Loose Dentures

Options for loose denture wearers

Dear Doctor,
My dentures are so loose. I would like to have implants but I am unable to at this time. Can you please give me some information to help me better understand my options?

Dear Shanai,
It would seem from your question that you already understand that implants are your best option. What you may not be aware of is that over time, the continued compression of the tissues under full dentures results in loss of bone and gum tissue volume. The bone that formerly supported your teeth is not designed to withstand these forces, and in response, it resorbs or melts away over time resulting in what you are experiencing now, loose fitting dentures. The beauty of implants is that they stop the resorptive process by actually stabilizing the bone to prevent further loss.

Having said that, loose dentures are a common problem for people who are full or complete denture wearers, especially if you have worn them for a long time. Whether or not new dentures are needed depends not only upon the condition of your existing dentures, but also how much the supporting tissues have changed.

Over time, the continued compression of the tissues under full dentures results in loss of bone and gum tissue volume.

A number of questions therefore arise to determine the next best option to implants in an effort to stabilize your dentures:

• Are you satisfied with the appearance of your denture teeth?
• How worn are they?
• Is your bite still functional?
• Can you eat and chew properly?

Your dentist will help you assess if it is in your best interests to make new dentures or reline (refit) your existing dentures as an interim measure.

There are some tricks to improve the fit of your dentures temporarily. Relining dentures is generally necessary when full (removable) dentures become loose, after years of wear. Because the rate of bone loss differs from person to person, some denture wearers may need more frequent relines than others. Upper dentures tend to fit better and be less problematic than lower dentures because they have a much larger surface area on which to suction and rest.

There are two ways to reline your existing dentures:

• A temporary reline necessitates adding a layer of material under the denture in your mouth while you are in your dentist's chair. This involves taking an impression (literally impressing material under the denture with a plastic or moldable material) that hardens and fills the void created where the oral tissues have shrunken away from the denture. This approach will generally stabilize the denture for a short period of time.
• A more permanent reline requires an indirect technique where material is added to the denture in the mouth in much the same way as described above for a temporary reline. However, the denture then needs to be sent to a dental laboratory to replace the temporary material with more permanent denture plastic, usually “methacrylate” (meth-a-cri-late). The advantage of a permanent reline is that it is longer lasting; although, it does mean that you will be without your denture for a day or more.

Dental implants are generally the best, if not only, option for long-term denture wearers with extremely loose fitting dentures.

If your dentist feels that a reline will not achieve the fit and stability desired, then remaking the dentures is the next option to consider. Other reasons for remaking the dentures are the wear of the denture teeth, poor esthetics, and poor condition of the denture's base material.

In spite of the best efforts of the dentist and laboratory, satisfaction cannot be guaranteed with the fit and function of previously loose dentures, particularly if you have extensive bone and gum tissue loss. At this stage it may be best to consider any reline option temporary. This is the reason why dental implants are generally the best, if not only, option for long-term denture wearers with extremely loose fitting dentures.

A new denture, particularly a lower one, can be successfully supported by implants. There are a number of options including mini-implants or as few as two implants (the minimum) that can provide stability for a denture. And because you will not need every tooth replaced by an implant, the cost is not as great as you may think. In fact, many people find implants to be a feasible and realistic solution once they compare the ongoing maintenance and discomfort of ill-fitting dentures to the cost and benefit implants provide with many years of successful and stable denture wear.

Improved function, biting, chewing, talking, and smiling will provide you with improved self-confidence and well-being with relined, renewed dentures or implant supported dentures. Ask your dentist about financing plans or consider saving over time so that dental implants can ultimately help resolve your denture problem in a more long-term way.