“Doc.  Just pull out all of my teeth so I won’t have anymore problems with them!”  Ever hear of jumping out of the frying pan into the fire?  Unfortunately, some people loose all of their teeth and have to have dentures made.  Many have their teeth removed and the very same day  have immediate dentures placed.  The age at which you loose your teeth is a big factor in how much bone you will loose under your denture throughout your lifetime.  Did you loose your teeth from decay, trauma or gum disease?  These are also important factors in the long term maintenance of your dentures.

Denture 300x199 Denture Reline: A Common Denture Maintenance Procedure

During the first 8 months after your teeth are extracted your underlying bone structure that used to support your teeth begins to remodel and round off into a ridge.  Some people are blessed with enormous ridges and can hold dentures in their mouth very well. Others are not so fortunate.  During the first 8 months you can expect, on an average, to loose up to 30% of your bone ridge height and width.  The year after your extractions you may loose an average of approximately 3% of the bone annually.  This bone loss can and will make your dentures loose.

Loose dentures increase the usage of denture adhesives and can cause sore spots and even breakage.  A classic example of a loose upper denture is that it rocks on the palate when you eat.  This is because the ridges have shrunk and the palate has not. Eating small pieces of food can be tolerated fairly well but if you eat large pieces such as when you eat bread, the denture can crack right down the middle.  This is similar to cracking a stick over your knee except it is your denture over your palate.  I cannot tell you how many times I’ve heard someone say, “But it was only bread!”

Unfortunately, people with dentures usually do not go to the dentist unless they are having trouble with their dentures.  We try to recall our denture patient every year, but far too many either “no-show” or cancel at the last minute.  They simply do not see the need to have their mouths looked at if they don’t have any teeth.

Reasons for recalling a patient with complete dentures:

  • Sore spots- Some people, believe it or not think if they ignore their denture sore spots they will go away.  They think their denture in like a leather shoe.  Wear it long enough and it will wear in over time.  Sorry, this is not going to happen.  Dentures are made out of hard acrylic and they will NEVER break in.  Instead, the denture must be relieved over the sore spot so it can heal.
  • Epulus Fissuratum- Or really, really big sore spots!  This sore spot has been neglected so long that the tissue is cut by the edge on the denture flange and folded up into a corners of the mouth.  The treatment for this is first relieving the denture sore and letting it heal for a few days/weeks, possibly even placing a tissue conditioner soft reline to help it heal.  If it doesn’t heal completely the excess tissue can be removed with a laser, let it heal and then reline the denture.
  • Oral Pathology- Just because you don’t have any teeth doesn’t mean you can’t get some other kind of disease inside your mouth.  I had a patient who I made a denture for years before and never wanted to come back for recall. Finally they come in with a “denture sore”.  Only it wasn’t a denture sore.  It was cancer.
  • Broken dentures- Broken teeth, flanges and bases are all reasons to be repaired.  If you have several sets of dentures I guess it would not matter to you if one of your dentures broke once in a while.  But if it is your only set and you need them for that important meeting or wedding or whatever, then maintaining your dentures are in your best interest.
  • Dirty denture-  Stains, plaque and calculus can all build up on the denture over time and cause them to look and smell badly. Plus if you do not clean your denture properly and often you may develop a yeast infection.
  • Systemic Diseases- Diseases in the rest of your body can effect the fit of your dentures.  Loosing or gaining weight can make your denture not fit well.

Denture Adhesive

Denture adhesives are a billion dollar industry in the USA alone.  It is used to hold loose fitting dentures in place.  It is commonly misused by most people.  This is compounded by the industry itself not instructing the people how to use their product “the right way” in the first place.  Upper dentures are like a big suction cup stuck to your palate.  They have a lot of surface area to support the denture with and are usually more secure than the lowers.  Adhesive companies say in their ads and product instructions to place two lines of adhesive on either side of the palate.  WRONG!  This may work in the short run but will contribute to rocking by becoming a high spot in the palate.  Instead, think of the denture like tupperware.  It has to have a seal all the way around it.  Denture adhesive is really a paste gasket to keep the air suction in the palate so it will hold up your denture with the minimal amount of adhesive.
The lower denture is a different animal all together.  It has no suction cup area or it is greatly diminished.  Lower denture are the reason why implants were invented in the first place (not really but that is a different blog). Place the paste in a long line right down the middle and hope for the best.  We like to use Fixodent because it has a small opening in the tube and is easier to use.

Relines

Basically, you need to reline your denture when they get loose.  This for most people can be in as little as a year or in as much as 5 years.  Both complete and partial removable dentures should be relined periodically.  This is how we do it in our office.

