Why Have Regular Comprehensive Denture Check-Ups?

Regular and comprehensive examinations by a dentist are critical to ensure not only the proper function of a denture, but also the maintenance of total oral health.

Two significant things happen to a denture over time:

• It loosens -- Jaw ridges (alveolar ridges) will shrink in size and become smaller due to gradual and continuing bone loss (bone resorption) that occurs in everyone to varying degrees. This results in dentures becoming increasingly loose because they were fabricated originally to fit larger alveolar ridges.
• It wears -- Denture teeth will wear from use. In addition, uneven and irregular tooth wear develops as a denture becomes loose and starts shifting.

Denture loosening combined with uneven tooth wear results in a reciprocal and cyclical reinforcing synergism between the two destructive processes.

As a denture increasingly shifts on its soft tissue and jawbone foundation, it rubs and chafes the alveolar ridge. This causes irritation, soreness, and various types of pathology, including accelerated bone loss. In turn, this will cause more uneven tooth wear, which will cause more accelerated bone loss, and so on, back and forth. This is a gradual and unrelenting process that worsens over time, frequently at the expense of excessive jawbone loss, the thinning of overlying gum tissue, and the need to prematurely replace a denture -- unless detected and corrected in a timely manner.

If these problems are detected early, as during a regular check-up, they often may be remediated by adding plastic (acrylic resin) to the inside of a denture in order to allow it to fit closely against the alveolar ridge again (called relining or rebasing). In addition, irregularly worn teeth may be adjusted, or sometimes replaced or built up. Eventually, a denture will need to be replaced, but generally this will not need to be done too soon if a person visits their licensed dentist for periodic examinations.

Some Other Check-Up Considerations

• The need to adjust a denture, as determined by regular check-ups, helps keep a proper relationship between the jaws and thus maintains esthetics. Keeping jaws in a proper functional relationship, and sometimes building out certain denture surfaces, will support the face and help prevent a premature aging appearance.
• The temporomandibular joints or TMJs (the jaw joints located in front of each ear) undergo constant change in shape throughout life by a process called bone remodeling. This process is a functional response. If improper jaw function occurs, as a result of unadjusted dentures and improper bite, it is possible for the TMJs to remodel into a pathologic relationship. This could result in numerous pathological conditions, including impaired jaw function, headache, and other head and neck pains.
• Sometimes, more importantly than finding denture problems, is the opportunity to detect serious oral pathology, such as cancer, that may be discovered in early stages rather than later when radical and sometimes devastating therapy is necessary. The maintenance of healthy oral tissues is essential for optimum comfort in long-term denture wearers.

by Joseph J. Massad, D.D.S.

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