Problems with dentures may arise because patients are not used to having something in their mouth that is not food. The brain senses the appliance and interprets it as 'food', sending messages to the salivary glands to produce more saliva and to secrete it at a higher rate. This usually only happens in the first 12 to 24 hours, after which the salivary glands return to their normal output. New dentures can also be the cause of sore spots as they compress the denture-bearing soft tissues (mucosa). A few denture adjustments in the days following insertion of the dentures can take care of this problem. Gagging is another problem encountered by a minority of patients. At times, this may be due to a denture that is too loose, too thick or extended too far posteriorly onto the soft palate. At times, gagging may also be attributed to psychological denial of the denture. Psychological gagging is the most difficult to treat since it is out of the dentist's control. In such cases, an implant-supported palateless denture may have to be constructed. Sometimes there could be a gingivitis infection under the completed dentures, caused by the accumulation of dental plaque. One of the most common problems for wearers of new upper complete denture is a loss of taste sensations.
The gums, tongue and palate should be brushed with a soft bristle brush every evening when the dentures are removed, and each day before you insert them to stimulate the gums and remove plaque accumulation. When removing dentures at night, brush them carefully to remove any loose debris and plaque then soak them in a cleansing solution. Your dentist will be able to recommend one. Some people keep theirs in an ultrasonic cleaner, but keep in mind that an ultrasonic cleaner doesn’t replace brushing. When cleaning your dentures, place a towel beneath them or clean them over a sink filled with water to avoid breakage.
Patients can become entirely edentulous (without teeth) for many reasons, the most prevalent being removal due to dental disease typically relating to oral flora control, i.e., periodontal disease and tooth decay. Other reasons include pregnancy, tooth developmental defects caused by severe malnutrition, genetic defects such as dentinogenesis imperfecta, trauma, or drug use.
Effervescent cleansers are the most popular immersion cleansers and include alkaline peroxides, perborates and persulphates. Their cleansing action occurs by the formation of small bubbles which displace loosely attached material from the surface of the denture. They are not very effective as cleansers and have a restricted ability to eliminate microbial plaque. Moreover, they are safe for use and do not cause deterioration of the acrylic resin or the metals used in denture construction.[32] Despite this, they are able to cause rapid damage to some short-term soft lining.[36] Discolouration of the acrylic resin to a white denture often occurs, however, this happens because patients do not follow the manufacturer’s instructions and often add very hot water to the cleaning agent.[37][38]
Support is the principle that describes how well the underlying mucosa (oral tissues, including gums) keeps the denture from moving vertically towards the arch in question during chewing, and thus being excessively depressed and moving deeper into the arch. For the mandibular arch, this function is provided primarily by the buccal shelf, a region extending laterally from the back or posterior ridges, and by the pear-shaped pad (the most posterior area of keratinized gingival formed by the scaling down of the retro-molar papilla after the extraction of the last molar tooth). Secondary support for the complete mandibular denture is provided by the alveolar ridge crest. The maxillary arch receives primary support from the horizontal hard palate and the posterior alveolar ridge crest. The larger the denture flanges (that part of the denture that extends into the vestibule), the better the stability (another parameter to assess fit of a complete denture). Long flanges beyond the functional depth of the sulcus are a common error in denture construction, often (but not always) leading to movement in function, and ulcerations (denture sore spots).
