Saturday, Nov. 18, 2010 -- Majority of denture wearers are using denture adhesives to keep their ill fitting dentures in place at a risk that could lead to dental bone loss. I have conducted research on this topic for a number of years and would like to share some of my findings.

In most instances, a properly constructed full upper denture should derive support from suction without the need of denture adhesives to stay in. In time, as the mouth begins to change and the suction dissipates, using adhesives to keep the denture in place can lead to the destruction of dental bone. The longer the patient continues to wear the ill fitting denture, the more damage to the bone will occur.

Immediate dentures, (dentures that are delivered right after the extractions of teeth are made) go through the change the quickest. As soon as the sites around the extractions begin to heal, dental bone in those areas begins to transform. As soon as the contact of the denture base and tissue in those areas lessens, greater pressure is applied to other areas on the ridge causing those areas to carry greater loads of masticatory pressure. If the masticatory pressure on the ridge and palatal areas is not evened out by relining the appliance, further damage to the bone will occur.

For example, I have examined the mouth of a patient who did not have his immediate upper and lower dentures relined for years, and continued to wear the dentures using adhesives to keep them in place. Both of his upper and lower ridges had become flabby and were easy to move back and forth, similar to fatty tissue. After the dentist took reline impressions to equalize the masticatory forces on the ridges, on the inside of both dentures I discovered that the ridges had gotten compressed by the denture base.

Since this patient did not have the finances to have oral surgery performed to remove the flabby tissue, I ground out the acrylic in the compressed areas of both dentures making more room for the impression material. After the dentist retook the impressions using light body impression material, the impression material inside both dentures reproduced the flabby ridges without compressing them. After both dentures were relined, the suction with the upper denture was fully restored. Even though the patient was very happy with the results achieved, he was warned that that the flabby tissue on the ridges will continue to exert uneven pressure on the top and bottom ridges and that it would be best to have the flabby tissues surgically removed.

Before a reline impression inside the denture is taken, the dentist should always examine the ridges for flabby tissue and if the ridges are solid and the impression material still shows through the impression material as illustrated in figure1, those areas still need to be ground out and a new impression retaken. If those areas are not relieved and the denture is relined, those areas will have contact with the tissue prematurely causing the denture to get dislodged.

Using a stock tray to take the final impression for a new denture or an improperly constructed custom tray as shown in Figures 2 & 3 can also cause the denture not to fit properly and lead to a situation as described in the cartoon below.