Options for Lower Dentures

Dentures are prosthetic appliances used to replace missing teeth. Denture construction began in approximately 700 BC when the Etruscan people in Italy made them with cadaver or animal teeth. The most famous early dentures were that of George Washington, who had a set made from wood. With advances in technology, the process of dentures has improved with the use of metals and acrylic. There are several denture options for replacement of missing lower teeth.

Reasons For a Lower Denture

• With proper care and nutrition, human teeth are intended to last a lifetime. The causes of tooth loss vary, such as congenital defects, decay, drug use, mouth injury and certain medical treatments. However, the most common cause is periodontal disease. Periodontal disease causes the supporting bone around the teeth to deteriorate, breeding bacteria, disease and causing the teeth to loosen and sometimes come out on their own. Left untreated, it becomes necessary for the teeth to be removed and replaced with a denture. Lower dentures are a last resort, recommended when the teeth are already missing or cannot be saved. Lower dentures are harder for the patient to adapt to than an upper denture.

Lower Partial Denture

• A lower partial denture is the most conservative denture procedure. The dentist removes the teeth in the worst shape, leaving the rest as anchors for the partial. Best results come from tooth removal and healing time prior to making the partial denture. However, for esthetic reasons, often the partial has to be made while the teeth are still in place. The dentist will remove them and place the new partial directly over the extraction site. A partial denture will use a custom fit, chrome frame with metal extensions fitting where the teeth are missing. The framework that sits on the gum is padded in pink acrylic called a saddle, with realistic teeth molded directly into the saddle. The metal frame has prongs that wrap around, holding onto the anchor teeth. A partial denture will require some adjustments by the dentist over time before it is fully functional.

Full Lower Denture

• Full lower dentures are made entirely of acrylic. Like the partial denture, best results follow tooth removal and healing taking place before a denture is made. Many patients choose an immediate denture, requiring the tooth removal and the denture placed over the extraction site. Acrylic used for the denture resembles real gum tissue as much as possible. It fits right over the ridge of bone, on top of the gums where the teeth were removed. Functional, realistic teeth are embedded in the acrylic. Lower dentures, whether immediate or routine, will require adjustments over time. The acrylic may be thicker than necessary, resulting in sore spots, or maybe the bite is off. Usually all issues can be resolved and the patient has a working, complete lower denture.

Full Lower Denture with Implant Support

• Over the years after tooth loss, the bone ridge continues to diminish because it no longer has teeth to support. This happens on both upper and lower arches, and is more extensive on the lower ridge since it is smaller than the upper ridge naturally. Often the bone gets so thin the denture literally flops about in the patient's mouth, not suitable for chewing or speaking. A new denture can be made, but not before the patient has an implant procedure. Implants are surgical steel or titanium metal posts drilled into the remaining bone of the lower ridge, one on either side of the jaw. Occasionally bone loss is so critical that gums have to be surgically opened, with metal framework placed directly over the bone. The gum tissue is closed and sutured around it. The metal integrates with the bone over time due to the artificial bone granules. Once healing occurs, a new lower denture can be made with precision attachments made to snap in place onto the protruding implant screws. With success and likely adjustments, the patient will have a functioning lower denture.