  1. We first check to see if the dentures are loose
  2. We check to see if there are any sore spots and adjust them out
  3. We check the bite to see if it needs adjustment
  4. We check to see if the dentures are too thick or thin.  They can be too thick from past multiple relines and too thin from being an immediate denture.
  5. We reduce the denture flanges and sometimes palate to keep the right denture thickness
  6. We check to see how your teeth come together so they will look the same when we deliver the new reline(s)
  7. We make sure the impression inside your denture was not too thick or thin before it is sent to the lab
  8. We deliver the dentures and make sure they fit and function correctly.
  9. We do follow up adjustments at no charge for 6 months
At our office we reline denture in an AM/PM appointment on the same day.  Come in in the morning and we make the impression inside your denture(s) and deliver them later the same day.  We usually do not reline denture on a Friday because we only work until 1 pm.

Refrences:

  1. Gerodontology. 2011 Jun;28(2):121-6. doi: 10.1111/j.1741-2358.2009.00332.x. Epub 2010 Jan 14. Effect of thermal cycling on microleakage between hard chairside relines and denture base acrylic resins. Giampaolo ETJorge JHMachado ALPavarina ACVergani CE. Department of Dental Materials and Prosthodontics, Araraquara Dental School, Sao Paulo State University, UNESP, Araraquara, Sao Paulo, Brazil. eunice@foar.unesp.br
  2. J Adhes Dent. 2010 Aug;12(4):319-27. doi: 10.3290/j.jad.a17652. Effect of water storage on the shear strength and fatigue limit of the reline resin bond to denture base resins. Vergani CESeó RSReis JMGiampaolo ETPavarina ACMachado AL. Department of Dental Materials and Prosthodontics, São Paulo State University-UNESP, Araraquara Dental School, SP, Brazil. vergani@foar.unesp.br
  3. Gerodontology. 2011 Jun;28(2):140-5. doi: 10.1111/j.1741-2358.2009.00356.x. Epub 2010 Jan 14. Colour change of soft denture liners after storage in coffee and coke. Goiato MCZuccolotti BCMoreno Ados Santos DMPesqueira AADekon SF. Department of Prosthodontics and Dental Materials, UNESP – São Paulo State University, São Paulo, Brazil. goiato@foa.unesp.br
  4. Gerodontology. 2010 Dec;27(4):283-91. doi: 10.1111/j.1741-2358.2009.00329.x. Experiments on in vivo biofilm formation and in vitro adhesion of Candida species on polysiloxane liners. Mutluay MMOğuz SØrstavik DFløystrand FDoğan ASöderling ENärhi TOlsen I. Department of Prosthodontics, Faculty of Dentistry, University of Oslo, Oslo, Norway. mmutluay@gmail.com
  5. J Prosthet Dent. 2009 Aug;102(2):115-22. Hardness and surface roughness of reline and denture base acrylic resins after repeated disinfection procedures. Machado ALBreeding LCVergani CEda Cruz Perez LE. Department of Dental Materials and Prosthodontics, Araraquara Dental School, São Paulo State University, Araraquara, São Paulo, Brazil. cucci@foar.unesp.br
  6. Gerodontology. 2009 Sep;26(3):232-6. Epub 2009 Jun 22. Relining of prosthesis with auto-polymerizing hard denture reline resins: effect of post-polymerization treatment on flexural strength. Takahashi JMMachado FMNuñez JMConsani RLMesquita MF. Department of Prosthodontics and Periodontics, Piracicaba Dental School, Campinas State University, São Paulo, Brazil.
  7. J Prosthodont. 2009 Oct;18(7):596-602. Epub 2009 Jun 8. Shear bond strength of two chemically different denture base polymers to reline materials. Ahmad FDent MYunus N. Department of Prosthetic Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
  8. Gerodontology. 2010 Jun;27(2):147-53. Epub 2009 Jun 8. Effect of repeated cycles of chemical disinfection on the roughness and hardness of hard reline acrylic resins. Pinto Lde RAcosta EJTávora FFda Silva PMPorto VC. Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
  9. J Adv Prosthodont. 2009 Mar;1(1):1-5. Epub 2009 Mar 31. Wettability of denture relining materials under water storage over time. Jin NYLee HRLee HPae A. Graduate Student, Department of Prosthodontics, Graduate School of Clinical Dentistry, Ewha Womans University, Korea.
  10. J Prosthet Dent. 2009 Mar;101(3):205-13. Influence of denture cleansers on the color stability of three types of denture base acrylic resin. Hong GMurata HLi YSadamori SHamada T. Department of Prosthetic Dentistry, Graduate School of Biomedical Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan. hong@hiroshima-u.ac.jp