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Look Ma No Teeth – I Mean No Dentures!

Dr. Crapo

Question: Dear Dr. Crapo: Two years ago I’d finally had it with my teeth. Every meal, it seemed, produced chips of tooth in my food. My dentist said it was because I was such a grinder. I had nine teeth on top and ten teeth on the bottom, so I went to a denturist to see about a set of dentures. He said he could make me a good set, so I proceeded. My dentist removed my teeth and put in the dentures. To my dismay they wouldn’t stay in and they hurt so badly, especially the bottom dentures, that I couldn’t wear them. I went back to get them adjusted at the denturist and he said he couldn’t help me. That was two years ago. I can’t wear the bottom denture and the top won’t stay in without denture goo which leaks around the edges and is gross. Is this what happens to people who get dentures? I’ve got friends, who say that they had a “break in period” but after adjustments they were fine. No one I’ve spoken to has trouble with their top denture – what’s my problem? Will I ever get to chew food again?

Answer: At face value many things are going on here, the least of which is ill fitting dentures. The only reason dentures will not stay in place is the lack of something to attach to. Given that you had teeth as recently as two years ago, you should have bone and gum support sufficient for your dentures. The first step would be to examine the bone support. The second would be to ensure a comfortable fit of the dentures if sufficient bone is present. Generally people have trouble with the lower denture, because it is mostly held in by gravity. The upper denture usually forms a suction-like grip thereby keeping it in place. The upper may have retention trouble if the palate is extremely flat and the boney ridges that once housed the roots are extremely short. I’ve seen cases where retention is impossible because this anatomy provides no retention. Narrow palates shaped like an upside down “V” provide little suction, thus little retention. In the past eighteen months I’ve seen two people with very flat palates – for them implants were the only solution to retain the dentures, but this did solve the problem. One gentleman had only enough bone for two implants but he’s functioning satisfactorily. The other, elected to have a “bridge in a day” and loves the security of eating and tasting her food as if she had her natural teeth. In 99.9% of the people with a lower denture that won’t stay in, implant retention is straight forward and 100% of the people that I know love them. Don’t be miserable one more day, help is available!

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