What are the Benefits of a Removable Partial Denture?

The main benefits to a partial denture are:

• Improved appearance and self- confidence. Having your smile back will of course do wonders for you confidence and ability to socialise.

• Better chewing. It will restore your bite and ability to chew.

• Improved speech. Your front top teeth are very important in making certain sounds- V and F are made when the bottom lip contacts the edges of the central upper incisors.

• Prevent teeth moving and the consequences of missing teeth. If spaces are left long term, we commonly see the teeth opposite over-erupt. Over many years, they can grow to almost touch the other gum. If at this point, you decide you want something done, the treatment isn’t going to be so simple. Neighbouring teeth to the space can also shift and tilt creating areas that lead to food packing, plaque accumulation, gum disease and tooth decay. The longer spaces are left the more chance of movement and problems. However not all teeth will move and if they haven’t for a number of years, it is unlikely they will start.

• Reduce the risk of TMJD

• Prevent facial changes- by helping support your muscles, cheeks and lips

• Protect other teeth. Reduce the likelihood of problems with other teeth by taking pressure off them. The fewer teeth you have, the increased stress they receive and the greater the risk of tooth wear, periodontal disease and the more likely fillings and restorations are to fail.

• Preparing for further tooth loss- by allowing you to develop the necessary muscle control for wearing complete dentures successfully in the future.

What are the Potential Risks of having a Removable Partial Denture?

There are a number of risks with having a removable partial dentures. These are:

• Plaque. If you are wearing a partial denture, it will increase the amount of plaque in your mouth if you don’t properly care for both your denture and your teeth. As we know- dental wise- plaque is the root of all evil.

It will cause:

(i) De-calcification andtooth decay

(ii) Gingivitis

(iii) Periodontal disease (gum disease).

• Resorption. Any denture that rests on your gums (mucosal borne denture) will put pressure on your ridges and underlying jaw bone and cause resorption over time. A poor fitting denture, lack of care on your part, or both, will accelerate the process.

• Trauma. If not properly designed your partial denture may directly traumatize your gums, or cause wear and abrasion of your teeth from the incorrect position and design of clasps.

• Worsening of tooth mobility. If the partial denture is not designed properly, it can mean excessive forces are put onto the teeth in directions and angles for which they were not intended. Instead of supporting the remaining teeth, this can cause them to shift and even become more loose.

• Bite problems. If the bite of the denture is wrong, your teeth may not close normally and you can hit part of the denture before anything else- this is known as a ‘premature contact’. This can put extra pressure in that area making pre-existing periodontal disease worse, causing problems with the gums, more resorption of your bone, or mean your muscles may adjust the way you close your mouth to avoid it. This can put increased stresses on some of the muscles you use for chewing resulting in TMJD and facial pain.

• Root caries. The older you get, the more recession on your teeth you will have from brushing, gum disease, denture clasps or some combination of these. Add poor hygiene, a lack of plaque control and lots of snacking on sugary things and root caries (decay on your exposed roots) is likely to be a significant problem.

• Denture stomatitis. If plaque is kept in contact with the gums on the underside of the denture for long periods, this generalised inflammation can occur.

What are the Advantages and Disadvantage a Removable Denture?

The advantages and disadvantages of partial dentures are discussed in the missing teeth series.

Are the Benefits of a Partial Denture going to Outweigh the Risks?

Are you likely to be better or worse off at the end of the day? This is the million dollar question.

To answer this, you need to look at the advantages of wearing the denture verses the potential damage it could cause.

It may be that your diet and hygiene are so poor that the extra plaque would rot your teeth and the gum disease that would result, would cause your remaining teeth to be lost much more quickly.

There are also times when there is little choice but to provide a partial denture, since the alternatives are too expensive. For example, the front teeth are missing and you need a solution. In this case, even if plaque control and hygiene is likely to get worse with wearing a partial denture and other teeth may suffer, walking around with no front teeth is simply not an option.

If you only have a couple of teeth left – again, something must be done, and in this case it is likely that partial denture will help ‘prepare’ you for wearing a full set of dentures in the future.

Let’s look at another scenario. A patient is missing a few teeth at the back, but all the remaining teeth bite on other teeth ( i.e. gaps correspond to gaps). If the patient requests a partial denture, has good hygiene and is motivated towards caring for their teeth, then restoring these spaces would be beneficial; improve their chewing, protecting their remaining teeth and stopping any unwanted tooth movement.

Imagine instead however, this same patient has terrible oral hygiene that hasn’t improved despite repeated efforts to teach them, has lots of plaque around and eats a crazy high sugar diet. Wearing a denture here could be extremely damaging, trapping even more plaque next to the teeth and tipping the balance resulting in a rapid breakdown of their natural teeth. This may sound extreme, but it is something that every dentist has unfortunately witnessed.

Does this make sense? Can you see the importance of caring for your mouth? Start getting into some good habits now or you may find yourself in a much worse position in a couple of years time.

It’s the same as wanting to get braces; an orthodontist knows that if you can’t look after your mouth and teeth without braces, then you haven’t got a chance of doing it with braces. If they went ahead and put them on, you would end up with straighter teeth in 2 years, but with so many areas of decay that you would have to spend thousands more dollars filling the teeth and having crowns to make things look nice again.