made to simply fit in between the remaining teeth and the load is taken mainly by the gums. Since gum tissue is compressible, the dentures tend to move up and down when you bite with them. This can accelerate gum and tooth disease as any food or bacteria are actively rubbed into the tooth and gum tissues. They can also be more painful because they press on the gums more. We tend to view acrylic dentures as a temporary solution.
Many people are familiar with the image of an older person putting their teeth in a glass overnight. This is usually a full set of teeth and was a reasonably normal situation a couple of generations ago. These ‘full’ dentures have no teeth to help support them in the mouth and they therefore rest on the gums alone. While it is easy to create a good cosmetic result with full dentures, the practicality of chewing with these is a different matter.
Full dentures (especially lower dentures) can move around and pinch the gums very easily. They tend to be loose, and they tend to hurt. Unless there is a lot of bone in the mouth to help stabilize the dentures, we would normally discuss whether the patient could be suitable for at least two implants in the lower jaw to act as retainers and stop the denture moving. The top dentures are often successful because they are large enough to get a form of ‘suction’ but even this is highly variable from patient to patient. Some patients love their dentures, and some hate them. They are a cheap option for a patient with no teeth, but they can affect taste and the temperature and feeling of the food in the mouth.
