Dentures are artificial appliances designed to replace lost teeth and other associated oral tissues. They may be constructed to replace all the teeth (complete dentures - see figure 1) or some of the teeth in a mouth where natural teeth remain (partial dentures). In addition more complicated designs are used to restore surgical loss of tissue or to close communications between the mouth cavity and the nose or air sinuses (obturators).

Tooth loss can occur for a variety of reasons but becomes more common as people become older. It is becoming rare nowadays for people under the age of 35 to be wearing dentures unless as a result of loss of teeth/tissue due to trauma.

Treatment

The treatment of patients requiring dentures is undertaken by a registered dental practitioner, and can be provided under the National Health Service or privately. Although the technical aspects of denture construction may be undertaken by a dental technician, technicians who advertise denture construction direct to the public via newspapers and yellow pages are not qualified or registered practitioners and are working illegally.

In constructing dentures the dentist will take impressions of the mouth, record the relation of the upper and lower jaws (the bite), check this in conjunction with the patient and provide and insert the dentures. This will take about 5 or 6 appointments of approximately 30 minutes each.

The Appliance

Most dentures will be constructed in plastic (acrylic resin) and will carry plastic teeth. The colouring of the plastic can be modified to suit the ethnic background of the patient and teeth are available in a wide variety of shades and sizes. Quite commonly, partial dentures are constructed in metal (cobalt chromium alloy) and more expensive porcelain teeth are also available.

All dentures should be removed after meals for cleaning and should also be removed at night. As a rule of thumb they should be replaced every five years.

Outcome

When completed a denture will restore both function and appearance. Whilst the vast majority of patients can wear dentures without any problems there still remains a significant minority who will have problems with retention, discomfort and adaptation, all of which become more common with increasing age and the slow reduction of the amount of bone remaining in the jaws. In any event it is unrealistic to expect a denture to function as well as natural teeth and patients must learn to accept limitations.

Other Treatments

Alternative treatment to the provision of dentures for patients who have lost all of their natural teeth and have difficulties controlling or adapting to dentures might include implants. For patients who still have natural teeth remaining, other forms of treatment might include implants or bridges or both.

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