1. Difficulty eating with dentures
Conventional dentures often result in a reduced biting force. Patients can’t bite as hard, and it creates problems eating certain types of foods.
Also, plastic on the maxillary covers the whole palette for suction, which reduces the effects of patients’ taste buds. Patients complain that they feel as if they lost their taste buds and they cannot tell if food is hot or cold.
Since there are no implants used with conventional dentures, the bones will continue to deteriorate. As the bone deteriorates, the soft tissue changes and the denture won’t fit as well as it did over time.. The denture will then move around and make sore spots. Dentures have to be relined periodically.
The lower denture is also problematic because the tongue and the floor of the mouth move, and it wants to dislodge every time the patient moves his or her tongue. Moreover, as the bone resorbs, the lower ridge gets flatter, making it more difficult for a lower denture to stay in place.
To deal with lower dentures flopping all around, consider implants which will then be able to secure it. For patients complaining on bite forec, implants are the first level of solution.
Then the denture can be retained, and the bite force is directed to the bone and not the soft tissue. The implants also help to stop bone loss. Putting in two to four implants per arch is a great option.
Implants would also help with taste and hot and cold sensitivity that patients lose with conventional dentures. By using six implants on the maxillary arch, the palette is freed from the acrylic denture base that obstructs patients’ taste buds and nerve endings.
Every patient doesn’t opt for implants, however, for a few different reasons. Usually, the cost is an issue since implants are more of an investment than conventional dentures. Another reason could be the patient is in poor health and doesn’t want to put the stress on this or her body with the surgery. Also, some patients have too many medications they take that could interfere with the procedure and recovery.
Nutrition equates to good health. Being able to eat proper foods for nutrition is a bigger deal than so many of us think about.
2. Denture(s) doesn’t fit Properly
Many denture patients think their dentures don’t fit because the denture moves in their mouth when they chew. This movement can make it difficult to eat and cause sore spots due the denture causing friction on the mucosa. To correct the denture fit, patients come in for an adjustment, which results in chair time for which the dental professional usually doesn’t bill for. If billing does occur, then patients typically stop receiving treatment and use denture adhesive.
Many times, however, dentures can fit and function properly. Perceived fit issues often stem from a few critical aspects of denture teeth design and construction.
Denture teeth are historically made flatter and with less anatomy than natural teeth. Teeth are designed this way to prevent rocking of the denture base while the patient is chewing.
Working and balancing describe how denture professionals use bilateral balanced occlusion to stabilize the denture when the patient chews. Denture design often neglects the concept of freedom in centric or the wiggle room our natural teeth have.
Our natural teeth and temporomandibular joint are not locked upon closing in centric. Both can move horizontally, so to speak. When one holds their teeth together in centric, they can wiggle them while holding them together. This is the freedom in centric principle. What is required is denture teeth that can wiggle a little bit.
Not all denture teeth incorporate these occlusal or centric “landmarks.” With something like VITA premium denture teeth, which incorporate the freedom in centric design. He says denture teeth that don’t incorporate freedom in centric cause the denture “waggle” on the gum when the patient chews. The movement gives the patient the mistaken impression that the denture doesn’t fit.
Another area of improvement for fit (and also bite force) is to incorporate lingualized occlusion into the denture design. Wagenseil says it helps people chew like they do with their natural teeth.
“Because lingualized occlusion is more of a mortar and pestle type of approach, it crushes food like natural teeth do,” Wagenseil explains.
Since adopting his denture designs to incorporate lingualized occlusion with freedom in centric functionality, Wagenseil says he doesn’t have as many patients complaining about the fit as before, and the use of adhesive and soft liners has also greatly diminished.
Wagenseil says he consistently delivers dentures with zero to one adjustment, down from the average adjustment rate of two to five.
“You have to look at the economic value of that. If you estimate $400/hour for an American general dentist and a patient comes in for two adjustments, and let’s say they take 30 minutes at a time, that’s $400 off the profit that the office lost. That’s a lot of money,” Wagenseil says. “It is more than what denture tooth is the cheapest. It has to function in relation to the human chewing cycle. The savings are in your adjustment time and costs, which more than offset the denture tooth cost.”
Wagenseil lectures about these concepts to try to help other denture professionals do the same for their patients.
“As a denture professional, we change lives. Patients trust us to help with their chewing ability. Eating is life,” Wagenseil says. “We change lives because we are able to help rehabilitate someone’s chewing cycle. Since incorporating freedom in centric denture teeth, I am able to do so with better predicable results and far less issues.”