Cosmetic Denture Techniques
Cosmetic Dentures….What does that mean?
Dentures can improve a person’s appearance in many ways. Cosmetic dentists can improve your smile with additional techniques. Almost all patients have bony ridge shrinkage as time goes by. At some point in time, many will lose so much bone that dentures will settle into a much deeper position than when they were first made. This can cause the corners of the mouth to form deep folds or wrinkles. The chin will come closer to the nose as you close your mouth because you close further than before and this also moves the chin outward to produce an “under bite”. Jaw joints do not function in the same position as before producing TMJ pain in some individuals. Upper lips collapse, which creates a “dished in” appearance and a more pronounced looking nose. All of these signs and symptoms tend to make a person look older than they need to. Please take a look at the before photo of our patient Dave at the bottom of this page.
To correct these problems dentures will need to be made with more tissue colored denture base material and teeth placed in positions where they used to be located. The bite will need to be opened to decrease facial folds and improve jaw function. Lips will need to be filled back out to improve profiles and natural smile contours. Teeth can be selected to give a denture character instead of an artificial look. The selection of teeth can be important too. Porcelain teeth wear longer but tend to make more noise while eating and can stain at the necks of the teeth where it attaches to the base. Porcelain teeth can aggressively wear down the natural teeth they bite against and most of the time should not be placed in a bite against natural teeth. Acrylic teeth make less noise and do not stain as easily near the neck but they tend to wear a little faster. Both can be used for excellent esthetic results. Placing teeth with small spaces and very minor nuances of color or slightly crooked alignment can enhance the natural look of a denture especially on more mature individuals. Denture base material, which simulate the gums, can be made darker or lighter depending on a person's skin color and ethnic characteristics. Some people have asked for dental fillings or gold fillings on the front teeth to add even more authenticity to the natural look of the dentures. Please take a look at the after photo of our patient Dave at the bottom of this page.
Finally, the type of denture can also be helpful in improving a cosmetic result. Below is listed a few of the most common types and how they are used.
Types of Dentures
These replace all of your teeth, upper or lower. They are made of an acrylic base and the teeth may be acrylic or porcelain. Some patients need this treatment if all their teeth are lost due to severe gum disease, accident, or uncontrolled tooth decay. Their comfort, appearance, and fit depend on muscle, bones, tongue, and saliva. If the bone is shaped poorly or there is not enough bone on the ridges that support the denture, it can be loose and less comfortable. This can be often be corrected with the placement of implants to secure the denture and may also require some bone grafting. If the mouth is dry, denture comfort and fit are compromised.
Immediate Dentures are placed all at once, and may require additional adjustments after the healing process. They are placed at the time of teeth extractions during the surgery. It can take months for your bone and tissue to stabilize after tooth extractions. After that time period, the dentures often need to have a reline to make them fit more securely.
Upper Dentures and Lower Dentures
Upper Dentures tend to be a bit easier to adjust to. These are made of the same materials as a Complete Denture, but are designed to provide you with upper teeth only. Because they cover the whole roof of the mouth, they tend to have a bit better “suction” to stay in place than the lower dentures do. Some patients will need a thin application of denture adhesive to secure their dentures better.
Over Dentures is a type of conventional denture similar to Complete Dentures. The difference is that not all teeth are extracted and they use one or more natural teeth for their support under the denture base. This type provides greater stabilization during chewing. They also tend to help conserve on the bone of the ridge because the roots in the bone keep the bone active. When all teeth are removed, bone on the ridge gradually is lost over time. This is also why implants tend to retain bone levels. Over Dentures cost more and typically require more preparation dental appointments until the procedure is fully complete.
Implant Supported Dentures
Implant supported dentures are like an overdenture except that implants support the denture rather than any teeth. Implants are placed into the bone and then posts or attachments are placed on the implants that clip to the bottom of the denture. The implants are not seen and give great support and power to chewing. They also have the advantage of preserving bone levels under the denture. Sometimes the implants are splinted together with a metal bar and then used to support and anchor the denture. This is becoming a very popular way of restoring bony ridge health and the beauty of peoples' smiles. It maintains facial contours better and jaw joint health too. In addition to these benefits, diets are improved with these dentures for better overall health.
Designed to correct the gaps in your smile when only some of your teeth are missing. Metal attachments anchor the dentures to your natural teeth. Partial Dentures maintain tooth alignment by preventing your remaining teeth from shifting. Partial Dentures can also help prevent your loss of more teeth due to decay or gum disease.
Advantages & Disadvantages of Dentures
Dentures definitely provide a great smile with a very natural appearance. They're made of an acrylic base and acrylic or porcelain teeth and can last a very long time when properly taken care of. Typically dentures last from five to ten years. They also correct several problems, from speech and appearance, to chewing and joint support for many patients.
There's no doubt that dentures take a little getting used to. There is maintenance involved, and initial speech issues to overcome (these are temporary and last only a couple of days). Mouth irritation or sores may occur. Dentures should be removed for at least four hours per day. It is common that your mouth changes over the life of your dentures, so even though they last a long time, they may need to be relined or replaced to achieve a better fit before they are worn out. With a denture a person typically chews at only 15-23% efficiency compared to a person chewing with their natural teeth. In the case of a full upper denture, the upper roof of mouth is covered which can reduce taste of foods you're chewing.
Before & After Images
Here is a picture of our patient Dave who graciously agreed to allow us to show these pictures. Before Dave had a new upper denture made, you can see here that the upper front teeth have been pushed up under his upper lip so that they hardly show. In addition to that, you can see the back teeth on his denture have tipped down in the back. This has created a "reverse smile line" in which the curve of the denture line is reverse of his lip smile line. He also has an under bite which is not too evident in this photo.
Here is a more ideal after smile on Dave. As you can see this denture now shows teeth beautifully. His back teeth are not lower than his front teeth, therefore his teeth smile line follows very well with his lip smile line. He no longer has an under bite and his jaw joints are being better supported. In order to have this result, Dave also had a new lower partial denture made which is not seen in this photo to bring his lower back teeth up into a good bite with the upper back teeth. His upper back teeth were also slightly raised to correct his reverse smile line.